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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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Niedbalski PJ, Willmering MM, Thomen RP, Mugler JP, Choi J, Hall C, Castro M. A single-breath-hold protocol for hyperpolarized 129 Xe ventilation and gas exchange imaging. NMR IN BIOMEDICINE 2023; 36:e4923. [PMID: 36914278 PMCID: PMC11077533 DOI: 10.1002/nbm.4923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Hyperpolarized 129 Xe MRI (Xe-MRI) is increasingly used to image the structure and function of the lungs. Because 129 Xe imaging can provide multiple contrasts (ventilation, alveolar airspace size, and gas exchange), imaging often occurs over several breath-holds, which increases the time, expense, and patient burden of scans. We propose an imaging sequence that can be used to acquire Xe-MRI gas exchange and high-quality ventilation images within a single, approximately 10 s, breath-hold. This method uses a radial one-point Dixon approach to sample dissolved 129 Xe signal, which is interleaved with a 3D spiral ("FLORET") encoding pattern for gaseous 129 Xe. Thus, ventilation images are obtained at higher nominal spatial resolution (4.2 × 4.2 × 4.2 mm3 ) compared with gas-exchange images (6.25 × 6.25 × 6.25 mm3 ), both competitive with current standards within the Xe-MRI field. Moreover, the short 10 s Xe-MRI acquisition time allows for 1 H "anatomic" images used for thoracic cavity masking to be acquired within the same breath-hold for a total scan time of about 14 s. Images were acquired using this single-breath method in 11 volunteers (N = 4 healthy, N = 7 post-acute COVID). For 11 of these participants, a separate breath-hold was used to acquire a "dedicated" ventilation scan and five had an additional "dedicated" gas exchange scan. The images acquired using the single-breath protocol were compared with those from dedicated scans using Bland-Altman analysis, intraclass correlation (ICC), structural similarity, peak signal-to-noise ratio, Dice coefficients, and average distance. Imaging markers from the single-breath protocol showed high correlation with dedicated scans (ventilation defect percent, ICC = 0.77, p = 0.01; membrane/gas, ICC = 0.97, p = 0.001; red blood cell/gas, ICC = 0.99, p < 0.001). Images showed good qualitative and quantitative regional agreement. This single-breath protocol enables the collection of essential Xe-MRI information within one breath-hold, simplifying scanning sessions and reducing costs associated with Xe-MRI.
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Affiliation(s)
- Peter J. Niedbalski
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Bioengineering, University of Kansas, Lawrence, KS, USA
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Matthew M. Willmering
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Robert P. Thomen
- Departments of Radiology and Bioengineering, University of Missouri School of Medicine, Columbia, MO, USA
| | - John P. Mugler
- Department of Radiology & Medical Imaging, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jiwoong Choi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Bioengineering, University of Kansas, Lawrence, KS, USA
| | - Chase Hall
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
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3
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Garrison WJ, Qing K, He M, Zhao L, Tustison NJ, Patrie JT, Mata JF, Shim YM, Ropp AM, Altes TA, Mugler JP, Miller GW. Lung Volume Dependence and Repeatability of Hyperpolarized 129Xe MRI Gas Uptake Metrics in Healthy Volunteers and Participants with COPD. Radiol Cardiothorac Imaging 2023; 5:e220096. [PMID: 37404786 PMCID: PMC10316289 DOI: 10.1148/ryct.220096] [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: 05/11/2022] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 07/06/2023]
Abstract
