The use of chest magnetic resonance imaging in interstitial lung disease: a systematic review.

Thin-slices multi-detector computed tomography (MDCT) plays a key role in the differential diagnosis of interstitial lung disease (ILD). However, thin-slices MDCT has a limited ability to detect active inflammation, which is an important target of newly developed ILD drug therapy. Magnetic resonance imaging (MRI), thanks to its multi-parameter capability, provides better tissue characterisation than thin-slices MDCT.Our aim was to summarise the current status of MRI applications in ILD and to propose an ILD-MRI protocol. A systematic literature search was conducted for relevant studies on chest MRI in patients with ILD.We retrieved 1246 papers of which 55 original papers were selected for the review. We identified 24 studies comparing image quality of thin-slices MDCT and MRI using several MRI sequences. These studies described new MRI sequences to assess ILD parenchymal abnormalities, such as honeycombing, reticulation and ground-glass opacity. Thin-slices MDCT remains superior to MRI for morphological imaging. However, recent studies with ultra-short echo-time MRI showed image quality comparable to thin-slices MDCT. Several studies demonstrated the added value of chest MRI by using functional imaging, especially to detect and quantify inflammatory changes.We concluded that chest MRI could play a role in ILD patients to differentiate inflammatory and fibrotic changes and to assess efficacy of new ILD drugs.
Competing Interests: Conflict of interest: C. Romei has nothing to disclose. Conflict of interest: L. Turturici has nothing to disclose. Conflict of interest: L. Tavanti has nothing to disclose. Conflict of interest: J. Miedema has nothing to disclose. Conflict of interest: S. Fiorini has nothing to disclose. Conflict of interest: M. Marletta has nothing to disclose. Conflict of interest: P. Wielopolski has nothing to disclose. Conflict of interest: H. Tiddens reports industry funding from Roche, lecture and advisory board fees from Novartis, and grants from CFF, Vertex, Gilead and Chiesi, outside the submitted work. In addition, H. Tiddens has a patent licensed with Vectura, and a patent PRAGMA-CF scoring system issued. Conflict of interest: F. Falaschi has nothing to disclose. Conflict of interest: P. Ciet reports personal fees from Vertex Pharmaceutical, outside the submitted work.
(Copyright ©ERS 2018.)