Application of Highly Flexible Adaptive Image Receive Coil for Lung MR Imaging Using Zero TE Sequence: Comparison with Conventional Anterior Array Coil

(1) Background: Highly flexible adaptive image receive (AIR) coil has become available for clinical use. The present study aimed to evaluate the performance of AIR anterior array coil in lung MR imaging using a zero echo time (ZTE) sequence compared with conventional anterior array (CAA) coil. (2) Methods: Sixty-six patients who underwent lung MR imaging using both AIR coil (ZTE-AIR) and CAA coil (ZTE-CAA) were enrolled. Image quality of ZTE-AIR and ZTE-CAA was quantified by calculating blur metric value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of lung parenchyma. Image quality was qualitatively assessed by two independent radiologists. Lesion detection capabilities for lung nodules and emphysema and/or lung cysts were evaluated. Patients' comfort levels during examinations were assessed. (3) Results: SNR and CNR of lung parenchyma were higher (both p < 0.001) in ZTE-AIR than in ZTE-CAA. Image sharpness was superior in ZTE-AIR (p < 0.001). Subjective image quality assessed by two independent readers was superior (all p < 0.05) in ZTE-AIR. AIR coil was preferred by 64 of 66 patients. ZTE-AIR showed higher (all p < 0.05) sensitivity for sub-centimeter nodules than ZTE-CAA by both readers. ZTE-AIR showed higher (all p < 0.05) sensitivity and accuracy for detecting emphysema and/or cysts than ZTE-CAA by both readers. (4) Conclusions: The use of highly flexible AIR coil in ZTE lung MR imaging can improve image quality and patient comfort. Application of AIR coil in parenchymal imaging has potential for improving delineation of low-density parenchymal lesions and tiny nodules.