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Fang Y, Li H, Shen L, Zhang M, Luo M, Li H, Rao Q, Chen Q, Li Y, Li Z, Zhao X, Shi L, Zhou Q, Han Y, Guo F, Zhou X. Rapid pulmonary 129Xe ventilation MRI of discharged COVID-19 patients with zigzag sampling. Magn Reson Med 2024; 92:956-966. [PMID: 38770624 DOI: 10.1002/mrm.30120] [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: 12/12/2023] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE To demonstrate the feasibility of zigzag sampling for 3D rapid hyperpolarized 129Xe ventilation MRI in human. METHODS Zigzag sampling in one direction was combined with gradient-recalled echo sequence (GRE-zigzag-Y) to acquire hyperpolarized 129Xe ventilation images. Image quality was compared with a balanced SSFP (bSSFP) sequence with the same spatial resolution for 12 healthy volunteers (HVs). For another 8 HVs and 9 discharged coronavirus disease 2019 subjects, isotropic resolution 129Xe ventilation images were acquired using zigzag sampling in two directions through GRE-zigzag-YZ. 129Xe ventilation defect percent (VDP) was quantified for GRE-zigzag-YZ and bSSFP acquisitions. Relationships and agreement between these VDP measurements were evaluated using Pearson correlation coefficient (r) and Bland-Altman analysis. RESULTS For 12 HVs, GRE-zigzag-Y and bSSFP required 2.2 s and 10.5 s, respectively, to acquire 129Xe images with a spatial resolution of 3.96 × 3.96 × 10.5 mm3. Structural similarity index, mean absolute error, and Dice similarity coefficient between the two sets of images and ventilated lung regions were 0.85 ± 0.03, 0.0015 ± 0.0001, and 0.91 ± 0.02, respectively. For another 8 HVs and 9 coronavirus disease 2019 subjects, 129Xe images with a nominal spatial resolution of 2.5 × 2.5 × 2.5 mm3 were acquired within 5.5 s per subject using GRE-zigzag-YZ. VDP provided by GRE-zigzag-YZ was strongly correlated (R2 = 0.93, p < 0.0001) with that generated by bSSFP with minimal biases (bias = -0.005%, 95% limit-of-agreement = [-0.414%, 0.424%]). CONCLUSION Zigzag sampling combined with GRE sequence provides a way for rapid 129Xe ventilation imaging.
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Affiliation(s)
- Yuan Fang
- School of Physics, Huazhong University of Science and Technology, Wuhan, China
- 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, Huazhong University of Science and Technology, Wuhan, 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, Huazhong University of Science and Technology, 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, Huazhong University of Science and Technology, 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, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Ming Luo
- 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, Huazhong University of Science and Technology, 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, Huazhong University of Science and Technology, 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, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Chen
- 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, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yecheng 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, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Zimeng Li
- School of Physics, Huazhong University of Science and Technology, Wuhan, China
- 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, Huazhong University of Science and Technology, Wuhan, 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, Huazhong University of Science and Technology, 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, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - 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, Huazhong University of Science and Technology, Wuhan, 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, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Fumin Guo
- 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, Huazhong University of Science and Technology, Wuhan, 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, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
- School of Biomedical Engineering, Hainan University, Hainan, China
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2
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Rao Q, Li H, Zhou Q, Zhang M, Zhao X, Shi L, Xie J, Fan L, Han Y, Guo F, Liu S, Zhou X. Assessment of pulmonary physiological changes caused by aging, cigarette smoking, and COPD with hyperpolarized 129Xe magnetic resonance. Eur Radiol 2024:10.1007/s00330-024-10800-w. [PMID: 38748243 DOI: 10.1007/s00330-024-10800-w] [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: 03/14/2024] [Revised: 03/14/2024] [Accepted: 04/05/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To comprehensively assess the impact of aging, cigarette smoking, and chronic obstructive pulmonary disease (COPD) on pulmonary physiology using 129Xe MR. METHODS A total of 90 subjects were categorized into four groups, including healthy young (HY, n = 20), age-matched control (AMC, n = 20), asymptomatic smokers (AS, n = 28), and COPD patients (n = 22). 129Xe MR was utilized to obtain pulmonary physiological parameters, including ventilation defect percent (VDP), alveolar sleeve depth (h), apparent diffusion coefficient (ADC), total septal wall thickness (d), and ratio of xenon signal from red blood cells and interstitial tissue/plasma (RBC/TP). RESULTS Significant differences were found in the measured VDP (p = 0.035), h (p = 0.003), and RBC/TP (p = 0.003) between the HY and AMC groups. Compared with the AMC group, higher VDP (p = 0.020) and d (p = 0.048) were found in the AS group; higher VDP (p < 0.001), d (p < 0.001) and ADC (p < 0.001), and lower h (p < 0.001) and RBC/TP (p < 0.001) were found in the COPD group. Moreover, significant differences were also found in the measured VDP (p < 0.001), h (p < 0.001), ADC (p < 0.001), d (p = 0.008), and RBC/TP (p = 0.032) between the AS and COPD groups. CONCLUSION Our findings indicate that pulmonary structure and functional changes caused by aging, cigarette smoking, and COPD are various, and show a progressive deterioration with the accumulation of these risk factors, including cigarette smoking and COPD. CLINICAL RELEVANCE STATEMENT Pathophysiological changes can be difficult to comprehensively understand due to limitations in common techniques and multifactorial etiologies. 129Xe MRI can demonstrate structural and functional changes caused by several common factors and can be used to better understand patients' underlying pathology. KEY POINTS Standard techniques for assessing pathophysiological lung function changes, spirometry, and chest CT come with limitations. 129Xe MR demonstrated progressive deterioration with accumulation of the investigated risk factors, without these limitations. 129Xe MR can assess lung changes related to these risk factors to stage and evaluate the etiology of the disease.
