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Plummer JW, Hussain R, Bdaiwi AS, Soderlund SA, Hoyos X, Lanier JM, Garrison WJ, Parra-Robles J, Willmering MM, Niedbalski P, Cleveland ZI, Walkup L. A decay-modeled compressed sensing reconstruction approach for non-Cartesian hyperpolarized 129Xe MRI. Magn Reson Med 2024; 92:1363-1375. [PMID: 38860514 PMCID: PMC11262966 DOI: 10.1002/mrm.30188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/15/2024] [Accepted: 05/18/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE Hyperpolarized 129Xe MRI benefits from non-Cartesian acquisitions that sample k-space efficiently and rapidly. However, their reconstructions are complex and burdened by decay processes unique to hyperpolarized gas. Currently used gridded reconstructions are prone to artifacts caused by magnetization decay and are ill-suited for undersampling. We present a compressed sensing (CS) reconstruction approach that incorporates magnetization decay in the forward model, thereby producing images with increased sharpness and contrast, even in undersampled data. METHODS Radio-frequency, T1, andT 2 * $$ {\mathrm{T}}_2^{\ast } $$ decay processes were incorporated into the forward model and solved using iterative methods including CS. The decay-modeled reconstruction was validated in simulations and then tested in 2D/3D-spiral ventilation and 3D-radial gas-exchange MRI. Quantitative metrics including apparent-SNR and sharpness were compared between gridded, CS, and twofold undersampled CS reconstructions. Observations were validated in gas-exchange data collected from 15 healthy and 25 post-hematopoietic-stem-cell-transplant participants. RESULTS CS reconstructions in simulations yielded images with threefold increases in accuracy. CS increased sharpness and contrast for ventilation in vivo imaging and showed greater accuracy for undersampled acquisitions. CS improved gas-exchange imaging, particularly in the dissolved-phase where apparent-SNR improved, and structure was made discernable. Finally, CS showed repeatability in important global gas-exchange metrics including median dissolved-gas signal ratio and median angle between real/imaginary components. CONCLUSION A non-Cartesian CS reconstruction approach that incorporates hyperpolarized 129Xe decay processes is presented. This approach enables improved image sharpness, contrast, and overall image quality in addition to up-to threefold undersampling. This contribution benefits all hyperpolarized gas MRI through improved accuracy and decreased scan durations.
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Affiliation(s)
- J. W. Plummer
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - R. Hussain
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - A. S. Bdaiwi
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - S. A. Soderlund
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - X. Hoyos
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - J. M. Lanier
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - W. J. Garrison
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - J. Parra-Robles
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - M. M. Willmering
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - P.J. Niedbalski
- Pulmonary, Critical Care and Sleep Medicine, Kansas University Medical Center, KS, United States
| | - Z. I. Cleveland
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - L.L. Walkup
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, United States
- Center for Pulmonary Imaging Research, Department of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States
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2
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Pilgrim-Morris JH, Collier GJ, Munro RS, Norquay G, Stewart NJ, Wild JM. Compressed sensing reconstruction for high-SNR, rapid dissolved 129Xe gas exchange MRI. Magn Reson Med 2024. [PMID: 39323101 DOI: 10.1002/mrm.30312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 08/21/2024] [Accepted: 09/05/2024] [Indexed: 09/27/2024]
Abstract
PURPOSE Three-dimensional hyperpolarized 129Xe gas exchange imaging suffers from low SNR and long breath-holds, which could be improved using compressed sensing (CS). The purpose of this work was to assess whether gas exchange ratio maps are quantitatively preserved in CS-accelerated dissolved-phase 129Xe imaging and to investigate the feasibility of CS-dissolved 129Xe imaging with reduced-cost natural abundance (NA) xenon. METHODS 129Xe gas exchange imaging was performed at 1.5 T with a multi-echo spectroscopic imaging sequence. A CS reconstruction with an acceleration factor of 2 was compared retrospectively with conventional gridding reconstruction in a cohort of 16 healthy volunteers, 5 chronic obstructive pulmonary disease patients, and 23 patients who were hospitalized following COVID-19 infection. Metrics of comparison included normalized mean absolute error, mean gas exchange ratio, and red blood cell (RBC) image SNR. Dissolved 129Xe CS imaging with NA xenon was assessed in 4 healthy volunteers. RESULTS CS reconstruction enabled acquisition time to be halved, and it reduced background noise. Median RBC SNR increased from 6 (2-18) to 11 (2-100) with CS, and there was strong agreement between CS and gridding mean ratio map values (R2 = 0.99). Image fidelity was maintained for gridding RBC SNR > 5, but below this, normalized mean absolute error increased nonlinearly with decreasing SNR. CS increased the mean SNR of NA 129Xe images 3-fold. CONCLUSION CS reconstruction of dissolved 129Xe imaging improved image quality with decreased scan time, while preserving key gas exchange metrics. This will benefit patients with breathlessness and/or low gas transfer and shows promise for NA-dissolved 129Xe imaging.
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Affiliation(s)
- Jemima H Pilgrim-Morris
- POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
| | - Ryan S Munro
- POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Neil J Stewart
- POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
| | - Jim M Wild
- POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
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3
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Bdaiwi AS, Svoboda AM, Murdock KE, Hendricks A, Hossain MM, Kramer EL, Brewington JJ, Willmering MM, Woods JC, Walkup LL, Cleveland ZI. Quantifying abnormal alveolar microstructure in cystic fibrosis lung disease via hyperpolarized 129Xe diffusion MRI. J Cyst Fibros 2024; 23:926-935. [PMID: 38997823 PMCID: PMC11410525 DOI: 10.1016/j.jcf.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/05/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024]
Abstract
RATIONALE Cystic Fibrosis (CF) progresses through recurrent infection and inflammation, causing permanent lung function loss and airway remodeling. CT scans reveal abnormally low-density lung parenchyma in CF, but its microstructural nature remains insufficiently explored due to clinical CT limitations. To this end, diffusion-weighted 129Xe MRI is a non-invasive and validated measure of lung microstructure. In this work, we investigate microstructural changes in people with CF (pwCF) relative to age-matched, healthy subjects using comprehensive imaging and analysis involving pulmonary-function tests (PFTs), and 129Xe MRI. METHODS 38 healthy subjects (age 6-40; 17.2 ± 9.5 years) and 39 pwCF (age 6-40; 15.6 ± 8.0 years) underwent 129Xe-diffusion MRI and PFTs. The distribution of diffusion measurements (i.e., apparent diffusion coefficients (ADC) and morphometric parameters) was assessed via linear binning (LB). The resulting volume percentages of bins were compared between controls and pwCF. Mean ADC and morphometric parameters were also correlated with PFTs. RESULTS Mean whole-lung ADC correlated significantly with age (P < 0.001) for both controls and CF, and with PFTs (P < 0.05) specifically for pwCF. Although there was no significant difference in mean ADC between controls and pwCF (P = 0.334), age-adjusted LB indicated significant voxel-level diffusion (i.e., ADC and morphometric parameters) differences in pwCF compared to controls (P < 0.05). CONCLUSIONS 129Xe diffusion MRI revealed microstructural abnormalities in CF lung disease. Smaller microstructural size may reflect compression from overall higher lung density due to interstitial inflammation, fibrosis, or other pathological changes. While elevated microstructural size may indicate emphysema-like remodeling due to chronic inflammation and infection.
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Affiliation(s)
- Abdullah S Bdaiwi
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, United States
| | - Alexandra M Svoboda
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; College of Medicine, University of Cincinnati, Cincinnati, OH 45221, United States
| | - Kyle E Murdock
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States
| | - Alexandra Hendricks
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, United States
| | - Md M Hossain
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - Elizabeth L Kramer
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - John J Brewington
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States; Department of Physics, University of Cincinnati, Cincinnati, United States
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, United States; Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221, United States; Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, United States; Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States.
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Soderlund SA, Bdaiwi AS, Plummer JW, Woods JC, Walkup LL, Cleveland ZI. Improved Diffusion-Weighted Hyperpolarized 129Xe Lung MRI with Patch-Based Higher-Order, Singular Value Decomposition Denoising. Acad Radiol 2024:S1076-6332(24)00388-X. [PMID: 38960843 DOI: 10.1016/j.acra.2024.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 05/31/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024]
Abstract
RATIONALE AND OBJECTIVES Hyperpolarized xenon (129Xe) MRI is a noninvasive method to assess pulmonary structure and function. To measure lung microstructure, diffusion-weighted imaging-commonly the apparent diffusion coefficient (ADC)-can be employed to map changes in alveolar-airspace size resulting from normal aging and pulmonary disease. However, low signal-to-noise ratio (SNR) decreases ADC measurement certainty, and biases ADC to spuriously low values. Further, these challenges are most severe in regions of the lung where alveolar simplification or emphysematous remodeling generate abnormally high ADCs. Here, we apply Global Local Higher Order Singular Value Decomposition (GLHOSVD) denoising to enhance image SNR, thereby reducing uncertainty and bias in diffusion measurements. MATERIALS AND METHODS GLHOSVD denoising was employed in simulated images and gas phantoms with known diffusion coefficients to validate its effectiveness and optimize parameters for analysis of diffusion-weighted 129Xe MRI. GLHOSVD was applied to data from 120 subjects (34 control, 39 cystic fibrosis (CF), 27 lymphangioleiomyomatosis (LAM), and 20 asthma). Image SNR, ADC, and distributed diffusivity coefficient (DDC) were compared before and after denoising using Wilcoxon signed-rank analysis for all images. RESULTS Denoising significantly increased SNR in simulated, phantom, and in-vivo images, showing a greater than 2-fold increase (p < 0.001) across diffusion-weighted images. Although mean ADC and DDC remained unchanged (p > 0.05), ADC and DDC standard deviation decreased significantly in denoised images (p < 0.001). CONCLUSION When applied to diffusion-weighted 129Xe images, GLHOSVD improved image quality and allowed airspace size to be quantified in high-diffusion regions of the lungs that were previously inaccessible to measurement due to prohibitively low SNR, thus providing insights into disease pathology.
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Affiliation(s)
- Stephanie A Soderlund
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio 45221, Cincinnati, Ohio 45229, USA
| | - Abdullah S Bdaiwi
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
| | - Joseph W Plummer
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio 45221, Cincinnati, Ohio 45229, USA
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45221, USA; Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio 45221, Cincinnati, Ohio 45229, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45221, USA; Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio 45221, Cincinnati, Ohio 45229, USA; Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45221, USA; Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
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5
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Tavakkoli M, Svenningsen S, Friedlander Y, Konyer NB, Nair P, Noseworthy MD. Sampling pattern discrepancy in the application of compressed sensing hyperpolarized xenon-129 lung MRI. NMR IN BIOMEDICINE 2024; 37:e5121. [PMID: 38423986 DOI: 10.1002/nbm.5121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 03/02/2024]
Abstract
Although hyperpolarized (HP) 129Xe ventilation MRI can be carried out within a breath hold, it is still challenging for many sick patients. Compressed sensing (CS) is a viable alternative to accelerate this approach. However, undersampled images with identical sampling ratios differ from one another. Twenty subjects (n = 10 healthy and n = 10 patients with asthma) were scanned using a GE MR750 3 T scanner, acquiring fully sampled 2D multi-slice HP 129Xe lung ventilation images (10 s breath hold, 128 × 80 (FE × PE-frequency encoding × phase encoding) and 16 slices). Using fully sampled data, 500 variable-density Cartesian random undersampling patterns were generated, each at eight different sampling ratios from 10% to 80%. The parallel imaging and compressed sensing (PICS) command from BART was employed to reconstruct undersampled data. The signal to noise ratio (SNR), structural similarity index measurement (SSIM) and sidelobe to peak ratio of each were subsequently compared. There was a high degree of variation in both SNR and SSIM results from each of the 500 masks of each sampling rate. As the undersampling increases, there is more variation in the quantifying metrics, for both healthy and asthmatic individuals. Our study shows that random undersampling poses a significant challenge when applied at sampling ratios less than 60%, despite fulfilling CS's incoherency criteria. Such low sampling ratios will result in a large variety of undersampling patterns. Therefore, skipped segments of k-space cannot be allowed to happen randomly at low sampling rates. By optimizing the sampling pattern, CS will reach its full potential and be able to be applied to a highly undersampled 129Xe lung dataset.
