Influence of Gadolinium, Field-strength and Sequence Type on Quantified Perfusion Values in Phase-resolved Functional Lung Mri

Julian Glandorf, Fynn Brunzema, Filip Klimeš, Lea Behrendt, Andreas Voskrebenzev, Marcel Gutberlet, Marius M. Wernz, Robert Grimm, Frank Wacker, Jens Vogel-Claussen


The purpose of this study is to evaluate the influences of gadolinium-based contrast agents, field-strength and different sequences on perfusion quantification in Phase-Resolved Functional Lung (PREFUL) MRI.


Functional lung imaging has proven to offer valuable information for surveillance and early detection of various pulmonary diseases [1–4]. Techniques such as phase-resolved functional lung (PREFUL) MRI [5] avoid potential risks of contrast media, increase comfort and are already implemented clinically as they allow the calculation of ventilation- and perfusion-weighted maps enabling detection and monitoring various pulmonary diseases [6–9].

Materials and method

In this study, datasets of 74 participants from four cohorts were evaluated (Fig 1). All datasets were analyzed retrospectively. The study was approved by the local ethics committee ‘Ethikkommission der Medizinischen Hochschule Hannover’, and written informed consent was obtained from all study participants.


No significant change of quantified perfusion was observed within the reproducibility cohort (P = 0.73) (Table 1). The Bland-Altman plot showed a mean difference of 0.21 ml/min/100ml with a standard deviation of 8.20 ml/min/100ml and a mean average of 19.69 ml/min/100ml between both series (S2 Fig). Voxelwise Pearson correlation of QQuant between both series was significant with a correlation coefficient of 0.8 (Fig 3 and Table 2). No change was detected for the value distribution in the normalized histogram analysis comparing skewness and kurtosis (P ≥ 0.41) or in the probability distribution using a two-sample Kolmogorov-Smirnov test (Fig 4 and S1 Table).


Our results indicated high regional correlation of the quantified perfusion parameters between all corresponding series. However, injection of gadobutrol, changing the field-strength or the sequence leads to significant alterations of the median values and/or the value distribution. In contrast, the reproducibility cohort with identical settings revealed quite stable median values together with a similar value distribution after two weeks.


The authors would like to express their gratitude to the radiographers from the Department of Radiology for their support with the MR measurements and patient care.

Citation: Glandorf J, Brunzema F, Klimeš F, Behrendt L, Voskrebenzev A, Gutberlet M, et al. (2023) Influence of gadolinium, field-strength and sequence type on quantified perfusion values in phase-resolved functional lung MRI. PLoS ONE 18(8): e0288744.

Editor: Pierluigi Ciet, Erasmus MC Sophia Children’s Hospital, NETHERLANDS

Received: February 10, 2023; Accepted: July 4, 2023; Published: August 1, 2023

Copyright: © 2023 Glandorf et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

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