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Affiliation(s)
- 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, Huazhong University of Science and Technology, Wuhan, 430071, 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, Huazhong University of Science and Technology, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - 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, Huazhong University of Science and Technology, Wuhan, 430071, 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, Huazhong University of Science and Technology, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, 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, Huazhong University of Science and Technology, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, 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, Huazhong University of Science and Technology, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Junshuai Xie
- 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, Huazhong University of Science and Technology, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Li Fan
- Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, 200003, 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, Huazhong University of Science and Technology, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Fumin Guo
- 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, Huazhong University of Science and Technology, Wuhan, 430071, China
| | - Shiyuan Liu
- Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, 200003, 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, Huazhong University of Science and Technology, Wuhan, 430071, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- School of Biomedical Engineering, Hainan University, Haikou, 570228, China.
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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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4
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Peiffer JD, Altes T, Ruset IC, Hersman FW, Mugler JP, Meyer CH, Mata J, Qing K, Thomen R. Hyperpolarized 129Xe MRI, 99mTc scintigraphy, and SPECT in lung ventilation imaging: a quantitative comparison. Acad Radiol 2024; 31:1666-1675. [PMID: 37977888 PMCID: PMC11015986 DOI: 10.1016/j.acra.2023.10.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/22/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023]
Abstract
RATIONALE AND OBJECTIVES The current clinical standard for functional imaging of patients with lung ailments is nuclear medicine scintigraphy and Single Photon Emission Computed Tomography (SPECT) which detect the gamma decay of inhaled radioactive tracers. Hyperpolarized (HP) Xenon-129 MRI (XeMRI) of the lungs has recently been FDA approved and provides similar functional images of the lungs with higher spatial resolution than scintigraphy and SPECT. Here we compare Technetium-99m (99mTc) diethylene-triamine-pentaacetate scintigraphy and SPECT with HP XeMRI in healthy controls, asthma, and chronic obstructive pulmonary disorder (COPD) patients. MATERIALS AND METHODS 59 subjects, healthy, with asthma, and with COPD, underwent 99mTc scintigraphy/SPECT, standard spirometry, and HP XeMRI. XeMRI and SPECT images were registered for direct voxel-wise signal comparisons. Images were also compared using ventilation defect percentage (VDP), and a standard 6-compartment method. VDP calculated from XeMRI and SPECT images was compared to spirometry. RESULTS Median Pearson correlation coefficient for voxel-wise signal comparison was 0.698 (0.613-0.782) between scintigraphy and XeMRI and 0.398 (0.286-0.502) between SPECT and XeMRI. Correlation between VDP measures was r = 0.853, p < 0.05. VDP separated asthma and COPD from the control group and was significantly correlated with FEV1, FEV1/FVC, and FEF 25-75. CONCLUSION HP XeMRI provides equivalent information to 99mTc SPECT and standard spirometry measures. Additionally, XeMRI is non-invasive, hence it could be used for longitudinal studies for evaluating emerging treatment for lung ailments.
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Affiliation(s)
- J D Peiffer
- Department of Chemical and Biomedical Engineering, University of Missouri, Columbia, Missouri 65201, USA (J.D.P., R.T.)
| | - Talissa Altes
- Department of Radiology, University of Missouri, Columbia, Missouri 65201, USA (T.A., R.T.)
| | - Iulian C Ruset
- Xemed LLC, Durham, New Hampshire 03833, USA (I.C.R., F.W.H.)
| | - F W Hersman
- Xemed LLC, Durham, New Hampshire 03833, USA (I.C.R., F.W.H.)
| | - John P Mugler
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M., J.M., K.Q.); Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M.)
| | - Craig H Meyer
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M., J.M., K.Q.); Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M.)
| | - Jamie Mata
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M., J.M., K.Q.)
| | - Kun Qing
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M., J.M., K.Q.)
| | - Robert Thomen
- Department of Chemical and Biomedical Engineering, University of Missouri, Columbia, Missouri 65201, USA (J.D.P., R.T.); Department of Radiology, University of Missouri, Columbia, Missouri 65201, USA (T.A., R.T.).
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5
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Yuan C, Guo Q, Zeng Q, Yuan Y, Jiang W, Yang Y, Bouchard LS, Ye C, Zhou X. Dual-Signal Chemical Exchange Saturation Transfer (Dusi-CEST): An Efficient Strategy for Visualizing Drug Delivery Monitoring in Living Cells. Anal Chem 2024; 96:1436-1443. [PMID: 38173081 DOI: 10.1021/acs.analchem.3c03408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
We report a dual-signal chemical exchange saturation transfer (Dusi-CEST) strategy for drug delivery and detection in living cells. The two signals can be detected by operators in complex environments. This strategy is demonstrated on a cucurbit[6]uril (CB[6]) nanoparticle probe, as an example. The CB[6] probe is equipped with two kinds of hydrophobic cavities: one is found inside CB[6] itself, whereas the other exists inside the nanoparticle. When the probe is dispersed in aqueous solution as part of a hyperpolarized 129Xe NMR experiment, two signals appear at two different chemical shifts (100 and 200 ppm). These two resonances correspond to the NMR signals of 129Xe in the two different cavities. Upon loading with hydrophobic drugs, such as paclitaxel, for intracellular drug delivery, the two resonances undergo significant changes upon drug loading and cargo release, giving rise to a metric enabling the assessment of drug delivery success. The simultaneous change of Dusi-CEST likes a mobile phone that can receive both LTE and Wi-Fi signals, which can help reduce the occurrence of false positives and false negatives in complex biological environments and help improve the accuracy and sensitivity of single-shot detection.
