BackgroundThe objective of this work was to apply quantitative and semiquantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF).MethodsIn this prospective trial 41 subjects, including healthy control and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year; progressive IPF (IPF_prog) subjects were distinguished from stable IPF (IPF_stable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (D_LCO% pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPF_stable: n=14; IPF_prog: n=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: controlversusIPF groups and controlversusIPF_stableversusIPF_proggroups, using linear regression analysis. Each measure was compared with FVC % pred,D_LCO% pred and the lung clearance index (LCI % pred) using a Spearman rank correlation.ResultsDCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPF_progcompared with both IPF_stable(p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV andD_LCO% pred (r_s= −0.48, p=0.022) and LCI % pred (r_s= +0.47, p=0.015). Significant group differences were detected in age (p<0.001),D_LCO% pred (p<0.001), FVC % pred (p=0.001) and LCI % pred (p=0.007).ConclusionsGlobal analysis obscures regional changes in pulmonary haemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.