Clinical Potential of UTE-MRI for Assessing COVID-19: Patient- and Lesion-Based Comparative Analysis

Background Chest computed tomography (CT) has shown tremendous clinical potential for screening, diagnosis, and surveillance of COVID-19. However, safety concerns are warranted due to repeated exposure of X-rays over a short period of time. Recent advances in MRI suggested that ultrashort echo time MRI (UTE-MRI) was valuable for pulmonary applications. Purpose To evaluate the effectiveness of UTE-MRI for assessing COVID-19. Study Type Prospective. Population In all, 23 patients with COVID-19 and with an average interval of 2.81 days between hospital admission and image examination. Field strength/Sequence 3T; Respiratory-gated three-dimensional radial UTE pulse sequence. Assessment Image quality score. Patient- and lesion-based interobserver and intermethod agreement for identifying the representative image findings of COVID-19. Statistical Tests Wilcoxon-rank sum test, Kendall's coefficient of concordance (Kendall's W), intraclass coefficients (ICCs), and weighted kappa statistics. Results There was no significant difference between the image quality of CT and UTE-MRI (CT vs. UTE-MRI: 4.3 +/- 0.4 vs. 4.0 +/- 0.5, P = 0.09). Moreover, both patient- and lesion-based interobserver agreement of CT and UTE-MRI for evaluating the image signs of COVID-19 were determined as excellent (ICC: 0.939-1.000, P < 0.05; Kendall's W: 0.894-1.000, P < 0.05.). In addition, the intermethod agreement of two image modalities for assessing the representative findings of COVID-19 including affected lobes, total severity score, ground glass opacities (GGO), consolidation, GGO with consolidation, the number of crazy paving pattern, and linear opacities, as well as pseudocavity were all determined as substantial or excellent (kappa: 0.649-1.000, P < 0.05; ICC: 0.913-1.000, P < 0.05). Data Conclusion Pulmonary MRI with UTE is valuable for assessing the representative image findings of COVID-19 with a high concordance to CT. Evidence Level 2 Technical Efficacy Stage 3