Longitudinal functional magnetic resonance imaging with matrix pencil decomposition in people with cystic fibrosis

Background: In the era of cystic fibrosis transmembrane conductance regulator modulator (CFTRm) therapy, lung disease remains an important determiner of morbidity and mortality in people with cystic fibrosis (pwCF). Matrix pencil decomposition magnetic resonance imaging (MP-MRI) can assess lung ventilation and perfusion, is independent from contrast media and can be quantitatively evaluated by automated software analysis. It is therefore a promising alternative for contrast-enhanced (CE) perfusion MRI, but longitudinal data is still limited. The aim of this study was to examine the longitudinal course of MP-MRI parameters in comparison to the established morpho-functional MRI scores as well as lung functions parameters from multiple-breath washout (MBW) and spirometry in pediatric and adult pwCF. Methods: Morpho-functional MRI including CE perfusion MRI and MP-MRI, MBW and spirometry were performed in 136 pwCF with a median (range) age of 14 (0–55) years at baseline and repeated after a median (range) of 483 (21–1947) days. The morpho-functional MRI score was obtained. Additionally, perfusion defect percentage (QDP) and ventilation defect percentage (VDP) were calculated by automated software and lung clearance index (LCI) 2.5% and percent predicted forced expiratory volume in one second (ppFEV1) were assessed by MBW and spirometry. Results: We found a moderate correlation of QDP change with CE perfusion score change (r s =0.53; p