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Affiliation(s)
- Chenlu Yuan
- 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, Huazhong University of Science and Technology, Wuhan 430071, China
| | - Qianni Guo
- 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, Huazhong University of Science and Technology, Wuhan 430071, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Optics Valley Laboratory, Wuhan, Hubei 430074, China
| | - Qingbin Zeng
- 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, Huazhong University of Science and Technology, Wuhan 430071, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yaping Yuan
- 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, Huazhong University of Science and Technology, Wuhan 430071, China
| | - Weiping Jiang
- 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, Huazhong University of Science and Technology, Wuhan 430071, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuqi Yang
- 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, Huazhong University of Science and Technology, Wuhan 430071, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Louis-S Bouchard
- Departments of Chemistry and Biochemistry and of Bioengineering, California NanoSystems Institute, Jonsson Comprehensive Cancer Center, The Molecular Biology Institute, University of California, Los Angeles, California 90095, United States
| | - 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, Huazhong University of Science and Technology, Wuhan 430071, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Optics Valley Laboratory, Wuhan, Hubei 430074, 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, Huazhong University of Science and Technology, Wuhan 430071, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- Optics Valley Laboratory, Wuhan, Hubei 430074, China
- Hainan University, Haikou, Hainan 570228, China
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6
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Bechtel A, Lu J, Mummy D, Bier E, Leewiwatwong S, Mugler J, Kabir S, Church A, Driehuys B. Establishing a hemoglobin adjustment for 129 Xe gas exchange MRI and MRS. Magn Reson Med 2023; 90:1555-1568. [PMID: 37246900 PMCID: PMC10524939 DOI: 10.1002/mrm.29712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/10/2023] [Accepted: 05/02/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE 129 Xe MRI and MRS signals from airspaces, membrane tissues (M), and red blood cells (RBCs) provide measurements of pulmonary gas exchange. However, 129 Xe MRI/MRS studies have yet to account for hemoglobin concentration (Hb), which is expected to affect the uptake of 129 Xe in the membrane and RBC compartments. We propose a framework to adjust the membrane and RBC signals for Hb and use this to assess sex-specific differences in RBC/M and establish a Hb-adjusted healthy reference range for the RBC/M ratio. METHODS We combined the 1D model of xenon gas exchange (MOXE) with the principle of TR-flip angle equivalence to establish scaling factors that normalize the dissolved-phase signals with respect to a standardH b 0 $$ H{b}^0 $$ (14 g/dL). 129 Xe MRI/MRS data from a healthy, young cohort (n = 18, age = 25.0± $$ \pm $$ 3.4 years) were used to validate this model and assess the impact of Hb adjustment on M/gas and RBC/gas images and RBC/M. RESULTS Adjusting for Hb caused RBC/M to change by up to 20% in healthy individuals with normal Hb and had marked impacts on M/gas and RBC/gas distributions in 3D gas-exchange maps. RBC/M was higher in males than females both before and after Hb adjustment (p < 0.001). After Hb adjustment, the healthy reference value for RBC/M for a consortium-recommended acquisition of TR = 15 ms and flip = 20° was 0.589± $$ \pm $$ 0.083 (mean± $$ \pm $$ SD). CONCLUSION MOXE provides a useful framework for evaluating the Hb dependence of the membrane and RBC signals. This work indicates that adjusting for Hb is essential for accurately assessing 129 Xe gas-exchange MRI/MRS metrics.
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Affiliation(s)
- Aryil Bechtel
- Radiology, Duke University Medical Center, Durham, North Carolina, United States
| | - Junlan Lu
- Medical Physics Graduate Program, Duke University, Durham, North Carolina
| | - David Mummy
- Radiology, Duke University Medical Center, Durham, North Carolina, United States
| | - Elianna Bier
- Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | | | - John Mugler
- Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia
| | - Sakib Kabir
- Radiology, Duke University Medical Center, Durham, North Carolina, United States
| | - Alex Church
- Radiology, Duke University Medical Center, Durham, North Carolina, United States
| | - Bastiaan Driehuys
- Radiology, Duke University Medical Center, Durham, North Carolina, United States
- Medical Physics Graduate Program, Duke University, Durham, North Carolina
- Biomedical Engineering, Duke University, Durham, North Carolina, United States
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7
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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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Hsia CCW, Bates JHT, Driehuys B, Fain SB, Goldin JG, Hoffman EA, Hogg JC, Levin DL, Lynch DA, Ochs M, Parraga G, Prisk GK, Smith BM, Tawhai M, Vidal Melo MF, Woods JC, Hopkins SR. Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report. Ann Am Thorac Soc 2023; 20:161-195. [PMID: 36723475 PMCID: PMC9989862 DOI: 10.1513/annalsats.202211-915st] [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] [Indexed: 02/02/2023] Open
Abstract
Multiple thoracic imaging modalities have been developed to link structure to function in the diagnosis and monitoring of lung disease. Volumetric computed tomography (CT) renders three-dimensional maps of lung structures and may be combined with positron emission tomography (PET) to obtain dynamic physiological data. Magnetic resonance imaging (MRI) using ultrashort-echo time (UTE) sequences has improved signal detection from lung parenchyma; contrast agents are used to deduce airway function, ventilation-perfusion-diffusion, and mechanics. Proton MRI can measure regional ventilation-perfusion ratio. Quantitative imaging (QI)-derived endpoints have been developed to identify structure-function phenotypes, including air-blood-tissue volume partition, bronchovascular remodeling, emphysema, fibrosis, and textural patterns indicating architectural alteration. Coregistered landmarks on paired images obtained at different lung volumes are used to infer airway caliber, air trapping, gas and blood transport, compliance, and deformation. This document summarizes fundamental "good practice" stereological principles in QI study design and analysis; evaluates technical capabilities and limitations of common imaging modalities; and assesses major QI endpoints regarding underlying assumptions and limitations, ability to detect and stratify heterogeneous, overlapping pathophysiology, and monitor disease progression and therapeutic response, correlated with and complementary to, functional indices. The goal is to promote unbiased quantification and interpretation of in vivo imaging data, compare metrics obtained using different QI modalities to ensure accurate and reproducible metric derivation, and avoid misrepresentation of inferred physiological processes. The role of imaging-based computational modeling in advancing these goals is emphasized. Fundamental principles outlined herein are critical for all forms of QI irrespective of acquisition modality or disease entity.
