Lung MRI: Indications, Capabilities, and Techniques- Expert Panel Narrative Review.

Journal: AJR. American journal of roentgenology
Published Date: May 21, 2025

Abstract

Lung MRI provides both structural and functional information across a spectrum of parenchymal and airway pathologies. MRI, using current widely available conventional sequences, provides high-quality diagnostic images that allow tissue characterization and delineation of lung lesions; dynamic evaluation of expiratory central airway collapse, diaphragmatic or chest wall motion, and the relations of lung masses to the chest wall; oncologic staging; surveillance of chronic lung pathologies; and differentiation of inflammation and fibrosis in interstitial lung disease. Ongoing technologic advances, including deep-learning acceleration methods, may enable future applications in longitudinal lung cancer screening without ionizing radiation exposure and in the regional quantification of ventilation and perfusion without hyperpolarized gas or IV contrast media. Although society statements highlight appropriate indications for lung MRI, and the modality has performed favorably relative to CT or FDG PET/CT in various indications, the examination's clinical utilization remains extremely low. Ongoing barriers to adoption include limited awareness by referring physicians, as well as insufficient proficiency and experience by radiologists and technologists. In this AJR Expert Panel Narrative Review, we review clinical indications for lung MRI, describe the examination's current capabilities, provide guidance on protocols comprised of widely available pulse sequences, introduce emerging techniques, and issue consensus recommendations.

Authors

  • Lea Azour
    Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States of America. Electronic address: Lea.Azour@nyulangone.org.
  • Yoshiharu Ohno
    From the Department of Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan (Y.O.); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.O., S.S., T.Y.); Canon Medical Systems, Otawara, Japan (K.A.); Corporate Research and Development Center, Toshiba, Kawasaki, Japan (A.Y.); Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (Y.U., Y.K.); Department of Radiology, Kohnan Hospital, Kobe, Japan (Y.K.); and Department of Radiology, Hyogo Cancer Center, Akashi, Japan (D.T.).
  • Jürgen Biederer
    Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
  • Bruno Hochhegger
    Pontificia Universidade Catolica do Rio Grande do Sul.
  • Grzegorz Bauman
    Division of Radiological Physics, Radiology and Nuclear Medicine Clinic, University Hospital of Basel, Petersgraben 4, 4031 Basel, Switzerland.
  • Hiroto Hatabu
    Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
  • Mark L Schiebler
    Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI.
  • Jeanne B Ackman
    Department of Radiology, Massachusetts General Brigham and Harvard Medical School, Boston, MA, USA.

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