Evans Ieuan Edward Shepherd, Baird Timothy, Haworth Charles S, Johnson Christopher, Barker Helen, Hill Uta, Grogono Dorothy, Eneje Odiri, Screaton Nicholas, Floto Andres
Cambridge Centre for Lung Infection (CCLI), Royal Papworth Hospital, Cambridge, United Kingdom.
Thoracic Medicine Department, The Prince Charles Hospital, Queensland, Australia.
PLoS One. 2025 Jun 23;20(6):e0325347. doi: 10.1371/journal.pone.0325347. eCollection 2025.
Non-tuberculous mycobacteria (NTM) are pulmonary pathogens with increasing incidence and prevalence worldwide, with people with cystic fibrosis (pwCF) traditionally considered at high risk of disease development. The imaging assessment of NTM-pulmonary disease (NTM-PD) relies heavily on high-resolution computed tomography (HRCT). However, due to lengthy treatment regimens and the need for long-term follow-up, serial HRCT's result in progressive exposure to ionizing radiation; a particular concern in younger people.
We performed a retrospective cohort study of patients who had undergone serial thoracic magnetic resonance imaging (tMRI) scans to monitor NTM-PD as a novel tool to image the lung with a view to creating an algorithm for the utility of tMRI in the management of NTM-PD.
Thirty-six patients, of which twenty-four had a diagnosis of CF, with suspected or confirmed NTM-PD underwent serial tMRI between 1st January 2013 and 30th June 2018. A total of 117 serial tMRI's were performed (mean number per patient 3.25; range 2-6). The associated clinical impact that each serial MRI had on management, deemed as the utility of tMRI, found that all tMRI's were classified as aiding management with 60 (51.3%) altering management. tMRI's were more likely to alter management in the non-CF cohort than the CF cohort (69.4% vs. 43.2%). No imaging-related adverse events were reported across the 117 tMRI's.
This study highlights that tMRI may hold promise as a monitoring tool in NTM-PD and should be prospectively evaluated in the monitoring of individuals with NTM-PD.
非结核分枝杆菌（NTM）是肺部病原体，在全球范围内发病率和患病率不断上升，传统上认为囊性纤维化患者（pwCF）患NTM病的风险很高。NTM肺病（NTM-PD）的影像学评估严重依赖高分辨率计算机断层扫描（HRCT）。然而，由于治疗方案冗长且需要长期随访，系列HRCT会导致患者逐渐暴露于电离辐射中；这在年轻人中尤为令人担忧。
我们对接受系列胸部磁共振成像（tMRI）扫描以监测NTM-PD的患者进行了一项回顾性队列研究，将tMRI作为一种新型肺部成像工具，旨在创建一种tMRI在NTM-PD管理中的应用算法。
2013年1月1日至2018年6月30日期间，36例疑似或确诊NTM-PD的患者接受了系列tMRI检查，其中24例诊断为CF。共进行了117次系列tMRI检查（每位患者平均3.25次；范围为2-6次）。每次系列MRI对管理的相关临床影响，即tMRI的效用，发现所有tMRI均被归类为有助于管理，其中60次（51.3%）改变了管理方式。与CF队列相比，tMRI在非CF队列中更有可能改变管理方式（69.4%对43.2%）。在117次tMRI检查中未报告与成像相关的不良事件。
本研究强调tMRI作为NTM-PD的监测工具可能具有前景，应在前瞻性研究中对NTM-PD患者进行监测评估。