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Tibiletti M, Eaden JA, Naish JH, Hughes PJC, Waterton JC, Heaton MJ, Chaudhuri N, Skeoch S, Bruce IN, Bianchi S, Wild JM, Parker GJM. Imaging biomarkers of lung ventilation in interstitial lung disease from 129Xe and oxygen enhanced 1H MRI. Magn Reson Imaging 2023; 95:39-49. [PMID: 36252693 DOI: 10.1016/j.mri.2022.10.005] [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: 05/18/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare imaging biomarkers from hyperpolarised 129Xe ventilation MRI and dynamic oxygen-enhanced MRI (OE-MRI) with standard pulmonary function tests (PFT) in interstitial lung disease (ILD) patients. To evaluate if biomarkers can separate ILD subtypes and detect early signs of disease resolution or progression. STUDY TYPE Prospective longitudinal. POPULATION Forty-one ILD (fourteen idiopathic pulmonary fibrosis (IPF), eleven hypersensitivity pneumonitis (HP), eleven drug-induced ILD (DI-ILD), five connective tissue disease related-ILD (CTD-ILD)) patients and ten healthy volunteers imaged at visit 1. Thirty-four ILD patients completed visit 2 (eleven IPF, eight HP, ten DIILD, five CTD-ILD) after 6 or 26 weeks. FIELD STRENGTH/SEQUENCE MRI was performed at 1.5 T, including inversion recovery T1 mapping, dynamic MRI acquisition with varying oxygen levels, and hyperpolarised 129Xe ventilation MRI. Subjects underwent standard spirometry and gas transfer testing. ASSESSMENT Five 1H MRI and two 129Xe MRI ventilation metrics were compared with spirometry and gas transfer measurements. STATISTICAL TEST To evaluate differences at visit 1 among subgroups: ANOVA or Kruskal-Wallis rank tests with correction for multiple comparisons. To assess the relationships between imaging biomarkers, PFT, age and gender, at visit 1 and for the change between visit 1 and 2: Pearson correlations and multilinear regression models. RESULTS The global PFT tests could not distinguish ILD subtypes. Percentage ventilated volumes were lower in ILD patients than in HVs when measured with 129Xe MRI (HV 97.4 ± 2.6, CTD-ILD: 91.0 ± 4.8 p = 0.017, DI-ILD 90.1 ± 7.4 p = 0.003, HP 92.6 ± 4.0 p = 0.013, IPF 88.1 ± 6.5 p < 0.001), but not with OE-MRI. 129Xe reported more heterogeneous ventilation in DI-ILD and IPF than in HV, and OE-MRI reported more heterogeneous ventilation in DI-ILD and IPF than in HP or CTD-ILD. The longitudinal changes reported by the imaging biomarkers did not correlate with the PFT changes between visits. DATA CONCLUSION Neither 129Xe ventilation nor OE-MRI biomarkers investigated in this study were able to differentiate between ILD subtypes, suggesting that ventilation-only biomarkers are not indicated for this task. Limited but progressive loss of ventilated volume as measured by 129Xe-MRI may be present as the biomarker of focal disease progresses. OE-MRI biomarkers are feasible in ILD patients and do not correlate strongly with PFT. Both OE-MRI and 129Xe MRI revealed more spatially heterogeneous ventilation in DI-ILD and IPF.
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Affiliation(s)
- Marta Tibiletti
- Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, United Kingdom
| | - James A Eaden
- POLARIS, University of Sheffield MRI Unit, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - Josephine H Naish
- Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, United Kingdom; MCMR, Manchester University NHS Foundation Trust, Wythenshawe, Manchester, UK
| | - Paul J C Hughes
- POLARIS, University of Sheffield MRI Unit, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - John C Waterton
- Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, United Kingdom; Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Matthew J Heaton
- Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, United Kingdom
| | - Nazia Chaudhuri
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah Skeoch
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Ian N Bruce
- NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK; Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Stephen Bianchi
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jim M Wild
- POLARIS, University of Sheffield MRI Unit, Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK; Insigneo Insititute for in silico medicine, Sheffield, UK
| | - Geoff J M Parker
- Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, United Kingdom; Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
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Gas exchange and ventilation imaging of healthy and COPD subjects using hyperpolarized xenon-129 MRI and a 3D alveolar gas-exchange model. Eur Radiol 2022; 33:3322-3331. [PMID: 36547671 DOI: 10.1007/s00330-022-09343-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the utility of hyperpolarized xenon-129 (HPX) gas-exchange magnetic resonance imaging (MRI) and modeling in a chronic obstructive pulmonary disease (COPD) cohort in comparison to a minimal CT-diagnosed emphysema (MCTE) cohort and a healthy cohort. METHODS A total of 25 subjects were involved in this study including COPD (n = 8), MCTE (n = 3), and healthy (n = 14) subjects. The COPD subjects were scanned using HPX ventilation, gas-exchange MRI, and volumetric CT. The healthy subjects were scanned using the same HPX gas-exchange MRI protocol with 9 of them scanned twice, 3 weeks apart. The coefficient of variation (CV) was used to quantify image heterogeneities. A three-dimensional computational fluid dynamic (CFD) model of gas exchange was used to derive functional volumes of pulmonary tissue, capillaries, and veins. RESULTS The CVs of gas distributions in the images showed that there was a statistically significant difference between the COPD and healthy subjects (p < 0.0001). The functional volumes of pulmonary tissue, capillaries, and veins were significantly lower in the subjects with COPD than in the healthy subjects (p < 0.001). The functional volume of pulmonary tissue was found to be (i) statistically different between the healthy and MCTE groups (p = 0.02) and (ii) dependent on the age of the subjects in the healthy group (p = 0.0008) while their CVs (p = 0.13) were not. CONCLUSION The novel HPX gas-exchange MRI and CFD model distinguished the healthy cohort from the MCTE and COPD cohorts. The proposed technique also showed that the functional volume of pulmonary tissue decreases with aging in the healthy group. KEY POINTS • The ventilation and gas-exchange imaging with hyperpolarized xenon-129 MRI has enabled the identification of gas-exchange variation between COPD and healthy groups. • This novel technique was promising to be sensitive to minimal CT-diagnosed emphysema and age-related changes in gas-exchange parameter in a small pilot cohort.
