X-ray or MRI

Question

Dear expert team,
in my CF-center, once a year an x-ray of the lung is done routinely. Does this is at present still the standard procedure or would an MRI not be better, as with this for example the bronchiectasis could be diagnosed better resp. MRI is overall more conclusive?
Also with regard to the radiation, I would prefer an MRI, as there is no exposure to x-ray radiation with that for me. What is your opinion? Many thanks in advance for your answer.

Answer

Dear questioner,
the at present the standard imaging measure that is still used for depicting the course of the structural changes of the lung is the thorax x-ray overview image. In general this is done once a year.
The diagnosis of probable early changes in the sense of focal air-trapping (regional over-stretching of the lungs due to a narrowing of the small airways) can be pictured with the help of the computer tomography (CT). Changes of the tissue of the lung can be pictured much more detailed in the CT, compared to the standard x-ray. Therefore the CT has a prognostic meaning. The relatively high radiation exposure in case of repeated investigatons has to be regareded as problematic.

The MRI of the lung is still in the stadium of scientific proof and can certainly not already be regarded as an alternative for the above mentioned investigations.

The biggest potential of the MRI lies in the possibility of the functional assessment of the lung. Regarding this however, one has to await the course of further investigations and also studies.
Yours sincerely,
Dr. Wolfgang Gleiber

23.11.2010