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Affiliation(s)
- Mitra Tavakkoli
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Svenningsen
- Firestone Institute for Respiratory Health, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada
| | - Yonni Friedlander
- Firestone Institute for Respiratory Health, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Norman B Konyer
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Parameswaran Nair
- Firestone Institute for Respiratory Health, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Michael D Noseworthy
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
- School of Biomedical Engineering, McMaster University, 1280 Main St W, Hamilton, Ontario, Canada
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
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6
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Elbehairy AF, Marshall H, Naish JH, Wild JM, Parraga G, Horsley A, Vestbo J. Advances in COPD imaging using CT and MRI: linkage with lung physiology and clinical outcomes. Eur Respir J 2024; 63:2301010. [PMID: 38548292 DOI: 10.1183/13993003.01010-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/16/2024] [Indexed: 05/04/2024]
Abstract
Recent years have witnessed major advances in lung imaging in patients with COPD. These include significant refinements in images obtained by computed tomography (CT) scans together with the introduction of new techniques and software that aim for obtaining the best image whilst using the lowest possible radiation dose. Magnetic resonance imaging (MRI) has also emerged as a useful radiation-free tool in assessing structural and more importantly functional derangements in patients with well-established COPD and smokers without COPD, even before the existence of overt changes in resting physiological lung function tests. Together, CT and MRI now allow objective quantification and assessment of structural changes within the airways, lung parenchyma and pulmonary vessels. Furthermore, CT and MRI can now provide objective assessments of regional lung ventilation and perfusion, and multinuclear MRI provides further insight into gas exchange; this can help in structured decisions regarding treatment plans. These advances in chest imaging techniques have brought new insights into our understanding of disease pathophysiology and characterising different disease phenotypes. The present review discusses, in detail, the advances in lung imaging in patients with COPD and how structural and functional imaging are linked with common resting physiological tests and important clinical outcomes.
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Affiliation(s)
- Amany F Elbehairy
- Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Helen Marshall
- POLARIS, Imaging, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Josephine H Naish
- MCMR, Manchester University NHS Foundation Trust, Manchester, UK
- Bioxydyn Limited, Manchester, UK
| | - Jim M Wild
- POLARIS, Imaging, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for in silico Medicine, Sheffield, UK
| | - Grace Parraga
- Robarts Research Institute, Western University, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
- Division of Respirology, Western University, London, ON, Canada
| | - Alexander Horsley
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
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7
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Stewart NJ, Higano NS, Mukthapuram S, Willmering MM, Loew W, West M, Arnsperger A, Pratt R, Rao MR, Schulte RF, Wild JM, Woods JC. Initial feasibility and challenges of hyperpolarized 129 Xe MRI in neonates with bronchopulmonary dysplasia. Magn Reson Med 2023; 90:2420-2431. [PMID: 37526031 PMCID: PMC10629838 DOI: 10.1002/mrm.29808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/14/2023] [Accepted: 07/08/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE The underlying functional and microstructural lung disease in neonates who are born preterm (bronchopulmonary dysplasia, BPD) remains poorly characterized. Moreover, there is a lack of suitable techniques to reliably assess lung function in this population. Here, we report our preliminary experience with hyperpolarized 129 Xe MRI in neonates with BPD. METHODS Neonatal intensive care patients with established BPD were recruited (N = 9) and imaged at a corrected gestational age of median:40.7 (range:37.1, 44.4) wk using a 1.5T neonatal scanner. 2D 129 Xe ventilation and diffusion-weighted images and dissolved phase spectroscopy were acquired, alongside 1 H 3D radial UTE. 129 Xe images were acquired during a series of short apneic breath-holds (˜3 s). 1 H UTE images were acquired during tidal breathing. Ventilation defects were manually identified and qualitatively compared to lung structures on UTE. ADCs were calculated on a voxel-wise basis. The signal ratio of the 129 Xe red blood cell (RBC) and tissue membrane (M) resonances from spectroscopy was determined. RESULTS Spiral-based 129 Xe ventilation imaging showed good image quality and sufficient sensitivity to detect mild ventilation abnormalities in patients with BPD. 129 Xe ADC values were elevated above that expected given healthy data in older children and adults (median:0.046 [range:0.041, 0.064] cm2 s-1 ); the highest value obtained from an extremely pre-term patient. 129 Xe spectroscopy revealed a low RBC/M ratio (0.14 [0.06, 0.21]). CONCLUSION We have demonstrated initial feasibility of 129 Xe lung MRI in neonates. With further data, the technique may help guide management of infant lung diseases in the neonatal period and beyond.
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Affiliation(s)
- Neil J Stewart
- Center for Pulmonary Imaging Research, Pulmonary Medicine and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Nara S Higano
- Center for Pulmonary Imaging Research, Pulmonary Medicine and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Shanmukha Mukthapuram
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Pulmonary Medicine and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Wolfgang Loew
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Michael West
- Center for Pulmonary Imaging Research, Pulmonary Medicine and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Anita Arnsperger
- Division of Respiratory Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Ronald Pratt
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Madhwesha R Rao
- POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | | | - Jim M Wild
- POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Pulmonary Medicine and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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8
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Saunders LC, Collier GJ, Chan HF, Hughes PJC, Smith LJ, Watson JGR, Meiring JE, Gabriel Z, Newman T, Plowright M, Wade P, Eaden JA, Thomas S, Strickland S, Gustafsson L, Bray J, Marshall H, Capener DA, Armstrong L, Rodgers J, Brook M, Biancardi AM, Rao MR, Norquay G, Rodgers O, Munro R, Ball JE, Stewart NJ, Lawrie A, Jenkins RG, Grist JT, Gleeson F, Schulte RF, Johnson KM, Wilson FJ, Cahn A, Swift AJ, Rajaram S, Mills GH, Watson L, Collini PJ, Lawson R, Thompson AAR, Wild JM. Longitudinal Lung Function Assessment of Patients Hospitalized With COVID-19 Using 1H and 129Xe Lung MRI. Chest 2023; 164:700-716. [PMID: 36965765 PMCID: PMC10036146 DOI: 10.1016/j.chest.2023.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Microvascular abnormalities and impaired gas transfer have been observed in patients with COVID-19. The progression of pulmonary changes in these patients remains unclear. RESEARCH QUESTION Do patients hospitalized with COVID-19 without evidence of architectural distortion on structural imaging exhibit longitudinal improvements in lung function measured by using 1H and 129Xe MRI between 6 and 52 weeks following hospitalization? STUDY DESIGN AND METHODS Patients who were hospitalized with COVID-19 pneumonia underwent a pulmonary 1H and 129Xe MRI protocol at 6, 12, 25, and 51 weeks following hospital admission in a prospective cohort study between November 2020 and February 2022. The imaging protocol was as follows: 1H ultra-short echo time, contrast-enhanced lung perfusion, 129Xe ventilation, 129Xe diffusion-weighted, and 129Xe spectroscopic imaging of gas exchange. RESULTS Nine patients were recruited (age 57 ± 14 [median ± interquartile range] years; six of nine patients were male). Patients underwent MRI at 6 (n = 9), 12 (n = 9), 25 (n = 6), and 51 (n = 8) weeks following hospital admission. Patients with signs of interstitial lung damage were excluded. At 6 weeks, patients exhibited impaired 129Xe gas transfer (RBC to membrane fraction), but lung microstructure was not increased (apparent diffusion coefficient and mean acinar airway dimensions). Minor ventilation abnormalities present in four patients were largely resolved in the 6- to 25-week period. At 12 weeks, all patients with lung perfusion data (n = 6) showed an increase in both pulmonary blood volume and flow compared with 6 weeks, although this was not statistically significant. At 12 weeks, significant improvements in 129Xe gas transfer were observed compared with 6-week examinations; however, 129Xe gas transfer remained abnormally low at weeks 12, 25, and 51. INTERPRETATION 129Xe gas transfer was impaired up to 1 year following hospitalization in patients who were hospitalized with COVID-19 pneumonia, without evidence of architectural distortion on structural imaging, whereas lung ventilation was normal at 52 weeks.
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Affiliation(s)
- Laura C Saunders
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Guilhem J Collier
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Ho-Fung Chan
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Paul J C Hughes
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Laurie J Smith
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - J G R Watson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - James E Meiring
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Zoë Gabriel
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Thomas Newman
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Megan Plowright
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Phillip Wade
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - James A Eaden
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Siby Thomas
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | | | - Lotta Gustafsson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Jody Bray
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Helen Marshall
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - David A Capener
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Leanne Armstrong
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Jennifer Rodgers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Martin Brook
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Alberto M Biancardi
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Madhwesha R Rao
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Graham Norquay
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Oliver Rodgers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Ryan Munro
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - James E Ball
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Neil J Stewart
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Allan Lawrie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - R Gisli Jenkins
- National Heart and Lung Institute, Imperial College London, London, England
| | - James T Grist
- Department of Radiology, Oxford University Hospitals, Oxford, England; Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, England; Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, England
| | - Fergus Gleeson
- Department of Oncology, University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England
| | | | - Kevin M Johnson
- Department of Medical Physics, University of Madison, Madison, WI, USA
| | | | | | - Andrew J Swift
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Smitha Rajaram
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Gary H Mills
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Lisa Watson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Paul J Collini
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Rod Lawson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - A A Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Jim M Wild
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England.
