Lung MRI in the Management of Idiopathic Pulmonary Fibrosis

High resolution computed tomography (HRCT) is an essential component in the diagnostic pathway of idiopathic pulmonary fibrosis (IPF). With the appropriate clinical setting, the presence of an usual interstitial pneumonia (UIP) pattern on HRCT is sufficient to diagnose IPF. Four morphological criteria are required: (1) Subpleural, basal predominance, (2) Reticular abnormality, (3) Honeycombing with or without traction bronchiectasis, (4) Absence of features inconsistent with UIP pattern. However, HRCT is a radiating technique and only give data about structural alterations. Recent advances in three-dimensional ultra-short echo time (3D-UTE) imaging have shown promising results in improving lung MR (Magnetic Resonance) imaging quality. Since HRCT is the standard reference in IPF, the investigators aimed to evaluate whether thoracic MRI could be an alternative to HRCT in the assessment of the four radiologic criteria required for the diagnosis of IPF. Moreover, thoracic MRI could give new functional data, expected to relate to lung inflammation.

In order to study the diagnostic's accuracy of MRI for each radiological criteria defining UIP pattern, the investigators will compare HRCT and thoracic MRI of patients with IPF to HRCT and thoracic MRI of patients with other lung diseases that do not have all the UIP criteria.

Study procedure will be gadolinium-enhanced PETRA (pointwise encoding time reduction with radial acquisition) MR sequencing compared to unenhanced HRCT within 15 days. No follow-up is needed.

Inclusion criteria

• Patients > 18 years old followed in Bordeaux University Hospital
• Patients with a definite diagnosis of IPF :

• Based on a "certain" UIP pattern at HRCT without histopathology
• Based on a "possible" UIP pattern at HRCT with histopathology given by surgical lung biopsy.
• Patients with a diagnosis of fibrosing sarcoidosis after multidisciplinary discussion
• Patients with a diagnosis of acute or sub-acute hypersensitivity pneumonitis after multidisciplinary discussion
• Patients diagnosed with organizing pneumonia after multidisciplinary discussion
• Patients with a diagnosis of isolated pleural plaques after multidisciplinary discussion
• Patient able to withstand supine position for more than 30 minutes
• Patient affiliated to a social security system
• Patients who gave their written informed consent

Exclusion criteria

• Subject detained by judicial or administrative decision.
• Major protected by law.
• Subject not affiliated to a social security care
• Subject in period of relative exclusion in relation to another protocol.
• Patients with specific contraindication to undergoing MRI: iron material, a heart pacemaker, claustrophobia, gadolinium hypersensitivity, renal impairment with glomerular filtration rate less than 30 mL/min, pregnant or nursing woman.