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Achekzai T, Ruppert K, Loza L, Amzajerdian F, Profka H, Duncan IF, Kadlecek SJ, Rizi RR. Investigating the impact of RF saturation-pulse parameters on compartment-selective gas-phase depolarization with xenon polarization transfer contrast MRI. Magn Reson Med 2022; 88:2447-2460. [PMID: 36046917 PMCID: PMC9529921 DOI: 10.1002/mrm.29405] [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: 02/15/2022] [Revised: 06/20/2022] [Accepted: 07/17/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To demonstrate the utility of continuous-wave (CW) saturation pulses in xenon-polarization transfer contrast (XTC) MRI and MRS, to investigate the selectivity of CW pulses applied to dissolved-phase resonances, and to develop a correction method for measurement biases from saturation of the nontargeted dissolved-phase compartment. METHODS Studies were performed in six healthy Sprague-Dawley rats over a series of end-exhale breath holds. Discrete saturation schemes included a series of 30 Gaussian pulses (8 ms FWHM), spaced 25 ms apart; CW saturation schemes included single block pulses, with variable flip angle and duration. In XTC imaging, saturation pulses were applied on both dissolved-phase resonance frequencies and off-resonance, to correct for other sources of signal loss and compromised selectivity. In spectroscopy experiments, saturation pulses were applied at a set of 19 frequencies spread out between 185 and 200 ppm to map out modified z-spectra. RESULTS Both modified z-spectra and imaging results showed that CW RF pulses offer sufficient depolarization and improved selectivity for generating contrast between presaturation and postsaturation acquisitions. A comparison of results obtained using a variety of saturation parameters confirms that saturation pulses applied at higher powers exhibit increased cross-contamination between dissolved-phase resonances. CONCLUSION Using CW RF saturation pulses in XTC contrast preparation, with the proposed correction method, offers a potentially more selective alternative to traditional discrete saturation. The suppression of the red blood cell contribution to the gas-phase depolarization opens the door to a novel way of quantifying exchange time between alveolar volume and hemoglobin.
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Affiliation(s)
- Tahmina Achekzai
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kai Ruppert
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Luis Loza
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Faraz Amzajerdian
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Harrilla Profka
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ian F. Duncan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Stephen J. Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rahim R. Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
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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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Wei Y, Yang C, Jiang H, Li Q, Che F, Wan S, Yao S, Gao F, Zhang T, Wang J, Song B. Multi-nuclear magnetic resonance spectroscopy: state of the art and future directions. Insights Imaging 2022; 13:135. [PMID: 35976510 PMCID: PMC9382599 DOI: 10.1186/s13244-022-01262-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/04/2022] [Indexed: 12/16/2022] Open
Abstract
With the development of heteronuclear fluorine, sodium, phosphorus, and other probes and imaging technologies as well as the optimization of magnetic resonance imaging (MRI) equipment and sequences, multi-nuclear magnetic resonance (multi-NMR) has enabled localize molecular activities in vivo that are central to a variety of diseases, including cardiovascular disease, neurodegenerative pathologies, metabolic diseases, kidney, and tumor, to shift from the traditional morphological imaging to the molecular imaging, precision diagnosis, and treatment mode. However, due to the low natural abundance and low gyromagnetic ratios, the clinical application of multi-NMR has been hampered. Several techniques have been developed to amplify the NMR sensitivity such as the dynamic nuclear polarization, spin-exchange optical pumping, and brute-force polarization. Meanwhile, a wide range of nuclei can be hyperpolarized, such as 2H, 3He, 13C, 15 N, 31P, and 129Xe. The signal can be increased and allows real-time observation of biological perfusion, metabolite transport, and metabolic reactions in vivo, overcoming the disadvantages of conventional magnetic resonance of low sensitivity. HP-NMR imaging of different nuclear substrates provides a unique opportunity and invention to map the metabolic changes in various organs without invasive procedures. This review aims to focus on the recent applications of multi-NMR technology not only in a range of preliminary animal experiments but also in various disease spectrum in human. Furthermore, we will discuss the future challenges and opportunities of this multi-NMR from a clinical perspective, in the hope of truly bridging the gap between cutting-edge molecular biology and clinical applications.
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Affiliation(s)
- Yi Wei
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Caiwei Yang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Hanyu Jiang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Qian Li
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Feng Che
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Shang Wan
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Shan Yao
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Feifei Gao
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Tong Zhang
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China
| | - Jiazheng Wang
- Clinical & Technical Support, Philips Healthcare, Beijing, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, People's Republic of China. .,Department of Radiology, Sanya People's Hospital, Sanya, China.