Purpose To assess the effect of lung volume on measured values and repeatability of xenon 129 (129Xe) gas uptake metrics in healthy volunteers and participants with chronic obstructive pulmonary disease (COPD). Materials and Methods This Health Insurance Portability and Accountability Act-compliant prospective study included data (March 2014-December 2015) from 49 participants (19 with COPD [mean age, 67 years ± 9 (SD)]; nine women]; 25 older healthy volunteers [mean age, 59 years ± 10; 20 women]; and five young healthy women [mean age, 23 years ± 3]). Thirty-two participants underwent repeated 129Xe and same-breath-hold proton MRI at residual volume plus one-third forced vital capacity (RV+FVC/3), with 29 also undergoing one examination at total lung capacity (TLC). The remaining 17 participants underwent imaging at TLC, RV+FVC/3, and residual volume (RV). Signal ratios between membrane, red blood cell (RBC), and gas-phase compartments were calculated using hierarchical iterative decomposition of water and fat with echo asymmetry and least-squares estimation (ie, IDEAL). Repeatability was assessed using coefficient of variation and intraclass correlation coefficient, and volume relationships were assessed using Spearman correlation and Wilcoxon rank sum tests. Results Gas uptake metrics were repeatable at RV+FVC/3 (intraclass correlation coefficient = 0.88 for membrane/gas; 0.71 for RBC/gas, and 0.88 for RBC/membrane). Relative ratio changes were highly correlated with relative volume changes for membrane/gas (r = -0.97) and RBC/gas (r = -0.93). Membrane/gas and RBC/gas measured at RV+FVC/3 were significantly lower in the COPD group than the corresponding healthy group (P ≤ .001). However, these differences lessened upon correction for individual volume differences (P = .23 for membrane/gas; P = .09 for RBC/gas). Conclusion Dissolved-phase 129Xe MRI-derived gas uptake metrics were repeatable but highly dependent on lung volume during measurement.Keywords: Blood-Air Barrier, MRI, Chronic Obstructive Pulmonary Disease, Pulmonary Gas Exchange, Xenon Supplemental material is available for this article © RSNA, 2023.
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Affiliation(s)
- William J. Garrison
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Kun Qing
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Mu He
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Li Zhao
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Nicholas J. Tustison
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - James T. Patrie
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Jaime F. Mata
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Y. Michael Shim
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Alan M. Ropp
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Talissa A. Altes
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - John P. Mugler
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - G. Wilson Miller
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
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4
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Collier GJ, Schulte RF, Rao M, Norquay G, Ball J, Wild JM. Imaging gas-exchange lung function and brain tissue uptake of hyperpolarized 129 Xe using sampling density-weighted MRSI. Magn Reson Med 2023; 89:2217-2226. [PMID: 36744585 DOI: 10.1002/mrm.29602] [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: 07/19/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
PURPOSE Imaging of the different resonances of hyperpolarized 129 Xe in the brain and lungs was performed using a 3D sampling density-weighted MRSI technique in healthy volunteers. METHODS Four volunteers underwent dissolved-phase hyperpolarized 129 Xe imaging in the lung with the MRSI technique, which was designed to improve the point-spread function while preserving SNR (1799 phase-encoding steps, 14-s breath hold, 2.1-cm isotropic resolution). A frequency-tailored RF excitation pulse was implemented to reliably excite both the 129 Xe gas and dissolved phase (tissue/blood signal) with 0.1° and 10° flip angles, respectively. Images of xenon gas in the lung airspaces and xenon dissolved in lung tissue/blood were used to generate quantitative signal ratio maps. The method was also optimized and used for imaging dissolved resonances of 129 Xe in the brain in 2 additional volunteers. RESULTS High-quality regional spectra of hyperpolarized 129 Xe were achieved in both the lung and the brain. Ratio maps of the different xenon resonances were obtained in the lung with sufficient SNR (> 10) at both 1.5 T and 3 T, making a triple Lorentzian fit possible and enabling the measurement of relaxation times and xenon frequency shifts on a voxel-wise basis. The imaging technique was successfully adapted for brain imaging, resulting in the first demonstration of 3D xenon brain images with a 2-cm isotropic resolution. CONCLUSION Density-weighted MRSI is an SNR and encoding-efficient way to image 129 Xe resonances in the lung and the brain, providing a valuable tool to quantify regional spectroscopic information.