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9
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Willmering MM, Bdaiwi AS, Kaspy KR, Racadio J, Machogu EM, Kwan OA, Cheng PC, Woods JC, Hysinger EB. MRI assessment and guidance for regionally targeted pulmonary interventions. Pediatr Pulmonol 2023; 58:2386-2388. [PMID: 37204226 PMCID: PMC10524559 DOI: 10.1002/ppul.26482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/01/2023] [Accepted: 05/07/2023] [Indexed: 05/20/2023]
Affiliation(s)
- Matthew M. Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Abdullah S. Bdaiwi
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kimberly R. Kaspy
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - John Racadio
- Department of Radiology, University of Cincinnati, Cincinnati, OH, USA
| | - Evans M. Machogu
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Olivia A. Kwan
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Pi Chun Cheng
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Jason C. Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
- Department of Physics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Erik B. Hysinger
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
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10
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Eaden JA, Weatherley ND, Chan HF, Collier G, Norquay G, Swift AJ, Rajaram S, Smith LJ, Bartholmai BJ, Bianchi SM, Wild JM. Hyperpolarised xenon-129 diffusion-weighted magnetic resonance imaging for assessing lung microstructure in idiopathic pulmonary fibrosis. ERJ Open Res 2023; 9:00048-2023. [PMID: 37650085 PMCID: PMC10463035 DOI: 10.1183/23120541.00048-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/12/2023] [Indexed: 09/01/2023] Open
Abstract
Background Hyperpolarised 129-xenon (129Xe) magnetic resonance imaging (MRI) shows promise in monitoring the progression of idiopathic pulmonary fibrosis (IPF) due to the lack of ionising radiation and the ability to quantify functional impairment. Diffusion-weighted (DW)-MRI with hyperpolarised gases can provide information about lung microstructure. The aims were to compare 129Xe DW-MRI measurements with pulmonary function tests (PFTs), and to assess whether they can detect early signs of disease progression in patients with newly diagnosed IPF. Methods This is a prospective, single-centre, observational imaging study of patients presenting with IPF to Northern General Hospital (Sheffield, UK). Hyperpolarised 129Xe DW-MRI was performed at 1.5 T on a whole-body General Electric HDx scanner and PFTs were performed on the same day as the MRI scan. Results There was an increase in global 129Xe apparent diffusion coefficient (ADC) between the baseline and 12-month visits (mean 0.043 cm2·s-1, 95% CI 0.040-0.047 cm2·s-1 versus mean 0.045 cm2·s-1, 95% CI 0.040-0.049 cm2·s-1; p=0.044; n=20), with no significant change in PFTs over the same time period. There was also an increase in 129Xe ADC in the lower zone (p=0.027), and an increase in 129Xe mean acinar dimension in the lower zone (p=0.033) between the baseline and 12-month visits. 129Xe DW-MRI measurements correlated strongly with diffusing capacity of the lung for carbon monoxide (% predicted), transfer coefficient of the lung for carbon monoxide (KCO) and KCO (% predicted). Conclusions 129Xe DW-MRI measurements appear to be sensitive to early changes of microstructural disease that are consistent with progression in IPF at 12 months. As new drug treatments are developed, the ability to quantify subtle changes using 129Xe DW-MRI could be particularly valuable.
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Affiliation(s)
- James A. Eaden
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Nicholas D. Weatherley
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem Collier
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andrew J. Swift
- Department of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Smitha Rajaram
- Department of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Laurie J. Smith
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | | | - Stephen M. Bianchi
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jim M. Wild
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for In-Silico Medicine, University of Sheffield, Sheffield, UK
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11
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Foo CT, Langton D, Thompson BR, Thien F. Functional lung imaging using novel and emerging MRI techniques. Front Med (Lausanne) 2023; 10:1060940. [PMID: 37181360 PMCID: PMC10166823 DOI: 10.3389/fmed.2023.1060940] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Respiratory diseases are leading causes of death and disability in the world. While early diagnosis is key, this has proven difficult due to the lack of sensitive and non-invasive tools. Computed tomography is regarded as the gold standard for structural lung imaging but lacks functional information and involves significant radiation exposure. Lung magnetic resonance imaging (MRI) has historically been challenging due to its short T2 and low proton density. Hyperpolarised gas MRI is an emerging technique that is able to overcome these difficulties, permitting the functional and microstructural evaluation of the lung. Other novel imaging techniques such as fluorinated gas MRI, oxygen-enhanced MRI, Fourier decomposition MRI and phase-resolved functional lung imaging can also be used to interrogate lung function though they are currently at varying stages of development. This article provides a clinically focused review of these contrast and non-contrast MR imaging techniques and their current applications in lung disease.
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Affiliation(s)
- Chuan T. Foo
- Department of Respiratory Medicine, Eastern Health, Melbourne, VIC, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - David Langton
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Department of Thoracic Medicine, Peninsula Health, Frankston, VIC, Australia
| | - Bruce R. Thompson
- Melbourne School of Health Science, Melbourne University, Melbourne, VIC, Australia
| | - Francis Thien
- Department of Respiratory Medicine, Eastern Health, Melbourne, VIC, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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12
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Bdaiwi AS, Willmering MM, Wang H, Cleveland ZI. Diffusion weighted hyperpolarized 129 Xe MRI of the lung with 2D and 3D (FLORET) spiral. Magn Reson Med 2023; 89:1342-1356. [PMID: 36352793 PMCID: PMC9892235 DOI: 10.1002/mrm.29518] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE To enable efficient hyperpolarized 129 Xe diffusion imaging using 2D and 3D (Fermat Looped, ORthogonally Encoded Trajectories, FLORET) spiral sequences and demonstrate that 129 Xe ADCs obtained using these sequences are comparable to those obtained using a conventional, 2D gradient-recalled echo (GRE) sequence. THEORY AND METHODS Diffusion-weighted 129 Xe MRI (b-values = 0, 7.5, 15 s/cm2 ) was performed in four healthy volunteers and one subject with lymphangioleiomyomatosis using slice-selective 2D-GRE (scan time = 15 s), slice-selective 2D-Spiral (4 s), and 3D-FLORET (16 s) sequences. Experimental SNRs from b-value = 0 images ( SNR 0 EX $$ SNR{0}_{EX} $$ ) and mean ADC values were compared across sequences. In two healthy subjects, a second b = 0 image was acquired using the 2D-Spiral sequence to map flip angle and correct RF-induced, hyperpolarized signal decay at the voxel level, thus improving regional ADC estimates. RESULTS Diffusion-weighted images from spiral sequences displayed image quality comparable to 2D-GRE and produced sufficient SNR 0 EX $$ SNR{0}_{EX} $$ (16.8 ± 3.8 for 2D-GRE, 21.2 ± 3.5 for 2D-Spiral, 20.4 ± 3.5 for FLORET) to accurately calculate ADC. Whole-lung means and SDs of ADC obtained via spiral were not significantly different (P > 0.54) from those obtained via 2D-GRE. Finally, 2D-Spiral images were corrected for signal decay, which resulted in a whole-lung mean ADC decrease of ˜15%, relative to uncorrected images. CONCLUSIONS Relative to GRE, efficient spiral sequences allow 129 Xe diffusion images to be acquired with isotropic lung coverage (3D), higher SNR $$ SNR $$ (2D and 3D), and three-fold faster (2D) within a single breath-hold. In turn, shortened breath-holds enable flip-angle mapping, and thus, allow RF-induced signal decay to be corrected, increasing ADC accuracy.
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Affiliation(s)
- Abdullah S. Bdaiwi
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229,Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
| | - Matthew M. Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Hui Wang
- Philips Healthcare, Cincinnati, OH 45229, USA
| | - Zackary I. Cleveland
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229,Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221,Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45221,Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229,Corresponding Author: Zackary I. Cleveland, Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC-2021, Cincinnati, OH 45229, Telephone: (513) 803-7186, Facsimile: (513) 803-4783,
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13
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Perron S, Ouriadov A. Hyperpolarized 129Xe MRI at low field: Current status and future directions. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2023; 348:107387. [PMID: 36731353 DOI: 10.1016/j.jmr.2023.107387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/07/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Magnetic Resonance Imaging (MRI) is dictated by the magnetization of the sample, and is thus a low-sensitivity imaging method. Inhalation of hyperpolarized (HP) noble gases, such as helium-3 and xenon-129, is a non-invasive, radiation-risk free imaging technique permitting high resolution imaging of the lungs and pulmonary functions, such as the lung microstructure, diffusion, perfusion, gas exchange, and dynamic ventilation. Instead of increasing the magnetic field strength, the higher spin polarization achievable from this method results in significantly higher net MR signal independent of tissue/water concentration. Moreover, the significantly longer apparent transverse relaxation time T2* of these HP gases at low magnetic field strengths results in fewer necessary radiofrequency (RF) pulses, permitting larger flip angles; this allows for high-sensitivity imaging of in vivo animal and human lungs at conventionally low (<0.5 T) field strengths and suggests that the low field regime is optimal for pulmonary MRI using hyperpolarized gases. In this review, theory on the common spin-exchange optical-pumping method of hyperpolarization and the field dependence of the MR signal of HP gases are presented, in the context of human lung imaging. The current state-of-the-art is explored, with emphasis on both MRI hardware (low field scanners, RF coils, and polarizers) and image acquisition techniques (pulse sequences) advancements. Common challenges surrounding imaging of HP gases and possible solutions are discussed, and the future of low field hyperpolarized gas MRI is posed as being a clinically-accessible and versatile imaging method, circumventing the siting restrictions of conventional high field scanners and bringing point-of-care pulmonary imaging to global facilities.
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Affiliation(s)
- Samuel Perron
- Department of Physics and Astronomy, The University of Western Ontario, London, Ontario, Canada.
| | - Alexei Ouriadov
- Department of Physics and Astronomy, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, Ontario, Canada
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14
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Marshall H, Wild JM, Smith LJ, Hardaker L, Fihn-Wikander T, Müllerová H, Hughes R. Functional imaging in asthma and COPD: design of the NOVELTY ADPro substudy. ERJ Open Res 2023; 9:00344-2022. [PMID: 37020837 PMCID: PMC10068571 DOI: 10.1183/23120541.00344-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/17/2022] [Indexed: 01/27/2023] Open
Abstract
The NOVEL observational longiTudinal studY (NOVELTY; ClinicalTrials.gov identifier NCT02760329) is a global, prospective, observational study of ∼12 000 patients with a diagnosis of asthma and/or COPD. Here, we describe the design of the Advanced Diagnostic Profiling (ADPro) substudy of NOVELTY being conducted in a subset of ∼180 patients recruited from two primary care sites in York, UK. ADPro is employing a combination of novel functional imaging and physiological and metabolic modalities to explore structural and functional changes in the lungs, and their association with different phenotypes and endotypes. Patients participating in the ADPro substudy will attend two visits at the University of Sheffield, UK, 12±2 months apart, at which they will undergo imaging and physiological lung function testing. The primary end-points are the distributions of whole lung functional and morphological measurements assessed with xenon-129 magnetic resonance imaging, including ventilation, gas transfer and airway microstructural indices. Physiological assessments of pulmonary function include spirometry, bronchodilator reversibility, static lung volumes via body plethysmography, transfer factor of the lung for carbon monoxide, multiple-breath nitrogen washout and airway oscillometry. Fractional exhaled nitric oxide will be measured as a marker of type-2 airways inflammation. Regional and global assessment of lung function using these techniques will enable more precise phenotyping of patients with physician-assigned asthma and/or COPD. These techniques will be assessed for their sensitivity to markers of early disease progression.