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14
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Lu J, Wang Z, Bier E, Leewiwatwong S, Mummy D, Driehuys B. Bias field correction in hyperpolarized 129 Xe ventilation MRI using templates derived by RF-depolarization mapping. Magn Reson Med 2022; 88:802-816. [PMID: 35506520 PMCID: PMC9248357 DOI: 10.1002/mrm.29254] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/30/2022] [Accepted: 03/11/2022] [Indexed: 11/08/2022]
Abstract
PURPOSE To correct for RF inhomogeneity for in vivo 129 Xe ventilation MRI using flip-angle mapping enabled by randomized 3D radial acquisitions. To extend this RF-depolarization mapping approach to create a flip-angle map template applicable to arbitrary acquisition strategies, and to compare these approaches to conventional bias field correction. METHODS RF-depolarization mapping was evaluated first in digital simulations and then in 51 subjects who had undergone radial 129 Xe ventilation MRI in the supine position at 3T (views = 3600; samples/view = 128; TR/TE = 4.5/0.45 ms; flip angle = 1.5; FOV = 40 cm). The images were corrected using newly developed RF-depolarization and templated-based methods and the resulting quantitative ventilation metrics (mean, coefficient of variation, and gradient) were compared to those resulting from N4ITK correction. RESULTS RF-depolarization and template-based mapping methods yielded a pattern of RF-inhomogeneity consistent with the expected variation based on coil architecture. The resulting corrected images were visually similar, but meaningfully distinct from those generated using standard N4ITK correction. The N4ITK algorithm eliminated the physiologically expected anterior-posterior gradient (-0.04 ± 1.56%/cm, P < 0.001). These 2 newly introduced methods of RF-depolarization and template correction retained the physiologically expected anterior-posterior ventilation gradient in healthy subjects (2.77 ± 2.09%/cm and 2.01 ± 2.73%/cm, respectively). CONCLUSIONS Randomized 3D 129 Xe MRI ventilation acquisitions can inherently be corrected for bias field, and this technique can be extended to create flip angle templates capable of correcting images from a given coil regardless of acquisition strategy. These methods may be more favorable than the de facto standard N4ITK because they can remove undesirable heterogeneity caused by RF effects while retaining results from known physiology.
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Affiliation(s)
- Junlan Lu
- Medical Physics Graduate Program, Duke University, Durham, North Carolina USA
| | - Ziyi Wang
- Biomedical Engineering, Duke University, Durham, North Carolina USA
| | - Elianna Bier
- Biomedical Engineering, Duke University, Durham, North Carolina USA
| | | | - David Mummy
- Department of Radiology, Duke University Medical Center, Durham, North Carolina USA
| | - Bastiaan Driehuys
- Medical Physics Graduate Program, Duke University, Durham, North Carolina USA
- Biomedical Engineering, Duke University, Durham, North Carolina USA
- Department of Radiology, Duke University Medical Center, Durham, North Carolina USA
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15
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Roach DJ, Willmering MM, Plummer JW, Walkup LL, Zhang Y, Hossain MM, Cleveland ZI, Woods JC. Hyperpolarized 129Xenon MRI Ventilation Defect Quantification via Thresholding and Linear Binning in Multiple Pulmonary Diseases. Acad Radiol 2022; 29 Suppl 2:S145-S155. [PMID: 34393064 PMCID: PMC8837732 DOI: 10.1016/j.acra.2021.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 02/03/2023]
Abstract
RATIONALE There is no agreed upon method for quantifying ventilation defect percentage (VDP) with high sensitivity and specificity from hyperpolarized (HP) gas ventilation MR images in multiple pulmonary diseases for both pediatrics and adults, yet identifying such methods will be necessary for future multi-site trials. Most HP gas MRI ventilation research focuses on a specific pulmonary disease and utilizes one quantification scheme for determining VDP. Here we sought to determine the potential of different methods for quantifying VDP from HP 129Xe images in multiple pulmonary diseases through comparison of the most utilized quantification schemes: linear binning and thresholding. MATERIALS AND METHODS HP 129Xe MRI was performed in a total of 176 subjects (125 pediatrics and 51 adults, age 20.98±16.48 years) who were either healthy controls (n = 23) or clinically diagnosed with cystic fibrosis (CF) (n = 37), lymphangioleiomyomatosis (LAM) (n = 29), asthma (n = 22), systemic juvenile idiopathic arthritis (sJIA) (n = 11), interstitial lung disease (ILD) (n = 7), or were bone marrow transplant (BMT) recipients (n = 47). HP 129Xe ventilation images were acquired during a ≤16 second breath-hold using a 2D multi-slice gradient echo sequence on a 3T Philips scanner (TR/TE 8.0/4.0ms, FA 10-12°, FOV 300 × 300mm, voxel size≈3 × 3 × 15mm). Images were analyzed using 5 different methods to quantify VDPs: linear binning (histogram normalization with binning into 6 clusters) following either linear or a variant of a nonparametric nonuniform intensity normalization algorithm (N4ITK) bias-field correction, thresholding ≤60% of the mean signal intensity with linear bias-field correction, and thresholding ≤60% and ≤75% of the mean signal intensity following N4ITK bias-field correction. Spirometry was successfully obtained in 84% of subjects. RESULTS All quantification schemes were able to label visually identifiable ventilation defects in similar regions within all subjects. The VDPs of control subjects were significantly lower (p<0.05) compared to BMT, CF, LAM, and ILD subjects for most of the quantification methods. No one quantification scheme was better able to differentiate individual disease groups from the control group. Advanced statistical modeling of the VDP quantification schemes revealed that in comparing controls to the combined disease group, N4ITK bias-field corrected 60% thresholding had the highest predictive efficacy, sensitivity, and specificity at the VDP cut-point of 2.3%. However, compared to the thresholding quantification schemes, linear binning was able to capture and label subtle low-ventilation regions in subjects with milder obstruction, such as subjects with asthma. CONCLUSION The difference in VDP between healthy controls and patients varied between the different disease states for all quantification methods. Although N4ITK bias-field corrected 60% thresholding was superior in separating the combined diseased group from controls, linear binning is able to better label low-ventilation regions unlike the current, 60% thresholding scheme. For future clinical trials, a consensus will need to be reached on which VDP scheme to utilize, as there are subtle advantages for each for specific disease.