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Affiliation(s)
- Guilhem J Collier
- POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK.,INSIGNEO institute, University of Sheffield, Sheffield, UK
| | | | - Madhwesha Rao
- POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - James Ball
- 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.,INSIGNEO institute, University of Sheffield, Sheffield, UK
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5
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Hahn AD, Carey KJ, Barton GP, Torres LA, Kammerman J, Cadman RV, Lee KE, Schiebler ML, Sandbo N, Fain SB. Hyperpolarized 129Xe MR Spectroscopy in the Lung Shows 1-year Reduced Function in Idiopathic Pulmonary Fibrosis. Radiology 2022; 305:688-696. [PMID: 35880982 PMCID: PMC9713448 DOI: 10.1148/radiol.211433] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 11/11/2022]
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a temporally and spatially heterogeneous lung disease. Identifying whether IPF in a patient is progressive or stable is crucial for treatment regimens. Purpose To assess the role of hyperpolarized (HP) xenon 129 (129Xe) MRI measures of ventilation and gas transfer in IPF generally and as an early signature of future IPF progression. Materials and Methods In a prospective study, healthy volunteers and participants with IPF were consecutively recruited between December 2015 and August 2019 and underwent baseline HP 129Xe MRI and chest CT. Participants with IPF were followed up with forced vital capacity percent predicted (FVC%p), diffusing capacity of the lungs for carbon monoxide percent predicted (DLco%p), and clinical outcome at 1 year. IPF progression was defined as reduction in FVC%p by at least 10%, reduction in DLco%p by at least 15%, or admission to hospice care. CT and MRI were spatially coregistered and a measure of pulmonary gas transfer (red blood cell [RBC]-to-barrier ratio) and high-ventilation percentage of lung volume were compared across groups and across fibrotic versus normal-appearing regions at CT by using Wilcoxon signed rank tests. Results Sixteen healthy volunteers (mean age, 57 years ± 14 [SD]; 10 women) and 22 participants with IPF (mean age, 71 years ± 9; 15 men) were evaluated, as follows: nine IPF progressors (mean age, 72 years ± 7; five women) and 13 nonprogressors (mean age, 70 years ± 10; 11 men). Reduction of high-ventilation percent (13% ± 6.1 vs 8.2% ± 5.9; P = .03) and RBC-to-barrier ratio (0.26 ± 0.06 vs 0.20 ± 0.06; P = .03) at baseline were associated with progression of IPF. Participants with progressive disease had reduced RBC-to-barrier ratio in structurally normal-appearing lung at CT (0.21 ± 0.07 vs 0.28 ± 0.05; P = .01) but not in fibrotic regions of the lung (0.15 ± 0.09 vs 0.14 ± 0.04; P = .62) relative to the nonprogressive group. Conclusion In this preliminary study, functional measures of gas transfer and ventilation measured with xenon 129 MRI and the extent of fibrotic structure at CT were associated with idiopathic pulmonary fibrosis disease progression. Differences in gas transfer were found in regions of nonfibrotic lung. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gleeson and Fraser in this issue.
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Affiliation(s)
- Andrew D. Hahn
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Katie J. Carey
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Gregory P. Barton
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Luis A. Torres
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Jeff Kammerman
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Robert V. Cadman
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Kristine E. Lee
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Mark L. Schiebler
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Nathan Sandbo
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
| | - Sean B. Fain
- From the Departments of Medical Physics (A.D.H., K.J.C., G.P.B.,
L.A.T., J.K., R.V.C., S.B.F.), Medicine (R.V.C., N.S.), Biostatistics and
Medical Informatics (K.E.L.), and Radiology (M.L.S.), University of
Wisconsin–Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705;
Department of Medicine, University of Texas Southwestern Medical Center, Dallas,
Tex (G.P.B.); and Department of Radiology, University of Iowa, Iowa City, Iowa
(A.D.H., S.B.F.)