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Affiliation(s)
- Helen Marshall
- POLARIS, Dept of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jim M. Wild
- POLARIS, Dept of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Laurie J. Smith
- POLARIS, Dept of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | | | - Titti Fihn-Wikander
- Evidence Delivery, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
| | - Hana Müllerová
- Respiratory and Immunology, Medical and Payer Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
| | - Rod Hughes
- External Scientific Engagement, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK
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15
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Zhou Q, Li H, Rao Q, Zhang M, Zhao X, Shen L, Fang Y, Li H, Liu X, Xiao S, Shi L, Han Y, Ye C, Zhou X. Assessment of pulmonary morphometry using hyperpolarized 129 Xe diffusion-weighted MRI with variable-sampling-ratio compressed sensing patterns. Med Phys 2023; 50:867-878. [PMID: 36196039 DOI: 10.1002/mp.16018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/26/2022] [Accepted: 09/24/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Hyperpolarized (HP) 129 Xe multiple b-values diffusion-weighted magnetic resonance imaging (DW-MRI) has been widely used for quantifying pulmonary microstructural morphometry. However, the technique requires long acquisition times, making it hard to apply in patients with severe pulmonary diseases, who cannot sustain long breath holds. PURPOSE To develop and evaluate the technique of variable-sampling-ratio compressed sensing (VCS) patterns for accelerating HP 129 Xe multiple b-values DW-MRI in humans. METHODS Optimal variable sampling ratios and corresponding k-space undersampling patterns for each b-value were obtained by retrospective simulations based on the fully sampled (FS) DW-MRI dataset acquired from six young healthy volunteers. Then, the FS datasets were retrospectively undersampled using both VCS patterns and conventional compressed sensing (CS) pattern with a similar average acceleration factor. The quality of reconstructed images with retrospective VCS (rVCS) and CS (rCS) datasets were quantified using mean absolute error (MAE) and structural similarity (SSIM). Pulmonary morphometric parameters were also evaluated between rVCS and FS datasets. In addition, prospective VCS multiple b-values 129 Xe DW-MRI datasets were acquired from 14 cigarette smokers and 13 age-matched healthy volunteers. The differences of lung morphological parameters obtained with the proposed method were compared between the groups using independent samples t-test. Pearson correlation coefficient was also utilized for evaluating the correlation of the pulmonary physiological parameters obtained with VCS DW-MRI and pulmonary function tests. RESULTS Lower MAE and higher SSIM values were found in the reconstructed images with rVCS measurement when compared to those using conventional rCS measurement. The details and quality of the images obtained with rVCS and FS measurements were found to be comparable. The mean values of the morphological parameters derived from rVCS and FS datasets showed no significant differences (p > 0.05), and the mean differences of measured acinar duct radius, mean linear intercept, surface-to-volume ratio, and apparent diffusion coefficient with cylinder model were -0.87%, -2.42%, 2.04%, and -0.50%, respectively. By using the VCS technique, significant differences were delineated between the pulmonary morphometric parameters of healthy volunteers and cigarette smokers (p < 0.001), while the acquisition time was reduced by four times. CONCLUSION A fourfold reduction in acquisition time was achieved using the proposed VCS method while preserving good image quality. Our preliminary results demonstrated that the proposed method can be used for evaluating pulmonary injuries caused by cigarette smoking and may prove to be helpful in diagnosing lung diseases in clinical practice.
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Affiliation(s)
- Qian Zhou
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Haidong Li
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Qiuchen Rao
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China
| | - Ming Zhang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Xiuchao Zhao
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Luyang Shen
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China
| | - Yuan Fang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China
| | - Hongchuang Li
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoling Liu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Sa Xiao
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Lei Shi
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Yeqing Han
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Chaohui Ye
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Xin Zhou
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, China.,University of Chinese Academy of Sciences, Beijing, China
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16
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Sembhi R, Ranota T, Fox M, Couch M, Li T, Ball I, Ouriadov A. Feasibility of Dynamic Inhaled Gas MRI-Based Measurements Using Acceleration Combined with the Stretched Exponential Model. Diagnostics (Basel) 2023; 13:diagnostics13030506. [PMID: 36766611 PMCID: PMC9914115 DOI: 10.3390/diagnostics13030506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/22/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023] Open
Abstract
Dynamic inhaled gas (3He/129Xe/19F) MRI permits the acquisition of regional fractional-ventilation which is useful for detecting gas-trapping in lung-diseases such as lung fibrosis and COPD. Deninger's approach used for analyzing the wash-out data can be substituted with the stretched-exponential-model (SEM) because signal-intensity is attenuated as a function of wash-out-breath in 19F lung imaging. Thirteen normal-rats were studied using 3He/129Xe and 19F MRI and the ventilation measurements were performed using two 3T clinical-scanners. Two Cartesian-sampling-schemes (Fast-Gradient-Recalled-Echo/X-Centric) were used to test the proposed method. The fully sampled dynamic wash-out images were retrospectively under-sampled (acceleration-factors (AF) of 10/14) using a varying-sampling-pattern in the wash-out direction. Mean fractional-ventilation maps using Deninger's and SEM-based approaches were generated. The mean fractional-ventilation-values generated for the fully sampled k-space case using the Deninger method were not significantly different from other fractional-ventilation-values generated for the non-accelerated/accelerated data using both Deninger and SEM methods (p > 0.05 for all cases/gases). We demonstrated the feasibility of the SEM-based approach using retrospective under-sampling, mimicking AF = 10/14 in a small-animal-cohort from the previously reported dynamic-lung studies. A pixel-by-pixel comparison of the Deninger-derived and SEM-derived fractional-ventilation-estimates obtained for AF = 10/14 (≤16% difference) has confirmed that even at AF = 14, the accuracy of the estimates is high enough to consider this method for prospective measurements.
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Affiliation(s)
- Ramanpreet Sembhi
- Department of Physics and Astronomy, The University of Western Ontario, London, ON N6A 3K7, Canada
| | - Tuneesh Ranota
- Faculty of Engineering, School of Biomedical Engineering, The University of Western Ontario, London, ON N6A 3K7, Canada
| | - Matthew Fox
- Department of Physics and Astronomy, The University of Western Ontario, London, ON N6A 3K7, Canada
- Lawson Health Research Institute, London, ON N6C 2R5, Canada
| | - Marcus Couch
- Siemens Healthcare Limited, Montreal, QC H4R 2N9, Canada
| | - Tao Li
- Department of Chemistry, Lakehead University, Thunder Bay, ON P7B 5E1, Canada
| | - Iain Ball
- Philips Australia and New Zealand, Sydney 2113, Australia
| | - Alexei Ouriadov
- Department of Physics and Astronomy, The University of Western Ontario, London, ON N6A 3K7, Canada
- Faculty of Engineering, School of Biomedical Engineering, The University of Western Ontario, London, ON N6A 3K7, Canada
- Lawson Health Research Institute, London, ON N6C 2R5, Canada
- Correspondence:
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17
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Chan HF, Smith LJ, Biancardi AM, Bray J, Marshall H, Hughes PJC, Collier GJ, Rao M, Norquay G, Swift AJ, Hart K, Cousins M, Watkins WJ, Wild JM, Kotecha S. Image Phenotyping of Preterm-Born Children Using Hyperpolarized 129Xe Lung Magnetic Resonance Imaging and Multiple-Breath Washout. Am J Respir Crit Care Med 2023; 207:89-100. [PMID: 35972833 PMCID: PMC9952860 DOI: 10.1164/rccm.202203-0606oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/16/2022] [Indexed: 02/03/2023] Open
Abstract
Rationale: Preterm birth is associated with low lung function in childhood, but little is known about the lung microstructure in childhood. Objectives: We assessed the differential associations between the historical diagnosis of bronchopulmonary dysplasia (BPD) and current lung function phenotypes on lung ventilation and microstructure in preterm-born children using hyperpolarized 129Xe ventilation and diffusion-weighted magnetic resonance imaging (MRI) and multiple-breath washout (MBW). Methods: Data were available from 63 children (aged 9-13 yr), including 44 born preterm (⩽34 weeks' gestation) and 19 term-born control subjects (⩾37 weeks' gestation). Preterm-born children were classified, using spirometry, as prematurity-associated obstructive lung disease (POLD; FEV1 < lower limit of normal [LLN] and FEV1/FVC < LLN), prematurity-associated preserved ratio of impaired spirometry (FEV1 < LLN and FEV1/FVC ⩾ LLN), preterm-(FEV1 ⩾ LLN) and term-born control subjects, and those with and without BPD. Ventilation heterogeneity metrics were derived from 129Xe ventilation MRI and SF6 MBW. Alveolar microstructural dimensions were derived from 129Xe diffusion-weighted MRI. Measurements and Main Results: 129Xe ventilation defect percentage and ventilation heterogeneity index were significantly increased in preterm-born children with POLD. In contrast, mean 129Xe apparent diffusion coefficient, 129Xe apparent diffusion coefficient interquartile range, and 129Xe mean alveolar dimension interquartile range were significantly increased in preterm-born children with BPD, suggesting changes of alveolar dimensions. MBW metrics were all significantly increased in the POLD group compared with preterm- and term-born control subjects. Linear regression confirmed the differential effects of obstructive disease on ventilation defects and BPD on lung microstructure. Conclusion: We show that ventilation abnormalities are associated with POLD, and BPD in infancy is associated with abnormal lung microstructure.
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Affiliation(s)
- Ho-Fung Chan
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Laurie J. Smith
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Alberto M. Biancardi
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Jody Bray
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Helen Marshall
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Paul J. C. Hughes
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Guilhem J. Collier
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Madhwesha Rao
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Graham Norquay
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Andrew J. Swift
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Kylie Hart
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Neonatal Unit, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Michael Cousins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Neonatal Unit, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - W. John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Jim M. Wild
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Neonatal Unit, Cardiff and Vale University Health Board, Cardiff, United Kingdom
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18
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MR Imaging for the Evaluation of Diffuse Lung Disease. Radiol Clin North Am 2022; 60:1021-1032. [DOI: 10.1016/j.rcl.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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Taskiran NP, Hiura GT, Zhang X, Barr RG, Dashnaw SM, Hoffman EA, Malinsky D, Oelsner EC, Prince MR, Smith BM, Sun Y, Sun Y, Wild JM, Shen W, Hughes EW. Mapping Alveolar Oxygen Partial Pressure in COPD Using Hyperpolarized Helium-3: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study. Tomography 2022; 8:2268-2284. [PMID: 36136886 PMCID: PMC9498778 DOI: 10.3390/tomography8050190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 11/24/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) and emphysema are characterized by functional and structural damage which increases the spaces for gaseous diffusion and impairs oxygen exchange. Here we explore the potential for hyperpolarized (HP) 3He MRI to characterize lung structure and function in a large-scale population-based study. Participants (n = 54) from the Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study, a nested case-control study of COPD among participants with 10+ packyears underwent HP 3He MRI measuring pAO2, apparent diffusion coefficient (ADC), and ventilation. HP MRI measures were compared to full-lung CT and pulmonary function testing. High ADC values (>0.4 cm2/s) correlated with emphysema and heterogeneity in pAO2 measurements. Strong correlations were found between the heterogeneity of global pAO2 as summarized by its standard deviation (SD) (p < 0.0002) and non-physiologic pAO2 values (p < 0.0001) with percent emphysema on CT. A regional study revealed a strong association between pAO2 SD and visual emphysema severity (p < 0.003) and an association with the paraseptal emphysema subtype (p < 0.04) after adjustment for demographics and smoking status. HP noble gas pAO2 heterogeneity and the fraction of non-physiological pAO2 results increase in mild to moderate COPD. Measurements of pAO2 are sensitive to regional emphysematous damage detected by CT and may be used to probe pulmonary emphysema subtypes. HP noble gas lung MRI provides non-invasive information about COPD severity and lung function without ionizing radiation.