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Affiliation(s)
- David J Roach
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Joseph W Plummer
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Yin Zhang
- Department of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Md Monir Hossain
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
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16
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Shammi UA, D'Alessandro MF, Altes T, Hersman FW, Ruset IC, Mugler J, Meyer C, Mata J, Qing K, Thomen R. Comparison of Hyperpolarized 3He and 129Xe MR Imaging in Cystic Fibrosis Patients. Acad Radiol 2022; 29 Suppl 2:S82-S90. [PMID: 33487537 DOI: 10.1016/j.acra.2021.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/24/2020] [Accepted: 01/06/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE In this study, we compared hyperpolarized 3He and 129Xe images from patients with cystic fibrosis using two commonly applied magnetic resonance sequences, standard gradient echo (GRE) and balanced steady-state free precession (TrueFISP) to quantify regional similarities and differences in signal distribution and defect analysis. MATERIALS AND METHODS Ten patients (7M/3F) with cystic fibrosis underwent hyperpolarized gas MR imaging with both 3He and 129Xe. Six had MRI with both GRE, and TrueFISP sequences and four patients had only GRE sequence but not TrueFISP. Ventilation defect percentages (VDPs) were calculated as lung voxels with <60% of the whole-lung hyperpolarized gas signal mean and was measured in all datasets. The voxel signal distributions of both 129Xe and 3He gases were visualized and compared using violin plots. VDPs of hyperpolarized 3 He and 129 Xe were compared in Bland-Altman plots; Pearson correlation coefficients were used to evaluate the relationships between inter-gas and inter-scan to assess the reproducibility. RESULTS A significant correlation was demonstrated between 129Xe VDP and 3He VDP for both GRE and TrueFISP sequences (ρ = 0.78, p<0.0004). The correlation between the GRE and TrueFISP VDP for 3He was ρ = 0.98 and was ρ = 0.91 for 129Xe. Overall, 129Xe (27.2±9.4) VDP was higher than 3He (24.3±6.9) VDP on average on cystic fibrosis patients. CONCLUSION In patients with cystic fibrosis, the selection of hyperpolarized 129Xe or 3He gas is most likely inconsequential when it comes to measure the overall lung function by VDP although 129Xe may be more sensitive to starker lung defects, particularly when using a TrueFISP sequence.
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Affiliation(s)
- Ummul Afia Shammi
- Biomedical, Biological, and Chemical Engineering, University of Missouri, Columbia, Missouri
| | | | - Talissa Altes
- Radiology, School of Medicine, University of Missouri, Columbia, Missouri
| | | | | | - John Mugler
- Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia; Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Craig Meyer
- Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia; Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Jamie Mata
- Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Kun Qing
- Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Robert Thomen
- Biomedical, Biological, and Chemical Engineering, University of Missouri, Columbia, Missouri; Radiology, School of Medicine, University of Missouri, Columbia, Missouri.
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17
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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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18
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Huang YCT, Wencker M, Driehuys B. Imaging in alpha-1 antitrypsin deficiency: a window into the disease. Ther Adv Chronic Dis 2021; 12_suppl:20406223211024523. [PMID: 34408834 PMCID: PMC8367205 DOI: 10.1177/20406223211024523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 05/25/2021] [Indexed: 12/21/2022] Open
Abstract
Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.
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Affiliation(s)
- Yuh-Chin Tony Huang
- Department of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Bastiaan Driehuys
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
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19
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Svenningsen S, McIntosh M, Ouriadov A, Matheson AM, Konyer NB, Eddy RL, McCormack DG, Noseworthy MD, Nair P, Parraga G. Reproducibility of Hyperpolarized 129Xe MRI Ventilation Defect Percent in Severe Asthma to Evaluate Clinical Trial Feasibility. Acad Radiol 2021; 28:817-826. [PMID: 32417033 DOI: 10.1016/j.acra.2020.04.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE AND OBJECTIVES 129Xe MRI has been developed to noninvasively visualize and quantify the functional consequence of airway obstruction in asthma. Its widespread application requires evidence of intersite reproducibility and agreement. Our objective was to evaluate reproducibility and agreement of 129Xe ventilation MRI measurements in severe asthmatics at two sites. MATERIALS AND METHODS In seven adults with severe asthma, 129Xe ventilation MRI was acquired pre- and post-bronchodilator at two geographic sites within 24-hours. 129Xe MRI signal-to-noise ratio (SNR) was calculated and ventilation abnormalities were quantified as the whole-lung and slice-by-slice ventilation defect percent (VDP). Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to determine intersite 129Xe VDP reproducibility and agreement. RESULTS Whole-lung and slice-by-slice 129Xe VDP measured at both sites were correlated and reproducible (pre-bronchodilator: whole-lung ICC = 0.90, p = 0.005, slice-by-slice ICC = 0.78, p < 0.0001; post-bronchodilator: whole-lung ICC = 0.94, p < 0.0001, slice-by-slice ICC = 0.83, p < 0.0001) notwithstanding intersite differences in the 129Xe-dose-equivalent-volume (101 ± 15 mL site 1, 49 ± 6 mL site 2, p < 0.0001), gas-mixture (129Xe/4He site 1; 129Xe/N2 site 2) and SNR (40 ± 19 site 1, 23 ± 5 site 2, p = 0.02). Qualitative 129Xe gas distribution differences were observed between sites and slice-by-slice 129Xe VDP, but not whole-lung 129Xe VDP, was significantly lower at site 1 (pre-bronchodilator VDP: whole-lung bias = -3%, p > 0.99, slice-by-slice bias = -3%, p = 0.0001; post-bronchodilator VDP: whole-lung bias = -2%, p = 0.59, slice-by-slice-bias = -2%, p = 0.0003). CONCLUSION 129Xe MRI VDP at two different sites measured within 24-hours in the same severe asthmatics were correlated. Qualitative and quantitative intersite differences in 129Xe regional gas distribution and VDP point to site-specific variability that may be due to differences in gas-mixture composition or SNR.