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Willmering MM, Walkup LL, Niedbalski PJ, Wang H, Wang Z, Hysinger EB, Myers KC, Towe CT, Driehuys B, Cleveland ZI, Woods JC. Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability. J Magn Reson Imaging 2022; 56:1207-1219. [PMID: 35244302 PMCID: PMC9519191 DOI: 10.1002/jmri.28136] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND 129 Xe gas-transfer MRI provides regional measures of pulmonary gas exchange in adults and separates xenon in interstitial lung tissue/plasma (barrier) from xenon in red blood cells (RBCs). The technique has yet to be demonstrated in pediatric populations or conditions. PURPOSE/HYPOTHESIS To perform an exploratory analysis of 129 Xe gas-transfer MRI in children. STUDY TYPE Prospective. POPULATION Seventy-seven human volunteers (38 males, age = 17.7 ± 15.1 years, range 5-68 years, 16 healthy). Four pediatric disease cohorts. FIELD STRENGTH/SEQUENCE 3-T, three-dimensional-radial one-point Dixon Fast Field Echo (FFE) Ultrashort Echo Time (UTE). ASSESSMENT Breath hold compliance was assessed by quantitative signal-to-noise and dynamic metrics. Whole-lung means and standard deviations were extracted from gas-transfer maps. Gas-transfer metrics were investigated with respect to age and lung disease. Clinical pulmonary function tests were retrospectively acquired for reference lung disease severity. STATISTICAL TESTS Wilcoxon rank-sum tests to compare age and disease cohorts, Wilcoxon signed-rank tests to compare pre- and post-breath hold vitals, Pearson correlations between age and gas-transfer metrics, and limits of normal with a binomial exact test to compare fraction of subjects with abnormal gas-transfer. P ≤ 0.05 was considered significant. RESULTS Eighty percentage of pediatric subjects successfully completed 129 Xe gas-transfer MRI. Gas-transfer parameters differed between healthy children and adults, including ventilation (0.75 and 0.67) and RBC:barrier ratio (0.31 and 0.46) which also correlated with age (ρ = -0.76, 0.57, respectively). Bone marrow transplant subjects had impaired ventilation (90% of reference) and increased dissolved 129 Xe standard deviation (242%). Bronchopulmonary dysplasia subjects had decreased barrier-uptake (69%). Cystic fibrosis subjects had impaired ventilation (91%) and increased RBC-transfer (146%). Lastly, childhood interstitial lung disease subjects had increased ventilation heterogeneity (113%). Limits of normal provided detection of abnormalities in additional gas-transfer parameters. DATA CONCLUSION Pediatric 129 Xe gas-transfer MRI was adequately successful and gas-transfer metrics correlated with age. Exploratory analysis revealed abnormalities in a variety of pediatric obstructive and restrictive lung diseases. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Matthew M. Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Laura L. Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Peter J. Niedbalski
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Hui Wang
- MR Clinical Science, Philips, Cincinnati, Ohio, USA
- Department of Physics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ziyi Wang
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, 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 Medical Center, Cincinnati, Ohio, USA
| | - Kasiani C. Myers
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Christopher T. Towe
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Bastiaan Driehuys
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Zackary I. Cleveland
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 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, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Physics, University of Cincinnati, Cincinnati, Ohio, USA
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7
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Niedbalski PJ, Lu J, Hall CS, Castro M, Mugler JP, Shim YM, Driehuys B. Utilizing flip angle/TR equivalence to reduce breath hold duration in hyperpolarized 129 Xe 1-point Dixon gas exchange imaging. Magn Reson Med 2022; 87:1490-1499. [PMID: 34644815 PMCID: PMC8776583 DOI: 10.1002/mrm.29040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/27/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To reduce scan duration in hyperpolarized 129 Xe 1-point Dixon gas exchange imaging by utilizing flip angle (FA)/TR equivalence. METHODS Images were acquired in 12 subjects (n = 3 radiation therapy, n = 1 unexplained dyspnea, n = 8 healthy) using both standard (TR = 15 ms, FA = 20°, duration = 15 s, 998 projections) and "fast" (TR = 5.4 ms, FA = 12°, duration = 11.3 s, 2100 projections) acquisition parameters. For the fast acquisition, 3 image sets were reconstructed using subsets of 1900, 1500, and 1000 projections. From the resulting ventilation, tissue ("barrier"), and red blood cell (RBC) images, image metrics and biomarkers were compared to assess agreement between methods. RESULTS Images acquired using both FA/TR settings had similar qualitative appearance. There were no significant differences in SNR, image mean, or image SD between images. Moreover, the percentage of the lungs in "defect", "normal", and "high" bins for each image (ventilation, RBC, barrier) was not significantly different among the acquisition types. After registration, comparison of 3D image metrics (Dice, volume similarity, average distance) agreed well between bins. Images using 1000 projections for reconstruction had no significant differences from images using all projections. CONCLUSION Using flip angle/TR equivalence, hyperpolarized 129 Xe gas exchange images can be acquired via the 1-point Dixon technique in as little as 6 s, compared to ~15 s for previously reported parameter settings. The resulting images from this accelerated scan have no significant differences from the standard method in qualitative appearance or quantitative metrics.