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Affiliation(s)
- Naz P. Taskiran
- Department of Chemical Engineering, Columbia University, New York, NY 10027, USA
- Correspondence: (N.P.T.); (E.W.H.); Tel.: +1-347-3693052 (N.P.T.); +1-626-4838731 (E.W.H.)
| | - Grant T. Hiura
- Division of General Medicine, Columbia University Irving Medial Center, New York, NY 10032, USA
| | - Xuzhe Zhang
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - R. Graham Barr
- Division of General Medicine, Columbia University Irving Medial Center, New York, NY 10032, USA
| | - Stephen M. Dashnaw
- Neurological Institute, Radiology, Columbia University, New York, NY 10032, USA
| | - Eric A. Hoffman
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Daniel Malinsky
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Elizabeth C. Oelsner
- Division of General Medicine, Columbia University Irving Medial Center, New York, NY 10032, USA
| | - Martin R. Prince
- Division of General Medicine, Columbia University Irving Medial Center, New York, NY 10032, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Benjamin M. Smith
- Division of General Medicine, Columbia University Irving Medial Center, New York, NY 10032, USA
- Department of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Yanping Sun
- Division of General Medicine, Columbia University Irving Medial Center, New York, NY 10032, USA
| | - Yifei Sun
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Jim M. Wild
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 10032, USA
- Institute of Human Nutrition, College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
- Columbia Magnetic Resonance Research Center (CMRRC), Columbia University, New York, NY 10027, USA
| | - Emlyn W. Hughes
- Department of Physics, Columbia University, New York, NY 10027, USA
- Correspondence: (N.P.T.); (E.W.H.); Tel.: +1-347-3693052 (N.P.T.); +1-626-4838731 (E.W.H.)
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20
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Stewart NJ, Smith LJ, Chan HF, Eaden JA, Rajaram S, Swift AJ, Weatherley ND, Biancardi A, Collier GJ, Hughes D, Klafkowski G, Johns CS, West N, Ugonna K, Bianchi SM, Lawson R, Sabroe I, Marshall H, Wild JM. Lung MRI with hyperpolarised gases: current & future clinical perspectives. Br J Radiol 2022; 95:20210207. [PMID: 34106792 PMCID: PMC9153706 DOI: 10.1259/bjr.20210207] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The use of pulmonary MRI in a clinical setting has historically been limited. Whilst CT remains the gold-standard for structural lung imaging in many clinical indications, technical developments in ultrashort and zero echo time MRI techniques are beginning to help realise non-ionising structural imaging in certain lung disorders. In this invited review, we discuss a complementary technique - hyperpolarised (HP) gas MRI with inhaled 3He and 129Xe - a method for functional and microstructural imaging of the lung that has great potential as a clinical tool for early detection and improved understanding of pathophysiology in many lung diseases. HP gas MRI now has the potential to make an impact on clinical management by enabling safe, sensitive monitoring of disease progression and response to therapy. With reference to the significant evidence base gathered over the last two decades, we review HP gas MRI studies in patients with a range of pulmonary disorders, including COPD/emphysema, asthma, cystic fibrosis, and interstitial lung disease. We provide several examples of our experience in Sheffield of using these techniques in a diagnostic clinical setting in challenging adult and paediatric lung diseases.
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Affiliation(s)
- Neil J Stewart
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Laurie J Smith
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - James A Eaden
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Smitha Rajaram
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andrew J Swift
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Nicholas D Weatherley
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Alberto Biancardi
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - David Hughes
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | | | - Christopher S Johns
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Noreen West
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Kelechi Ugonna
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Stephen M Bianchi
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Rod Lawson
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Ian Sabroe
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Helen Marshall
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
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21
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Bdaiwi AS, Niedbalski PJ, Hossain MM, Willmering MM, Walkup LL, Wang H, Thomen RP, Ruppert K, Woods JC, Cleveland ZI. Improving hyperpolarized 129 Xe ADC mapping in pediatric and adult lungs with uncertainty propagation. NMR IN BIOMEDICINE 2022; 35:e4639. [PMID: 34729838 PMCID: PMC8828677 DOI: 10.1002/nbm.4639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
RATIONALE Hyperpolarized (HP) 129 Xe-MRI provides non-invasive methods to quantify lung function and structure, with the 129 Xe apparent diffusion coefficient (ADC) being a well validated measure of alveolar airspace size. However, the experimental factors that impact the precision and accuracy of HP 129 Xe ADC measurements have not been rigorously investigated. Here, we introduce an analytical model to predict the experimental uncertainty of 129 Xe ADC estimates. Additionally, we report ADC dependence on age in healthy pediatric volunteers. METHODS An analytical expression for ADC uncertainty was derived from the Stejskal-Tanner equation and simplified Bloch equations appropriate for HP media. Parameters in the model were maximum b-value (bmax ), number of b-values (Nb ), number of phase encoding lines (Nph ), flip angle and the ADC itself. This model was validated by simulations and phantom experiments, and five fitting methods for calculating ADC were investigated. To examine the lower range for 129 Xe ADC, 32 healthy subjects (age 6-40 years) underwent diffusion-weighted 129 Xe MRI. RESULTS The analytical model provides a lower bound on ADC uncertainty and predicts that decreased signal-to-noise ratio yields increases in relative uncertainty (ϵADC) . As such, experimental parameters that impact non-equilibrium 129 Xe magnetization necessarily impact the resulting ϵADC . The values of diffusion encoding parameters (Nb and bmax ) that minimize ϵADC strongly depend on the underlying ADC value, resulting in a global minimum for ϵADC . Bayesian fitting outperformed other methods (error < 5%) for estimating ADC. The whole-lung mean 129 Xe ADC of healthy subjects increased with age at a rate of 1.75 × 10-4 cm2 /s/yr (p = 0.001). CONCLUSIONS HP 129 Xe diffusion MRI can be improved by minimizing the uncertainty of ADC measurements via uncertainty propagation. Doing so will improve experimental accuracy when measuring lung microstructure in vivo and should allow improved monitoring of regional disease progression and assessment of therapy response in a range of lung diseases.
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Affiliation(s)
- Abdullah S. Bdaiwi
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
- Department of Biomedical Engineering, University of
Cincinnati, Cincinnati, OH 45221
| | - Peter J. Niedbalski
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
| | - Md M. Hossain
- Division of Biostatistics and Epidemiology, Cincinnati
Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Matthew M. Willmering
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
| | - Laura L. Walkup
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
- Department of Biomedical Engineering, University of
Cincinnati, Cincinnati, OH 45221
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45221
| | - Hui Wang
- Philips Healthcare, Cincinnati, OH, USA
| | - Robert P. Thomen
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
| | - Kai Ruppert
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
| | - Jason C. Woods
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45221
| | - Zackary I. Cleveland
- Center for Pulmonary Imaging Research, Division of
Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH
45229
- Department of Biomedical Engineering, University of
Cincinnati, Cincinnati, OH 45221
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45221
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22
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Accelerate gas diffusion-weighted MRI for lung morphometry with deep learning. Eur Radiol 2022; 32:702-713. [PMID: 34255160 PMCID: PMC8276538 DOI: 10.1007/s00330-021-08126-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/14/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Multiple b-value gas diffusion-weighted MRI (DW-MRI) enables non-invasive and quantitative assessment of lung morphometry, but its long acquisition time is not well-tolerated by patients. We aimed to accelerate multiple b-value gas DW-MRI for lung morphometry using deep learning. METHODS A deep cascade of residual dense network (DC-RDN) was developed to reconstruct high-quality DW images from highly undersampled k-space data. Hyperpolarized 129Xe lung ventilation images were acquired from 101 participants and were retrospectively collected to generate synthetic DW-MRI data to train the DC-RDN. Afterwards, the performance of the DC-RDN was evaluated on retrospectively and prospectively undersampled multiple b-value 129Xe MRI datasets. RESULTS Each slice with size of 64 × 64 × 5 could be reconstructed within 7.2 ms. For the retrospective test data, the DC-RDN showed significant improvement on all quantitative metrics compared with the conventional reconstruction methods (p < 0.05). The apparent diffusion coefficient (ADC) and morphometry parameters were not significantly different between the fully sampled and DC-RDN reconstructed images (p > 0.05). For the prospectively accelerated acquisition, the required breath-holding time was reduced from 17.8 to 4.7 s with an acceleration factor of 4. Meanwhile, the prospectively reconstructed results showed good agreement with the fully sampled images, with a mean difference of -0.72% and -0.74% regarding global mean ADC and mean linear intercept (Lm) values. CONCLUSIONS DC-RDN is effective in accelerating multiple b-value gas DW-MRI while maintaining accurate estimation of lung microstructural morphometry, facilitating the clinical potential of studying lung diseases with hyperpolarized DW-MRI. KEY POINTS • The deep cascade of residual dense network allowed fast and high-quality reconstruction of multiple b-value gas diffusion-weighted MRI at an acceleration factor of 4. • The apparent diffusion coefficient and morphometry parameters were not significantly different between the fully sampled images and the reconstructed results (p > 0.05). • The required breath-holding time was reduced from 17.8 to 4.7 s and each slice with size of 64 × 64 × 5 could be reconstructed within 7.2 ms.
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23
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Niedbalski PJ, Hall CS, Castro M, Eddy RL, Rayment JH, Svenningsen S, Parraga G, Zanette B, Santyr GE, Thomen RP, Stewart NJ, Collier GJ, Chan HF, Wild JM, Fain SB, Miller GW, Mata JF, Mugler JP, Driehuys B, Willmering MM, Cleveland ZI, Woods JC. Protocols for multi-site trials using hyperpolarized 129 Xe MRI for imaging of ventilation, alveolar-airspace size, and gas exchange: A position paper from the 129 Xe MRI clinical trials consortium. Magn Reson Med 2021; 86:2966-2986. [PMID: 34478584 DOI: 10.1002/mrm.28985] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/13/2021] [Accepted: 08/06/2021] [Indexed: 12/12/2022]
Abstract
Hyperpolarized (HP) 129 Xe MRI uniquely images pulmonary ventilation, gas exchange, and terminal airway morphology rapidly and safely, providing novel information not possible using conventional imaging modalities or pulmonary function tests. As such, there is mounting interest in expanding the use of biomarkers derived from HP 129 Xe MRI as outcome measures in multi-site clinical trials across a range of pulmonary disorders. Until recently, HP 129 Xe MRI techniques have been developed largely independently at a limited number of academic centers, without harmonizing acquisition strategies. To promote uniformity and adoption of HP 129 Xe MRI more widely in translational research, multi-site trials, and ultimately clinical practice, this position paper from the 129 Xe MRI Clinical Trials Consortium (https://cpir.cchmc.org/XeMRICTC) recommends standard protocols to harmonize methods for image acquisition in HP 129 Xe MRI. Recommendations are described for the most common HP gas MRI techniques-calibration, ventilation, alveolar-airspace size, and gas exchange-across MRI scanner manufacturers most used for this application. Moreover, recommendations are described for 129 Xe dose volumes and breath-hold standardization to further foster consistency of imaging studies. The intention is that sites with HP 129 Xe MRI capabilities can readily implement these methods to obtain consistent high-quality images that provide regional insight into lung structure and function. While this document represents consensus at a snapshot in time, a roadmap for technical developments is provided that will further increase image quality and efficiency. These standardized dosing and imaging protocols will facilitate the wider adoption of HP 129 Xe MRI for multi-site pulmonary research.
