September 17, 2025

DCE-MRI enables quantitative assessment of microvascular differences in chronic lung allograft rejection post-lung transplantation

Key Points

DCE-MRI detected changes in lung perfusion in chronic lung allograft dysfunction patients, indicating its potential for non-invasive diagnostics.
Contrast kinetics showed significant alterations, with lung transplant patients with CLAD displaying distinct profiles compared to those without.
A free-breathing lung-specific DCE-MRI protocol was employed to evaluate differences in microvascular perfusion and permeability.
Findings highlight the importance of DCE-MRI in identifying early signs of CLAD that may influence patient management.

Abstract

Motivation: Chronic lung allograft dysfunction (CLAD) is a major cause of mortality after the first year post-lung transplant, with limited treatment options and challenges in early diagnosis. Goal(s): Motivated by the need for non-invasive detection methods, this study aimed to assess microvascular perfusion and extracellular extravascular space changes in CLAD using dynamic contrast-enhanced MRI (DCE-MRI). Approach: Using a free-breathing lung-specific DCE-MRI protocol, we compared lung transplant patients with and without CLAD. Results: Our findings suggest DCE-MRI can detect alternations in lung perfusion and permeability, as well as extravascular space expansion between the two cohorts. Impact: In this study, we report distinct differences in model-free quantification of contrast kinetics in lung transplant recipients with CLAD compared to those without, as assessed by DCE-MRI.

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