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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,Corresponding Author: Peter J. Niedbalski, 3901 Rainbow Blvd. Lied 3043, Kansas City, KS 66160, 913-588-2271,
| | - Junlan Lu
- Medical Physics Graduate Program, Duke University, Durham, North Carolina, 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
| | - John P. Mugler
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Yun M. Shim
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Bastiaan Driehuys
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
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8
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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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9
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Hyperpolarized 129Xe Magnetic Resonance Imaging for Functional Avoidance Treatment Planning in Thoracic Radiation Therapy: A Comparison of Ventilation- and Gas Exchange-Guided Treatment Plans. Int J Radiat Oncol Biol Phys 2021; 111:1044-1057. [PMID: 34265395 DOI: 10.1016/j.ijrobp.2021.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To present a methodology to use pulmonary gas exchange maps to guide functional avoidance treatment planning in radiation therapy (RT) and evaluate its efficacy compared with ventilation-guided treatment planning. METHODS AND MATERIALS Before receiving conventional RT for non-small cell lung cancer, 11 patients underwent hyperpolarized 129Xe gas exchange magnetic resonance imaging to map the distribution of xenon in its gas phase (ventilation) and transiently bound to red blood cells in the alveolar capillaries (gas exchange). Both ventilation and gas exchange maps were independently used to guide development of new functional avoidance treatment plans for every patient, while adhering to institutional dose-volume constraints for normal tissues and target coverage. Furthermore, dose-volume histogram (DVH)-based reoptimizations of the clinical plan, with reductions in mean lung dose (MLD) equal to the functional avoidance plans, were created to serve as the control group. To evaluate each plan (regardless of type), gas exchange maps, representing end-to-end lung function, were used to calculate gas exchange-weighted MLD (fMLD), gas exchange-weighted volume receiving ≥20 Gy (fV20), and mean dose in the highest gas exchanging 33% and 50% volumes of lung (MLD-f33% and MLD-f50%). Using each clinically approved plan as a baseline, the reductions in functional metrics were compared for ventilation-optimization, gas exchange optimization, and DVH-based reoptimization. Statistical significance was determined using the Freidman test, with subsequent subdivision when indicated by P values less than .10 and post hoc testing with Wilcoxon signed rank tests to determine significant differences (P < .05). Toxicity modeling was performed using an established function-based model to estimate clinical significance of the results. RESULTS Compared with DVH-based reoptimization of the clinically approved plans, gas exchange-guided functional avoidance planning more effectively reduced the gas exchange-weighted metrics fMLD (average ± SD, -78 ± 79 cGy for gas exchange, compared with -45 ± 34 cGy for DVH-based; P = .03), MLD-f33% (-135 ± 136 cGy, compared with -52 ± 47 cGy; P = .004), and MLD-f50% (-96 ± 95 cGy, compared with -47 ± 40 cGy; P = .01). Comparing the 2 functional planning types, gas exchange-guided planning more effectively reduced MLD-f33% compared with ventilation-guided planning (-64 ± 95; P = .009). For some patients, gas exchange-guided functional avoidance plans demonstrated clinically significant reductions in model-predicted toxicity, more so than the accompanying ventilation-guided plans and DVH-based reoptimizations. CONCLUSION Gas exchange-guided planning effectively reduced dose to high gas exchanging regions of lung while maintaining clinically acceptable plan quality. In many patients, ventilation-guided planning incidentally reduced dose to higher gas exchange regions, to a lesser extent. This methodology enables future prospective trials to examine patient outcomes.