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Affiliation(s)
- Peter J Niedbalski
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Chase S Hall
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Rachel L Eddy
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan H Rayment
- Division of Respiratory Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Svenningsen
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Brandon Zanette
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giles E Santyr
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Robert P Thomen
- Departments of Radiology and Bioengineering, University of Missouri, Columbia, Missouri, USA
| | - Neil J Stewart
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jim M Wild
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Sean B Fain
- Departments of Medical Physics, Radiology, and Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
| | - G Wilson Miller
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Jaime F Mata
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - John P Mugler
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Bastiaan Driehuys
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics (Pulmonary Medicine) and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics (Pulmonary Medicine) and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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24
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Wild JM, Porter JC, Molyneaux PL, George PM, Stewart I, Allen RJ, Aul R, Baillie JK, Barratt SL, Beirne P, Bianchi SM, Blaikley JF, Brooke J, Chaudhuri N, Collier G, Denneny EK, Docherty A, Fabbri L, Gibbons MA, Gleeson FV, Gooptu B, Hall IP, Hanley NA, Heightman M, Hillman TE, Johnson SR, Jones MG, Khan F, Lawson R, Mehta P, Mitchell JA, Platé M, Poinasamy K, Quint JK, Rivera-Ortega P, Semple M, Simpson AJ, Smith DJF, Spears M, Spencer LIG, Stanel SC, Thickett DR, Thompson AAR, Walsh SLF, Weatherley ND, Weeks ME, Wootton DG, Brightling CE, Chambers RC, Ho LP, Jacob J, Piper Hanley K, Wain LV, Jenkins RG. Understanding the burden of interstitial lung disease post-COVID-19: the UK Interstitial Lung Disease-Long COVID Study (UKILD-Long COVID). BMJ Open Respir Res 2021; 8:e001049. [PMID: 34556492 PMCID: PMC8461362 DOI: 10.1136/bmjresp-2021-001049] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/19/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has led to over 100 million cases worldwide. The UK has had over 4 million cases, 400 000 hospital admissions and 100 000 deaths. Many patients with COVID-19 suffer long-term symptoms, predominantly breathlessness and fatigue whether hospitalised or not. Early data suggest potentially severe long-term consequence of COVID-19 is development of long COVID-19-related interstitial lung disease (LC-ILD). METHODS AND ANALYSIS The UK Interstitial Lung Disease Consortium (UKILD) will undertake longitudinal observational studies of patients with suspected ILD following COVID-19. The primary objective is to determine ILD prevalence at 12 months following infection and whether clinically severe infection correlates with severity of ILD. Secondary objectives will determine the clinical, genetic, epigenetic and biochemical factors that determine the trajectory of recovery or progression of ILD. Data will be obtained through linkage to the Post-Hospitalisation COVID platform study and community studies. Additional substudies will conduct deep phenotyping. The Xenon MRI investigation of Alveolar dysfunction Substudy will conduct longitudinal xenon alveolar gas transfer and proton perfusion MRI. The POST COVID-19 interstitial lung DiseasE substudy will conduct clinically indicated bronchoalveolar lavage with matched whole blood sampling. Assessments include exploratory single cell RNA and lung microbiomics analysis, gene expression and epigenetic assessment. ETHICS AND DISSEMINATION All contributing studies have been granted appropriate ethical approvals. Results from this study will be disseminated through peer-reviewed journals. CONCLUSION This study will ensure the extent and consequences of LC-ILD are established and enable strategies to mitigate progression of LC-ILD.
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Affiliation(s)
- Jim M Wild
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Joanna C Porter
- Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK,Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK,Department of Respiratory Medicine, University College London, London, UK
| | - Philip L Molyneaux
- National Heart and Lung Institute, Imperial College London, London, UK,Department of Interstitial Lung Disease, Royal Brompton and Harefield Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Peter M George
- National Heart and Lung Institute, Imperial College London, London, UK,Department of Interstitial Lung Disease, Royal Brompton and Harefield Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Iain Stewart
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Raminder Aul
- Respiratory Medicine, St George's Hospital NHS Foundation Trust, London, UK
| | | | - Shaney L Barratt
- Bristol Interstitial Lung Diseases Service, North Bristol NHS Trust, Bristol, UK
| | - Paul Beirne
- Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Stephen M Bianchi
- Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - John F Blaikley
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK,Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Jonathan Brooke
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK,NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK,School of Medicine, University of Nottingham, Nottingham, UK
| | - Nazia Chaudhuri
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK,Respiratory Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - Guilhem Collier
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Emma K Denneny
- Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK,Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK,Department of Respiratory Medicine, University College London, London, UK
| | - Annemarie Docherty
- Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Laura Fabbri
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael A Gibbons
- Respiratory Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK,College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Bibek Gooptu
- Department of Molecular and Cell Biology, University of Leicester, Leicester, UK,Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Ian P Hall
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK,School of Medicine, University of Nottingham, Nottingham, UK
| | - Neil A Hanley
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK,Wythenshaw Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Melissa Heightman
- Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - Toby E Hillman
- Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - Simon R Johnson
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK,School of Medicine, University of Nottingham, Nottingham, UK
| | - Mark G Jones
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK,Southampton NIHR Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Fasihul Khan
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK,School of Medicine, University of Nottingham, Nottingham, UK
| | - Rod Lawson
- Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Puja Mehta
- Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK,School of Life & Medical Sciences, UCL, London, UK
| | - Jane A Mitchell
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Manuela Platé
- Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK,UCL Respiratory, UCL, London, UK
| | | | - Jennifer K Quint
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Pilar Rivera-Ortega
- Respiratory Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | | | - A John Simpson
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - DJF Smith
- National Heart and Lung Institute, Imperial College London, London, UK,Department of Interstitial Lung Disease, Royal Brompton and Harefield Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Mark Spears
- Respiratory Medicine, Perth Royal Infirmary, NHS Tayside, Perth, UK,School of Medicine, University of Dundee, Dundee, UK
| | - LIsa G Spencer
- Respiratory Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Stefan C Stanel
- Respiratory Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK,Division of Diabetes, Endocrinology & Gastroenterology, The University of Manchester, Manchester, UK
| | - David R Thickett
- Birmingham Acute Care Research Group, University of Birmingham, Birmingham, UK,Acute and Respiratory Medicine, University Hospitals Birmingham Foundation Trust, Birmingham, uk
| | - A A Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Simon LF Walsh
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Nicholas D Weatherley
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | | | - Dan G Wootton
- Respiratory Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK,Institute of Infection Veterinary and Ecological Science, University of Liverpool, Liverpool, UK
| | - Chris E Brightling
- Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Rachel C Chambers
- Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK
| | - Ling-Pei Ho
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine Oncology, Oxford, UK,Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
| | - Joseph Jacob
- Department of Respiratory Medicine, University College London, London, UK,Centre for Medical Imaging and Computing, University College London, London, UK
| | - Karen Piper Hanley
- Division of Diabetes, Endocrinology & Gastroenterology, The University of Manchester, Manchester, UK
| | - Louise V Wain
- Department of Health Sciences, University of Leicester, Leicester, UK,Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
| | - R Gisli Jenkins
- National Heart and Lung Institute, Imperial College London, London, UK,Department of Interstitial Lung Disease, Royal Brompton and Harefield Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
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25
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Airspace Dimension Assessment (AiDA) by inhaled nanoparticles: benchmarking with hyperpolarised 129Xe diffusion-weighted lung MRI. Sci Rep 2021; 11:4721. [PMID: 33633165 PMCID: PMC7907057 DOI: 10.1038/s41598-021-83975-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/10/2021] [Indexed: 11/26/2022] Open
Abstract
Enlargements of distal airspaces can indicate pathological changes in the lung, but accessible and precise techniques able to measure these regions are lacking. Airspace Dimension Assessment with inhaled nanoparticles (AiDA) is a new method developed for in vivo measurement of distal airspace dimensions. The aim of this study was to benchmark the AiDA method against quantitative measurements of distal airspaces from hyperpolarised 129Xe diffusion-weighted (DW)-lung magnetic resonance imaging (MRI). AiDA and 129Xe DW-MRI measurements were performed in 23 healthy volunteers who spanned an age range of 23–70 years. The relationship between the 129Xe DW-MRI and AiDA metrics was tested using Spearman’s rank correlation coefficient. Significant correlations were observed between AiDA distal airspace radius (rAiDA) and mean 129Xe apparent diffusion coefficient (ADC) (p < 0.005), distributed diffusivity coefficient (DDC) (p < 0.001) and distal airspace dimension (LmD) (p < 0.001). A mean bias of − 1.2 µm towards rAiDA was observed between 129Xe LmD and rAiDA, indicating that rAiDA is a measure of distal airspace dimension. The AiDA R0 intercept correlated with MRI 129Xe α (p = 0.02), a marker of distal airspace heterogeneity. This study demonstrates that AiDA has potential to characterize the distal airspace microstructures and may serve as an alternative method for clinical examination of the lungs.
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26
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Chan HF, Collier GJ, Parra-Robles J, Wild JM. Finite element simulations of hyperpolarized gas DWI in micro-CT meshes of acinar airways: validating the cylinder and stretched exponential models of lung microstructural length scales. Magn Reson Med 2021; 86:514-525. [PMID: 33624325 DOI: 10.1002/mrm.28703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/07/2020] [Accepted: 01/07/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This work assesses the accuracy of the stretched exponential (SEM) and cylinder models of lung microstructural length scales that can be derived from hyperpolarized gas DWI. This was achieved by simulating 3 He and 129 Xe DWI signals within two micro-CT-derived realistic acinar airspace meshes that represent healthy and idiopathic pulmonary fibrosis lungs. METHODS The healthy and idiopathic pulmonary fibrosis acinar airway meshes were derived from segmentations of 3D micro-CT images of excised human lungs and meshed for finite element simulations of the Bloch-Torrey equations. 3 He and 129 Xe multiple b value DWI experiments across a range of diffusion times (3 He Δ = 1.6 ms; 129 Xe Δ = 5 to 20 ms) were simulated in each mesh. Global SEM mean diffusive length scale and cylinder model mean chord length value was derived from each finite element simulation and compared against each mesh's mean linear intercept length, calculated from intercept length measurements within micro-CT segmentation masks. RESULTS The SEM-derived mean diffusive length scale was within ±10% of the mean linear intercept length for simulations with both 3 He (Δ = 1.6 ms) and 129 Xe (Δ = 7 to 13 ms) in the healthy mesh, and with 129 Xe (Δ = 13 to 20 ms) for the idiopathic pulmonary fibrosis mesh, whereas for the cylinder model-derived mean chord length the closest agreement with mean linear intercept length (11.7% and 22.6% difference) was at 129 Xe Δ = 20 ms for both healthy and IPF meshes, respectively. CONCLUSION This work validates the use of the SEM for accurate estimation of acinar dimensions and indicates that the SEM is relatively robust across a range of experimental conditions and acinar length scales.
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Affiliation(s)
- Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Juan Parra-Robles
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.,Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain
| | - Jim M Wild
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.,Insigneo, Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom
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Marshall H, Stewart NJ, Chan HF, Rao M, Norquay G, Wild JM. In vivo methods and applications of xenon-129 magnetic resonance. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2021; 122:42-62. [PMID: 33632417 PMCID: PMC7933823 DOI: 10.1016/j.pnmrs.2020.11.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 05/28/2023]
Abstract
Hyperpolarised gas lung MRI using xenon-129 can provide detailed 3D images of the ventilated lung airspaces, and can be applied to quantify lung microstructure and detailed aspects of lung function such as gas exchange. It is sensitive to functional and structural changes in early lung disease and can be used in longitudinal studies of disease progression and therapy response. The ability of 129Xe to dissolve into the blood stream and its chemical shift sensitivity to its local environment allow monitoring of gas exchange in the lungs, perfusion of the brain and kidneys, and blood oxygenation. This article reviews the methods and applications of in vivo129Xe MR in humans, with a focus on the physics of polarisation by optical pumping, radiofrequency coil and pulse sequence design, and the in vivo applications of 129Xe MRI and MRS to examine lung ventilation, microstructure and gas exchange, blood oxygenation, and perfusion of the brain and kidneys.
