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

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.