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10
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Willmering MM, Cleveland ZI, Walkup LL, Woods JC. Removal of off-resonance xenon gas artifacts in pulmonary gas-transfer MRI. Magn Reson Med 2021; 86:907-915. [PMID: 33665905 DOI: 10.1002/mrm.28737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE Hyperpolarized xenon (129 Xe) gas-transfer imaging allows different components of pulmonary gas transfer-alveolar air space, lung interstitium/blood plasma (barrier), and red blood cells (RBCs)-to be assessed separately in a single breath. However, quantitative analysis is challenging because dissolved-phase 129 Xe images are often contaminated by off-resonant gas-phase signal generated via imperfectly selective excitation. Although previous methods required additional data for gas-phase removal, the method reported here requires no/minimal sequence modifications/data acquisitions, allowing many previously acquired images to be corrected retroactively. METHODS 129 Xe imaging was implemented at 3.0T via an interleaved three-dimensional radial acquisition of the gaseous and dissolved phases (using one-point Dixon reconstruction for the dissolved phase) in 46 human subjects and a phantom. Gas-phase contamination (9.5% ± 4.8%) was removed from gas-transfer data using a modified gas-phase image. The signal-to-noise ratio (SNR) and signal distributions were compared before and after contamination removal. Additionally, theoretical gaseous contaminations were simulated at different magnetic field strengths for comparison. RESULTS Gas-phase contamination at 3.0T was more diffuse and located predominantly outside the lungs, relative to simulated 1.5T contamination caused by the larger frequency offset. Phantom experiments illustrated a 91% removal efficiency. In human subjects, contamination removal produced significant changes in dissolved signal SNR (+7.8%), mean (-1.4%), and standard deviation (-2.3%) despite low contamination. Repeat measurements showed reduced variance (dissolved mean, -1.0%; standard deviation, -8.4%). CONCLUSION Off-resonance gas-phase contamination can be removed robustly with no/minimal sequence modifications. Contamination removal permits more accurate quantification, reduces radiofrequency stringency requirements, and increases data consistency, providing improved sensitivity needed for multicenter trials.
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Affiliation(s)
- Matthew M Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Department of Physics, University of Cincinnati, Cincinnati, OH, USA.,Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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11
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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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12
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Inhaled Gas Magnetic Resonance Imaging: Advances, Applications, Limitations, and New Frontiers. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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Collier GJ, Eaden JA, Hughes PJC, Bianchi SM, Stewart NJ, Weatherley ND, Norquay G, Schulte RF, Wild JM. Dissolved
129
Xe lung MRI with four‐echo 3D radial spectroscopic imaging: Quantification of regional gas transfer in idiopathic pulmonary fibrosis. Magn Reson Med 2020; 85:2622-2633. [DOI: 10.1002/mrm.28609] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Guilhem J. Collier
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
| | - James A. Eaden
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
| | - Paul J. C. Hughes
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
| | - Stephen M. Bianchi
- Academic Directorate of Respiratory Medicine Sheffield Teaching Hospitals NHS Foundation Trust Sheffield United Kingdom
| | - Neil J. Stewart
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
| | - Nicholas D. Weatherley
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
| | - Graham Norquay
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
| | | | - Jim M. Wild
- POLARIS, Department of Infection Immunity & Cardiovascular Disease University of Sheffield Sheffield United Kingdom
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14
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Niedbalski PJ, Cochran AS, Akinyi TG, Thomen RP, Fugate EM, Lindquist DM, Pratt RG, Cleveland ZI. Preclinical hyperpolarized 129 Xe MRI: ventilation and T 2 * mapping in mouse lungs at 7 T using multi-echo flyback UTE. NMR IN BIOMEDICINE 2020; 33:e4302. [PMID: 32285574 PMCID: PMC7702724 DOI: 10.1002/nbm.4302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/28/2020] [Accepted: 03/07/2020] [Indexed: 05/13/2023]
Abstract
Fast apparent transverse relaxation (short T2 *) is a common obstacle when attempting to perform quantitative 1 H MRI of the lungs. While T2 * times are longer for pulmonary hyperpolarized (HP) gas functional imaging (in particular for gaseous 129 Xe), T2 * can still lead to quantitative inaccuracies for sequences requiring longer echo times (such as diffusion weighted images) or longer readout duration (such as spiral sequences). This is especially true in preclinical studies, where high magnetic fields lead to shorter relaxation times than are typically seen in human studies. However, the T2 * of HP 129 Xe in the most common animal model of human disease (mice) has not been reported. Herein, we present a multi-echo radial flyback imaging sequence and use it to measure HP 129 Xe T2 * at 7 T under a variety of respiratory conditions. This sequence mitigates the impact of T1 relaxation outside the animal by using multiple gradient-refocused echoes to acquire images at a number of effective echo times for each RF excitation. After validating the sequence using a phantom containing water doped with superparamagnetic iron oxide nanoparticles, we measured the 129 Xe T2 * in vivo for 10 healthy C57Bl/6 J mice and found T2 * ~ 5 ms in the lung airspaces. Interestingly, T2 * was relatively constant over all experimental conditions, and varied significantly with sex, but not age, mass, or the O2 content of the inhaled gas mixture. These results are discussed in the context of T2 * relaxation within porous media.