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Affiliation(s)
- Helen Marshall
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Neil J Stewart
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Ho-Fung Chan
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Madhwesha Rao
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Graham Norquay
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Jim M Wild
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
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28
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Dournes G, Walkup LL, Benlala I, Willmering MM, Macey J, Bui S, Laurent F, Woods JC. The Clinical Use of Lung MRI in Cystic Fibrosis: What, Now, How? Chest 2020; 159:2205-2217. [PMID: 33345950 PMCID: PMC8579315 DOI: 10.1016/j.chest.2020.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/24/2020] [Accepted: 12/03/2020] [Indexed: 12/19/2022] Open
Abstract
To assess airway and lung parenchymal damage noninvasively in cystic fibrosis (CF), chest MRI has been historically out of the scope of routine clinical imaging because of technical difficulties such as low proton density and respiratory and cardiac motion. However, technological breakthroughs have emerged that dramatically improve lung MRI quality (including signal-to-noise ratio, resolution, speed, and contrast). At the same time, novel treatments have changed the landscape of CF clinical care. In this contemporary context, there is now consensus that lung MRI can be used clinically to assess CF in a radiation-free manner and to enable quantification of lung disease severity. MRI can now achieve three-dimensional, high-resolution morphologic imaging, and beyond this morphologic information, MRI may offer the ability to sensitively differentiate active inflammation vs scarring tissue. MRI could also characterize various forms of inflammation for early guidance of treatment. Moreover, functional information from MRI can be used to assess regional, small-airway disease with sensitivity to detect small changes even in patients with mild CF. Finally, automated quantification methods have emerged to support conventional visual analyses for more objective and reproducible assessment of disease severity. This article aims to review the most recent developments of lung MRI, with a focus on practical application and clinical value in CF, and the perspectives on how these modern techniques may converge and impact patient care soon.
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Affiliation(s)
- Gaël Dournes
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France; Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
| | - Ilyes Benlala
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Julie Macey
- CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Stephanie Bui
- CHU Bordeaux, Hôpital Pellegrin-Enfants, Pediatric Cystic Fibrosis Reference Center (CRCM), Centre d'Investigation Clinique (CIC 1401), Bordeaux, France
| | - François Laurent
- University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Bordeaux, France; CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, CIC 1401, Pessac, France
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH
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29
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Maunder A, Chan HF, Hughes PJC, Collier G, Norquay G, Rodgers O, Thelwall P, Robb F, Rao M, Wild JM. MR properties of 19 F C 3 F 8 gas in the lungs of healthy volunteers: T 2 ∗ and apparent diffusion coefficient at 1.5T and T 2 ∗ at 3T. Magn Reson Med 2020; 85:1561-1570. [PMID: 32926448 DOI: 10.1002/mrm.28511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/08/2020] [Accepted: 08/17/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE To measure the transverse relaxation time ( T 2 ∗ ) and apparent diffusion coefficient (ADC) of 19 F-C3 F8 gas in vivo in human lungs at 1.5T and 3T, and to determine the representative distribution of values of these parameters in a cohort of healthy volunteers. METHODS Mapping of ADC at lung inflation levels of functional residual capacity (FRC) and total lung capacity (TLC) was performed with inhaled 19 F-C3 F8 (eight subjects) and 129 Xe (six subjects) at 1.5T. T 2 ∗ mapping with 19 F-C3 F8 was performed at 1.5T (at FRC and TLC) for 8 subjects and at 3T (at TLC for seven subjects). RESULTS At both FRC and TLC, the 19 F-C3 F8 ADC was smaller than the free diffusion coefficient demonstrating airway microstructural diffusion restriction. From FRC to TLC, the mean ADC significantly increased from 1.56 mm2 /s to 1.83 mm2 /s (P = .0017) for 19 F-C3 F8, and from 2.49 mm2 /s to 3.38 mm2 /s (P = .0015) for 129 Xe. The posterior-to-anterior gradient in ADC for FRC versus TLC in the superior half of the lungs was measured as 0.0308 mm2 /s per cm versus 0.0168 mm2 /s per cm for 19 F-C3 F8 and 0.0871 mm2 /s per cm versus 0.0326 mm2 /s per cm for 129 Xe. A consistent distribution of 19 F-C3 F8 T 2 ∗ values was observed in the lungs, with low values observed near the diaphragm and large pulmonary vessels. The mean T 2 ∗ across volunteers was 4.48 ms at FRC and 5.33 ms at TLC for 1.5T, and 3.78 ms at TLC for 3T. CONCLUSION In this feasibility study, values of physiologically relevant parameters of lung microstructure measurable by MRI ( T 2 ∗ , and ADC) were established for C3 F8 in vivo lung imaging in healthy volunteers.
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Affiliation(s)
- Adam Maunder
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Ho-Fung Chan
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Paul J C Hughes
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Guillhem Collier
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Graham Norquay
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Oliver Rodgers
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Peter Thelwall
- Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fraser Robb
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom.,GE Healthcare, Aurora, Ohio, USA
| | - Madhwesha Rao
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Jim M Wild
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
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30
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Hatabu H, Ohno Y, Gefter WB, Parraga G, Madore B, Lee KS, Altes TA, Lynch DA, Mayo JR, Seo JB, Wild JM, van Beek EJR, Schiebler ML, Kauczor HU. Expanding Applications of Pulmonary MRI in the Clinical Evaluation of Lung Disorders: Fleischner Society Position Paper. Radiology 2020; 297:286-301. [PMID: 32870136 DOI: 10.1148/radiol.2020201138] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pulmonary MRI provides structural and quantitative functional images of the lungs without ionizing radiation, but it has had limited clinical use due to low signal intensity from the lung parenchyma. The lack of radiation makes pulmonary MRI an ideal modality for pediatric examinations, pregnant women, and patients requiring serial and longitudinal follow-up. Fortunately, recent MRI techniques, including ultrashort echo time and zero echo time, are expanding clinical opportunities for pulmonary MRI. With the use of multicoil parallel acquisitions and acceleration methods, these techniques make pulmonary MRI practical for evaluating lung parenchymal and pulmonary vascular diseases. The purpose of this Fleischner Society position paper is to familiarize radiologists and other interested clinicians with these advances in pulmonary MRI and to stratify the Society recommendations for the clinical use of pulmonary MRI into three categories: (a) suggested for current clinical use, (b) promising but requiring further validation or regulatory approval, and (c) appropriate for research investigations. This position paper also provides recommendations for vendors and infrastructure, identifies methods for hypothesis-driven research, and suggests opportunities for prospective, randomized multicenter trials to investigate and validate lung MRI methods.
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Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Yoshiharu Ohno
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Warren B Gefter
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Grace Parraga
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Kyung Soo Lee
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Talissa A Altes
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - David A Lynch
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - John R Mayo
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Joon Beom Seo
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Jim M Wild
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Edwin J R van Beek
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Mark L Schiebler
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
| | - Hans-Ulrich Kauczor
- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
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- From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.)
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Application of a stretched-exponential model for morphometric analysis of accelerated diffusion-weighted 129Xe MRI of the rat lung. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:73-84. [PMID: 32632748 DOI: 10.1007/s10334-020-00860-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Diffusion-weighted, hyperpolarized 129Xe MRI is useful for the characterization of microstructural changes in the lung. A stretched exponential model was proposed for morphometric extraction of the mean chord length (Lm) from diffusion-weighted data. The stretched exponential model enables accelerated mapping of Lm in a single-breathhold using compressed sensing. Our purpose was to compare Lm maps obtained from stretched-exponential model analysis of accelerated versus unaccelerated diffusion-weighted 129Xe MRI data obtained from healthy/injured rat lungs. MATERIAL AND METHODS Lm maps were generated using a stretched-exponential model analysis of previously acquired fully sampled diffusion-weighted 129Xe rat data (b values = 0 … 110 s/cm2) and compared to Lm maps generated from retrospectively undersampled data simulating acceleration factors of 7/10. The data included four control rats and five rats receiving whole-lung irradiation to mimic radiation-induced lung injury. Mean Lm obtained from the accelerated/unaccelerated maps were compared to histological mean linear intercept. RESULTS Accelerated Lm estimates were similar to unaccelerated Lm estimates in all rats, and similar to those previously reported (< 12% different). Lm was significantly reduced (p < 0.001) in the irradiated rat cohort (90 ± 20 µm/90 ± 20 µm) compared to the control rats (110 ± 20 µm/100 ± 15 µm) and agreed well with histological mean linear intercept. DISCUSSION Accelerated mapping of Lm using a stretched-exponential model analysis is feasible, accurate and agrees with histological mean linear intercept. Acceleration reduces scan time, thus should be considered for the characterization of lung microstructural changes in humans where breath-hold duration is short.
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Topping GJ, Hundshammer C, Nagel L, Grashei M, Aigner M, Skinner JG, Schulte RF, Schilling F. Acquisition strategies for spatially resolved magnetic resonance detection of hyperpolarized nuclei. MAGMA (NEW YORK, N.Y.) 2020; 33:221-256. [PMID: 31811491 PMCID: PMC7109201 DOI: 10.1007/s10334-019-00807-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/08/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022]
Abstract
Hyperpolarization is an emerging method in magnetic resonance imaging that allows nuclear spin polarization of gases or liquids to be temporarily enhanced by up to five or six orders of magnitude at clinically relevant field strengths and administered at high concentration to a subject at the time of measurement. This transient gain in signal has enabled the non-invasive detection and imaging of gas ventilation and diffusion in the lungs, perfusion in blood vessels and tissues, and metabolic conversion in cells, animals, and patients. The rapid development of this method is based on advances in polarizer technology, the availability of suitable probe isotopes and molecules, improved MRI hardware and pulse sequence development. Acquisition strategies for hyperpolarized nuclei are not yet standardized and are set up individually at most sites depending on the specific requirements of the probe, the object of interest, and the MRI hardware. This review provides a detailed introduction to spatially resolved detection of hyperpolarized nuclei and summarizes novel and previously established acquisition strategies for different key areas of application.
