在一项前瞻性研究中使用氧增强MRI T1定位预测肺移植物损失。

IF 4.2 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Milan Speth, Till F Kaireit, Marcel Gutberlet, Filip Klimeš, Lea Behrendt, Andreas Voskrebenzev, Frank Wacker, Jens Gottlieb, Jens Vogel-Claussen
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Applying Kaplan-Meier survival analysis and Cox proportional hazards model, all biomarkers were compared regarding the time to CLAD-related graft loss as the primary outcome measure. Results Participants (<i>n</i> = 141; mean age, 50 years ± 13 [SD], 76 men, 65 women) underwent baseline MRI, of which 132 were analyzed. Over the following 5.6-year observational period, 24 (18%) participants experienced graft loss related to CLAD. At baseline, oxygen-enhanced MRI parameters predicted graft loss within 5.6 years: delta T1 median (hazard ratio [HR], 3.50; 95% CI: 1.0, 9.4; <i>P</i> = .048), quartile coefficient of dispersion (HR, 3.43; 95% CI: 1.1, 8.7; <i>P</i> = .03), and delta T1 oxygenated volume (HR, 3.07; 95% CI 1.18, 7.22; <i>P</i> = .02), while OTF (<i>P</i> = .18) and spirometry (<i>P</i> = .32) did not. At follow-up (91 stable vs 11 graft loss), all parameter changes (follow-up/baseline value × 100 [%baseline]) predicted poorer survival: OTF (HR, 11.1; 95% CI: 2.5, 75.9; <i>P</i> = .001), delta T1 OV (HR, 6.47; 95% CI: 1.52, 27.53; <i>P</i> = .01), and forced expiratory volume in 1 second from spirometry (HR, 7.94; 95% CI: 2.16, 27.4; <i>P</i> = .003). Conclusion Oxygen-enhanced MRI parameters predict CLAD-related graft loss at 6-12 months following lung transplant and 2.5 years after baseline MRI. Delta T1 OV was the most consistent predictor of future graft loss. <b>Keywords:</b> MRI, Lung, Transplantation <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":21168,"journal":{"name":"Radiology. 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引用次数: 0

摘要

目的:在5.6年的观察间隔中,研究氧增强MRI T1定位参数在肺移植后6-12个月和2.5年内检测慢性同种异体肺移植功能障碍(CLAD)相关移植物损失的预测效果。在2013年8月至2018年12月进行的这项单中心、纵向和前瞻性研究中,研究人员从141名临床稳定的双肺移植受者(移植后6-12个月)和随访(基线MRI后2.5年)中获得氧增强MRI T1定位参数(包括氧传递函数[OTF], δ T1氧合体积[OV])。应用Kaplan-Meier生存分析和Cox比例风险模型,比较所有生物标志物到clad相关移植物损失的时间作为主要结局指标。结果参与者(n = 141,平均年龄50岁±13岁[SD],男性76人,女性65人)接受了基线MRI检查,其中132人进行了分析。在接下来的5.6年观察期间,24名(18%)参与者经历了与CLAD相关的移植物丧失。在基线时,氧增强MRI参数预测5.6年内移骨损失:δ T1中位数(风险比[HR], 3.50; 95% CI: 1.0, 9.4; P = 0.048),四分位数分散系数(HR, 3.43; 95% CI: 1.1, 8.7; P = 0.03), δ T1含氧体积(HR, 3.07; 95% CI: 1.18, 7.22; P = 0.02),而OTF (P = 0.18)和肺活量(P = 0.32)没有预测。在随访中(91例稳定vs 11例移骨丢失),所有参数变化(随访/基线值× 100[%基线])预测较差的生存:OTF (HR, 11.1; 95% CI: 2.5, 75.9; P = 0.001), δ T1 OV (HR, 6.47; 95% CI: 1.52, 27.53; P = 0.01),肺活量测定1秒内用力呼气量(HR, 7.94; 95% CI: 2.16, 27.4; P = 0.003)。结论氧增强MRI参数预测肺移植后6-12个月和基线MRI后2.5年的clad相关移植物损失。δ T1 OV是预测未来移植物损失最一致的指标。关键词:MRI,肺,移植,本文有补充材料。©rsna, 2025。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predicting Pulmonary Graft Loss Using Oxygen-enhanced MRI T1 Mapping in a Prospective Study.

Purpose To investigate the predictive efficacy of oxygen-enhanced MRI T1 mapping parameters for detecting chronic lung allograft dysfunction (CLAD)-related graft loss at 6-12 months and for an additional 2.5 years following pulmonary transplant over a 5.6-year observational interval. Materials and Methods In this single-center, longitudinal, and prospective study conducted between August 2013 and December 2018, parameters from oxygen-enhanced MRI T1 mapping (including oxygen transfer function [OTF], delta T1 oxygenated volume [OV]) were acquired from 141 clinically stable double-lung transplant recipients (6-12 months after transplant) and follow-up (2.5 years after baseline MRI). Applying Kaplan-Meier survival analysis and Cox proportional hazards model, all biomarkers were compared regarding the time to CLAD-related graft loss as the primary outcome measure. Results Participants (n = 141; mean age, 50 years ± 13 [SD], 76 men, 65 women) underwent baseline MRI, of which 132 were analyzed. Over the following 5.6-year observational period, 24 (18%) participants experienced graft loss related to CLAD. At baseline, oxygen-enhanced MRI parameters predicted graft loss within 5.6 years: delta T1 median (hazard ratio [HR], 3.50; 95% CI: 1.0, 9.4; P = .048), quartile coefficient of dispersion (HR, 3.43; 95% CI: 1.1, 8.7; P = .03), and delta T1 oxygenated volume (HR, 3.07; 95% CI 1.18, 7.22; P = .02), while OTF (P = .18) and spirometry (P = .32) did not. At follow-up (91 stable vs 11 graft loss), all parameter changes (follow-up/baseline value × 100 [%baseline]) predicted poorer survival: OTF (HR, 11.1; 95% CI: 2.5, 75.9; P = .001), delta T1 OV (HR, 6.47; 95% CI: 1.52, 27.53; P = .01), and forced expiratory volume in 1 second from spirometry (HR, 7.94; 95% CI: 2.16, 27.4; P = .003). Conclusion Oxygen-enhanced MRI parameters predict CLAD-related graft loss at 6-12 months following lung transplant and 2.5 years after baseline MRI. Delta T1 OV was the most consistent predictor of future graft loss. Keywords: MRI, Lung, Transplantation Supplemental material is available for this article. © RSNA, 2025.

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