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Affiliation(s)
- Peter J. Niedbalski
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Alexander S. Cochran
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
| | - Teckla G. Akinyi
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
| | - Robert P. Thomen
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Elizabeth M. Fugate
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Diana M. Lindquist
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Ronald G. Pratt
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
| | - Zackary I. Cleveland
- Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
- Imaging Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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15
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Hahn AD, Kammerman J, Evans M, Zha W, Cadman RV, Meyer K, Sandbo N, Fain SB. Repeatability of regional pulmonary functional metrics of Hyperpolarized 129 Xe dissolved-phase MRI. J Magn Reson Imaging 2019; 50:1182-1190. [PMID: 30968993 DOI: 10.1002/jmri.26745] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND MRI of hyperpolarized 129 Xenon (HP 129 Xe) is increasingly utilized for investigating pulmonary function. The solubility of HP 129 Xe in lung tissue, blood plasma (Barrier), and red blood cells (RBC), with unique chemical shifts, enables spectroscopic imaging of potential imaging biomarkers of gas exchange and microstructural pulmonary physiology. PURPOSE To quantify global average and regional repeatability of Barrier:gas, RBC:gas, and RBC:Barrier ratios derived from dissolved-phase 129 Xe imaging and their dependence on intervisit changes in lung inflation volume. STUDY TYPE Prospective. POPULATION Fourteen healthy volunteers. One subject was unable to complete the study resulting in 13 subjects for analysis (eight female, five male, ages 24-69, 53.8 ± 13.9). FIELD STRENGTH 1.5T. ASSESSMENT Subjects were imaged using a 3D radial 1-point Dixon method to separate Barrier and RBC component signals, at two different timepoints, with ~1 month between visits. RBC:Gas, Barrier:Gas, and RBC:Barrier measures were compared across time and with pulmonary function tests (PFTs). STATISTICAL TESTS Repeatablilty was quantified using Bland-Altman plots, coefficient of repeatability, coefficient of variation (CV), and intraclass correlation coefficients (ICCs). Dependence of imaging measures on PFTs and lung volume was evaluated using Spearman and Pearson correlation coefficients, respectively. Statistical significance was determined by F-test for intraclass correlations, and t-test for Spearman correlations and regression. RESULTS Mean RBC:Gas, Barrier:Gas, and RBC:Barrier had CVs of 19.2%, 20.0%, and 11.5%, respectively, and had significant ICCs, equal to 0.78, 0.79, and 0.92, respectively. Intervisit differences in RBC:Barrier were significantly correlated with intervisit differences in DLCO (r = 0.93, P = 0.007). Significant correlations with intervisit lung volume differences and intervisit differences in mean RBC:Gas (r = -0.73, P = 0.005) and Barrier:Gas (r = -0.69, P = 0.009) were found. DATA CONCLUSION Three commonly used 129 Xe MRI-based measures of gas-exchange show good repeatability, particularly the Barrier:RBC ratio, which did not depend on lung inflation volume and was strongly associated with intervisit changes in DLCO . LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1182-1190.
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Affiliation(s)
- Andrew D Hahn
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Jeff Kammerman
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Michael Evans
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | - Wei Zha
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Robert V Cadman
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Keith Meyer
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Nathan Sandbo
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
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16
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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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