MRI of Pulmonary Fibrosis
Gael Dournes1
1Centre de Recherche Cardio-Thoracique de Bordeaux, France

Synopsis

Keywords: Body: Lung, Image acquisition: Multiparametric, Contrast mechanisms: Non-Proton

To assess interstitial lung disease (ILD), chest MRI has been historically out of the scope of clinical imaging because of technical difficulties such as low proton density and respiratory and cardiac motion. However, technological breakthroughs have emerged that dramatically improve lung MRI quality. At the same time, novel treatment approaches are changing the landscape of clinical care. Also, MRI may offer the ability to differentiate active inflammation vs scarring tissue. This presentation aims to review the most recent developments of lung MRI in ILD, and the perspectives on how these modern techniques may converge and could impact patient care soon.

To assess lung parenchymal damage noninvasively in interstitial lung disease (ILD), chest MRI has been historically out of the scope of clinical imaging because of technical difficulties such as low proton density and respiratory and cardiac motion. However, technological breakthroughs have emerged that dramatically improve lung MRI quality (including signal-to-noise ratio, reso- lution, speed, and contrast). At the same time, novel treatment approaches are changing the landscape of clinical care, including the need for longitudinal evaluation of the disease extent and severity. In this contemporary context, there are now reports that lung MRI could be used clinically to assess ILD in a radiation-free manner and to enable quantification of lung disease severity. MRI can now achieve three-dimensional, high-resolution morphologic imaging, and beyond this morphologic information, MRI may offer the ability to sensitively differentiate active inflammation vs scarring tissue. MRI could also characterize various forms of inflammation for early guidance of treatment. Moreover, functional information from MRI can be used to assess regional, alterations with sensitivity and specificity to discriminate between lung involvement early. Finally, automated quantification methods have emerged to support conventional visual analyses for more objective and reproducible assessment of disease severity. This article aims to review the most recent developments of lung MRI, with a focus on practical application and clinical value in ILD, and the perspectives on how these modern techniques may converge and could impact patient care soon.

Acknowledgements

This work was conducted in the framework of the University of Bordeaux’s IdEx ”Investments for the Future” program RRI”IMPACT” which received financial support from the French government.

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Proc. Intl. Soc. Mag. Reson. Med. 32 (2024)