Milan Speth, Till F Kaireit, Marcel Gutberlet, Filip Klimeš, Lea Behrendt, Andreas Voskrebenzev, Frank Wacker, Jens Gottlieb, Jens Vogel-Claussen
{"title":"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。","authors":"Milan Speth, Till F Kaireit, Marcel Gutberlet, Filip Klimeš, Lea Behrendt, Andreas Voskrebenzev, Frank Wacker, Jens Gottlieb, Jens Vogel-Claussen","doi":"10.1148/ryct.240274","DOIUrl":null,"url":null,"abstract":"<p><p>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 (<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. Cardiothoracic imaging","volume":"7 4","pages":"e240274"},"PeriodicalIF":4.2000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predicting Pulmonary Graft Loss Using Oxygen-enhanced MRI T1 Mapping in a Prospective Study.\",\"authors\":\"Milan Speth, Till F Kaireit, Marcel Gutberlet, Filip Klimeš, Lea Behrendt, Andreas Voskrebenzev, Frank Wacker, Jens Gottlieb, Jens Vogel-Claussen\",\"doi\":\"10.1148/ryct.240274\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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 (<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. Cardiothoracic imaging\",\"volume\":\"7 4\",\"pages\":\"e240274\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiology. Cardiothoracic imaging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1148/ryct.240274\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology. Cardiothoracic imaging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1148/ryct.240274","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0