Contemporary 0.55 T MRI to visualize interstitial lung disease – An exploratory study

TL;DR

This study explores whether 0.55T MRI can be used to visualize lung disease as effectively as CT scans, finding it promising but needing improvement.

Contribution

The study is the first to explore contemporary 0.55T MRI as a radiation-free alternative for assessing interstitial lung disease.

Findings

0.55T MRI showed comparable overall disease extent to HRCT with no significant difference.

MRI overestimated ground-glass opacities and underestimated reticulation compared to HRCT.

Despite limitations, 0.55T MRI is a promising radiation-free imaging option for ILD.

Abstract

To evaluate the feasibility of contemporary 0.55 T MRI for visualizing interstitial lung disease (ILD) compared to high-resolution computed tomography (HRCT) in an exploratory first-experience study.

Thirty participants (mean age 60 ± 13 years; 13 females) with rheumatologic ILD underwent HRCT and 0.55 T MRI within 31 days. MRI protocols included proton-density-weighted turbo-spin-echo sequences (transverse) and T2-weighted short-tau inversion recovery sequences (coronal). Three blinded radiologists independently assessed overall disease extent, ground-glass opacity (GGO), reticulation, and emphysema using a semi-quantitative scoring system. Differences between modalities were tested using Wilcoxon signed-rank tests, and Bland-Altman analysis evaluated systematic bias.

Overall disease extent showed no statistically significant difference between low-field MRI and HRCT (median 22.5 % vs. 24.5 %), with excellent interobserver agreement (MRI ICC = 0.94; HRCT ICC = 0.97). MRI significantly overestimated GGO (13.1 % vs. 9.7 %) and underestimated reticulation (8.1 % vs. 11.4 %) compared to HRCT. Bland-Altman analysis confirmed no systematic bias for overall disease extent but consistent overestimation of GGO and underestimation of reticulation on MRI.

Contemporary 0.55 T MRI showed no statistically significant difference in overall ILD extent compared to HRCT but tended to overestimate GGO and underestimate reticulation. Despite these limitations, 0.55 T MRI represents a promising candidate for future development as a radiation-free alternative for gross disease burden assessment in ILD, warranting further technical refinement before routine clinical use.

•Contemporary 0.55 T MRI assessed ILD extent comparably to HRCT.•Ground-glass opacities were overestimated and reticulations underestimated on 0.55 T MRI compared to HRCT.•0.55 T MRI shows promise as a radiation-free ILD imaging option in the future.•Technical advancements are needed before considering clinical use.

Contemporary 0.55 T MRI assessed ILD extent comparably to HRCT.

Ground-glass opacities were overestimated and reticulations underestimated on 0.55 T MRI compared to HRCT.

0.55 T MRI shows promise as a radiation-free ILD imaging option in the future.

Technical advancements are needed before considering clinical use.

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