Dynamic Oxygen-Enhanced MR Imaging. Development for Clinical Stage Classification of COPD and TherapeuticEffect Evaluation

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The purpose of this study was to develop the dynamic oxygen-enhanced MR imaging for clinical stage classification and therapeutic effect evaluation in COPD subjects.Non-smoking subjects and COPD patients in our institution were included in this study. All patients were assessed ATS/ERS classification of COPD or GOLD classifications. All subjects were prospectively underwent pulmonary function test, dynamic oxygen-enhanced MR imaging, perfusion scan and/ or CT. Mean relative enhancement ratio and wash-in time on dynamic oxygen-enhanced MRI and CT-base functional lung volume on quantitative CT were computationally calculated by using our proprietary software. To compare the efficacy of dynamic oxygen-enhanced MRI and quantitative CT for pulmonary functional loss assessment, both indexes were correlated with pulmonary functional parameters. To determine the efficacy of two methods for clinical stage classification, the four clinical stage groups' mean relative enhancement ratio and CT-based functional lung volume were statistically compared. In addition, this study was also included the multicenter study for assessment of oxygen-enhanced MRI, and compared capability of oxygen-enhancement and CP-based functional lung volume in clinical stages in COPD. Correlations of both indexes with pulmonary functional parameters were significant (p<0.0001). Pulmonary functional parameters and mean relative enhancement ratio for the four clinical groups showed significant differences (p<0.05). CT-based functional lung volumes of ‘Smokers without COPD' and ‘Mild COPD' were significantly different from those for 'Moderate COPD' and 'Severe or Very Severe COPD' (p<0.05). In conclusion, dynamic oxygen-enhanced MRI is effective for pulmonary functional loss assessment and clinical stage classification of smoking-related COPD as well as quantitative CT.