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Affiliation(s)
- Geoffrey J Topping
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christian Hundshammer
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Luca Nagel
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martin Grashei
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian Aigner
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jason G Skinner
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Franz Schilling
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
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Chan HF, Weatherley ND, Johns CS, Stewart NJ, Collier GJ, Bianchi SM, Wild JM. Airway Microstructure in Idiopathic Pulmonary Fibrosis: Assessment at Hyperpolarized 3He Diffusion-weighted MRI. Radiology 2019; 291:223-229. [DOI: 10.1148/radiol.2019181714] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mammarappallil JG, Rankine L, Wild JM, Driehuys B. New Developments in Imaging Idiopathic Pulmonary Fibrosis With Hyperpolarized Xenon Magnetic Resonance Imaging. J Thorac Imaging 2019; 34:136-150. [PMID: 30801449 PMCID: PMC6392051 DOI: 10.1097/rti.0000000000000392] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive pulmonary disease that is ultimately fatal. Although the diagnosis of IPF has been revolutionized by high-resolution computed tomography, this imaging modality still exhibits significant limitations, particularly in assessing disease progression and therapy response. The need for noninvasive regional assessment has become more acute in light of recently introduced novel therapies and numerous others in the pipeline. Thus, it will likely be valuable to complement 3-dimensional imaging of lung structure with 3-dimensional regional assessment of function. This challenge is well addressed by hyperpolarized (HP) Xe magnetic resonance imaging (MRI), exploiting the unique properties of this inert gas to image its distribution, not only in the airspaces, but also in the interstitial barrier tissues and red blood cells. This single-breath imaging exam could ultimately become the ideal, noninvasive tool to assess pulmonary gas-exchange impairment in IPF. This review article will detail the evolution of HP Xe MRI from its early development to its current state as a clinical research platform. It will detail the key imaging biomarkers that can be generated from the Xe MRI examination, as well as their potential in IPF for diagnosis, prognosis, and assessment of therapeutic response. We conclude by discussing the types of studies that must be performed for HP Xe MRI to be incorporated into the IPF clinical algorithm and begin to positively impact IPF disease diagnosis and management.
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Affiliation(s)
| | - Leith Rankine
- Department of Radiology, Duke University Medical Center, Durham, NC
| | - Jim M Wild
- Department of Infection, Immunity & Cardiovascular Disease, Academic Radiology, University of Sheffield, Western Bank, UK
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Collier GJ, Hughes PJC, Horn FC, Chan H, Tahir B, Norquay G, Stewart NJ, Wild JM. Single breath‐held acquisition of coregistered 3D
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Xe lung ventilation and anatomical proton images of the human lung with compressed sensing. Magn Reson Med 2019; 82:342-347. [DOI: 10.1002/mrm.27713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/25/2019] [Accepted: 02/05/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Guilhem J. Collier
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
| | - Paul J. C. Hughes
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
| | - Felix C. Horn
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
| | - Ho‐Fung Chan
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
| | - Bilal Tahir
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
- Academic Unit of Clinical Oncology University of Sheffield Sheffield UK
| | - Graham Norquay
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
| | - Neil J. Stewart
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
| | - Jim M. Wild
- POLARIS, Academic Unit of Radiology, Department of IICD University of Sheffield Sheffield UK
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Westcott A, McCormack DG, Parraga G, Ouriadov A. Advanced pulmonary MRI to quantify alveolar and acinar duct abnormalities: Current status and future clinical applications. J Magn Reson Imaging 2019; 50:28-40. [PMID: 30637857 DOI: 10.1002/jmri.26623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 12/23/2022] Open
Abstract
There are serious clinical gaps in our understanding of chronic lung disease that require novel, sensitive, and noninvasive in vivo measurements of the lung parenchyma to measure disease pathogenesis and progressive changes over time as well as response to treatment. Until recently, our knowledge and appreciation of the tissue changes that accompany lung disease has depended on ex vivo biopsy and concomitant histological and stereological measurements. These measurements have revealed the underlying pathologies that drive lung disease and have provided important observations about airway occlusion, obliteration of the terminal bronchioles and airspace enlargement, or fibrosis and their roles in disease initiation and progression. ex vivo tissue stereology and histology are the established gold standards and, more recently, micro-computed tomography (CT) measurements of ex vivo tissue samples has also been employed to reveal new mechanistic findings about the progression of obstructive lung disease in patients. While these approaches have provided important understandings using ex vivo analysis of excised samples, recently developed hyperpolarized noble gas MRI methods provide an opportunity to noninvasively measure acinar duct and terminal airway dimensions and geometry in vivo, and, without radiation burden. Therefore, in this review we summarize emerging pulmonary MRI morphometry methods that provide noninvasive in vivo measurements of the lung in patients with bronchopulmonary dysplasia and chronic obstructive pulmonary disease, among others. We discuss new findings, future research directions, as well as clinical opportunities to address current gaps in patient care and for testing of new therapies. Level of Evidence: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:28-40.
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Affiliation(s)
- Andrew Westcott
- Robarts Research Institute, University of Western Ontario, London, Canada.,Department of Medical Biophysics, University of Western Ontario, London, Canada
| | - David G McCormack
- Division of Respirology, Department of Medicine, University of Western Ontario, London, Canada
| | - Grace Parraga
- Robarts Research Institute, University of Western Ontario, London, Canada.,Department of Medical Biophysics, University of Western Ontario, London, Canada.,Division of Respirology, Department of Medicine, University of Western Ontario, London, Canada
| | - Alexei Ouriadov
- Department of Physics and Astronomy, University of Western Ontario, London, Canada
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37
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Chan HF, Collier GJ, Weatherley ND, Wild JM. Comparison of in vivo lung morphometry models from 3D multiple b-value3He and129Xe diffusion-weighted MRI. Magn Reson Med 2018; 81:2959-2971. [DOI: 10.1002/mrm.27608] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Ho-Fung Chan
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
| | - Guilhem J. Collier
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
| | - Nicholas D. Weatherley
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
- Academic Directorate of Respiratory Medicine; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield United Kingdom
| | - Jim M. Wild
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
- Insigneo, Institute for in Silico Medicine; University of Sheffield; Sheffield United Kingdom
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38
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Ruppert K, Amzajerdian F, Hamedani H, Xin Y, Loza L, Achekzai T, Duncan IF, Profka H, Siddiqui S, Pourfathi M, Cereda MF, Kadlecek S, Rizi RR. Rapid assessment of pulmonary gas transport with hyperpolarized 129Xe MRI using a 3D radial double golden-means acquisition with variable flip angles. Magn Reson Med 2018; 80:2439-2448. [PMID: 29682792 DOI: 10.1002/mrm.27217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/20/2018] [Accepted: 03/24/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To demonstrate the feasibility of using a 3D radial double golden-means acquisition with variable flip angles to monitor pulmonary gas transport in a single breath hold with hyperpolarized xenon-129 MRI. METHODS Hyperpolarized xenon-129 MRI scans with interleaved gas-phase and dissolved-phase excitations were performed using a 3D radial double golden-means acquisition in mechanically ventilated rabbits. The flip angle was either held fixed at 15 ° or 5 °, or it was varied linearly in ascending or descending order between 5 ° and 15 ° over a sampling interval of 1000 spokes. Dissolved-phase and gas-phase images were reconstructed at high resolution (32 × 32 × 32 matrix size) using all 1000 spokes, or at low resolution (22 × 22 × 22 matrix size) using 400 spokes at a time in a sliding-window fashion. Based on these sliding-window images, relative change maps were obtained using the highest mean flip angle as the reference, and aggregated pixel-based changes were tracked. RESULTS Although the signal intensities in the dissolve-phase maps were mostly constant in the fixed flip-angle acquisitions, they varied significantly as a function of average flip angle in the variable flip-angle acquisitions. The latter trend reflects the underlying changes in observed dissolve-phase magnetization distribution due to pulmonary gas uptake and transport. CONCLUSION 3D radial double golden-means acquisitions with variable flip angles provide a robust means for rapidly assessing lung function during a single breath hold, thereby constituting a particularly valuable tool for imaging uncooperative or pediatric patient populations.
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Affiliation(s)
- Kai Ruppert
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Faraz Amzajerdian
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yi Xin
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Luis Loza
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tahmina Achekzai
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ian F Duncan
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Harrilla Profka
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sarmad Siddiqui
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mehrdad Pourfathi
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maurizio F Cereda
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rahim R Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
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Stewart NJ, Chan H, Hughes PJ, Horn FC, Norquay G, Rao M, Yates DP, Ireland RH, Hatton MQ, Tahir BA, Ford P, Swift AJ, Lawson R, Marshall H, Collier GJ, Wild JM. Comparison of 3 He and 129 Xe MRI for evaluation of lung microstructure and ventilation at 1.5T. J Magn Reson Imaging 2018; 48:632-642. [PMID: 29504181 PMCID: PMC6175321 DOI: 10.1002/jmri.25992] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 02/07/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To support translational lung MRI research with hyperpolarized 129 Xe gas, comprehensive evaluation of derived quantitative lung function measures against established measures from 3 He MRI is required. Few comparative studies have been performed to date, only at 3T, and multisession repeatability of 129 Xe functional metrics have not been reported. PURPOSE/HYPOTHESIS To compare hyperpolarized 129 Xe and 3 He MRI-derived quantitative metrics of lung ventilation and microstructure, and their repeatability, at 1.5T. STUDY TYPE Retrospective. POPULATION Fourteen healthy nonsmokers (HN), five exsmokers (ES), five patients with chronic obstructive pulmonary disease (COPD), and 16 patients with nonsmall-cell lung cancer (NSCLC). FIELD STRENGTH/SEQUENCE 1.5T. NSCLC, COPD patients and selected HN subjects underwent 3D balanced steady-state free-precession lung ventilation MRI using both 3 He and 129 Xe. Selected HN, all ES, and COPD patients underwent 2D multislice spoiled gradient-echo diffusion-weighted lung MRI using both hyperpolarized gas nuclei. ASSESSMENT Ventilated volume percentages (VV%) and mean apparent diffusion coefficients (ADC) were derived from imaging. COPD patients performed the whole MR protocol in four separate scan sessions to assess repeatability. Same-day pulmonary function tests were performed. STATISTICAL TESTS Intermetric correlations: Spearman's coefficient. Intergroup/internuclei differences: analysis of variance / Wilcoxon's signed rank. Repeatability: coefficient of variation (CV), intraclass correlation (ICC) coefficient. RESULTS A significant positive correlation between 3 He and 129 Xe VV% was observed (r = 0.860, P < 0.001). VV% was larger for 3 He than 129 Xe (P = 0.001); average bias, 8.79%. A strong correlation between mean 3 He and 129 Xe ADC was obtained (r = 0.922, P < 0.001). MR parameters exhibited good correlations with pulmonary function tests. In COPD patients, mean CV of 3 He and 129 Xe VV% was 4.08% and 13.01%, respectively, with ICC coefficients of 0.541 (P = 0.061) and 0.458 (P = 0.095). Mean 3 He and 129 Xe ADC values were highly repeatable (mean CV: 2.98%, 2.77%, respectively; ICC: 0.995, P < 0.001; 0.936, P < 0.001). DATA CONCLUSION: 129 Xe lung MRI provides near-equivalent information to 3 He for quantitative lung ventilation and microstructural MRI at 1.5T. LEVEL OF EVIDENCE 3 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Neil J. Stewart
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | - Ho‐Fung Chan
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | | | - Felix C. Horn
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | - Graham Norquay
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | - Madhwesha Rao
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | - Denise P. Yates
- Novartis Institutes for Biomedical ResearchCambridgeMassachusettsUSA
| | - Rob H. Ireland
- Academic Unit of Clinical OncologyUniversity of SheffieldSheffieldUK
| | - Matthew Q. Hatton
- Academic Unit of Clinical OncologyUniversity of SheffieldSheffieldUK
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - Bilal A. Tahir
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
- Academic Unit of Clinical OncologyUniversity of SheffieldSheffieldUK
| | - Paul Ford
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | - Andrew J. Swift
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | - Rod Lawson
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - Helen Marshall
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
| | | | - Jim M. Wild
- Academic Unit of RadiologyUniversity of SheffieldSheffieldUK
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