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Affiliation(s)
- Sarah Svenningsen
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Department of Medicine, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, Canada L8N 4A6.
| | - Marrissa McIntosh
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Alexei Ouriadov
- Department of Physics and Astronomy, Western University, London, Canada
| | - Alexander M Matheson
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Norman B Konyer
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Rachel L Eddy
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | | | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Canada
| | - Parameswaran Nair
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Canada; Department of Medicine, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, Canada L8N 4A6
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada; Department of Medicine, Western University, London, Canada
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20
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Fujita Y, Kent M, Wisner E, Johnson L, Stern J, Qi L, Boone J, Yamamoto T. Combined Assessment of Pulmonary Ventilation and Perfusion with Single-Energy Computed Tomography and Image Processing. Acad Radiol 2021; 28:636-646. [PMID: 32534966 DOI: 10.1016/j.acra.2020.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
Abstract
RATIONALE AND OBJECTIVES To establish a proof-of-principle for combined assessment of pulmonary ventilation and perfusion using single-energy computed tomography (CT) and image processing/analysis (denoted as single-energy CT ventilation/perfusion imaging). MATERIALS AND METHODS Breath-hold CT scans were acquired at end-expiration and end-inspiration before injection of iodinated contrast agents, and repeated at end-inspiration after contrast injection for 17 canines (8 normal and 9 diseased lung subjects). Ventilation images were calculated with deformable image registration to map the end-expiratory and end-inspiratory CT images and quantitative analysis for regional volume changes as surrogates for ventilation. Perfusion images were calculated by subtracting the end-inspiratory precontrast CT from the deformably registered end-inspiratory postcontrast CT, yielding a map of regional Hounsfield unit enhancement as a surrogate for perfusion. Ventilation-perfusion matching, spatial heterogeneity, and gravitationally directed gradients were compared between two groups using a Wilcoxon rank-sum test. RESULTS The normal group had significantly higher Dice similarity coefficients for spatial overlap of segmented functional volumes between ventilation and perfusion (median 0.40 vs. 0.33, p = 0.05), suggesting stronger ventilation-perfusion matching. The normal group also had greater Spearman's correlation coefficients based on 16 regions of interest (median 0.58 vs. 0.40, p = 0.09). The coefficients of variation were comparable (median, ventilation 0.71 vs. 0.91, p = 0.60; perfusion 0.63 vs. 0.75, p = 0.27). The linear regression slopes of gravitationally directed gradient were also comparable for ventilation (median, ventilation -0.26 vs. -0.18, p = 0.19; perfusion -0.17 vs. -0.06, p = 0.11). CONCLUSION These findings provide proof-of-principle for single-energy CT ventilation/perfusion imaging.
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21
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CT Pulmonary Vessels and MRI Ventilation in Chronic Obstructive Pulmonary Disease: Relationship with worsening FEV 1 in the TINCan cohort study. Acad Radiol 2021; 28:495-506. [PMID: 32303446 DOI: 10.1016/j.acra.2020.03.006] [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: 02/19/2020] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 12/20/2022]
Abstract
RATIONALE AND OBJECTIVES The relationships between computed tomography (CT) pulmonary vascularity and MRI ventilation is not well-understood in chronic obstructive pulmonary disease (COPD) patients. Our objective was to evaluate CT pulmonary vascular and MRI ventilation measurements in ex-smokers and to investigate their associations and how such measurements change over time. MATERIALS AND METHODS Ninety ex-smokers (n = 41 without COPD 71 ± 10 years and n = 49 COPD 71 ± 8 years) provided written informed-consent to an ethics-board approved protocol and underwent imaging and pulmonary-function-tests twice, 31 ± 7 months apart. 3He MRI was acquired to generate ventilation-defect-percent (VDP). CT measurements of the relative area-of-the-lung with attenuation <-950 Hounsfield units (RA950), pulmonary vascular total-blood-volume (TBV) and percent of vessels with radius < one voxel (PV1) were evaluated. RESULTS At baseline, there were significant differences in RA950 (p = 0.0001), VDP (p = 0.0001), total-blood-volume (p = 0.0001) and PV1 (p = 0.01) between ex-smokers and COPD participants as well as for VDP (p = 0.0001) in COPD participants with and without emphysema. The annual FEV1 change (-40 ± 93 mL/year) was not different among participant subgroups (p = 0.87), but the annual RA950 (p = 0.01) and PV1 (p = 0.007) changes were significantly different in participants with an accelerated annual FEV1 decline as compared to participants with a diminished annual FEV1 decline. There were significant but weak relationships for PV1 with FEV1%pred (p = 0.02), FEV1/FVC (p = 0.001), and log RA950 (p = 0.0001), but not VDP (p=0.20). The mean change in PV1 was also weakly but significantly related to the change in RA950 (p = 0.02). CONCLUSION CT pulmonary vascular measurements were significantly different in ex-smokers and participants with COPD and related to RA950 but not VDP worsening over 2.5 years.
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22
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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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23
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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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24
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Goralski JL, Stewart NJ, Woods JC. Novel imaging techniques for cystic fibrosis lung disease. Pediatr Pulmonol 2021; 56 Suppl 1:S40-S54. [PMID: 32592531 PMCID: PMC7808406 DOI: 10.1002/ppul.24931] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/25/2020] [Indexed: 12/24/2022]
Abstract
With an increasing number of patients with cystic fibrosis (CF) receiving highly effective CFTR (cystic fibrosis transmembrane regulator protein) modulator therapy, particularly at a young age, there is an increasing need to identify imaging tools that can detect and regionally visualize mild CF lung disease and subtle changes in disease state. In this review, we discuss the latest developments in imaging modalities for both structural and functional imaging of the lung available to CF clinicians and researchers, from the widely available, clinically utilized imaging methods for assessing CF lung disease-chest radiography and computed tomography-to newer techniques poised to become the next phase of clinical tools-structural/functional proton and hyperpolarized gas magnetic resonance imaging (MRI). Finally, we provide a brief discussion of several newer lung imaging techniques that are currently available only in selected research settings, including chest tomosynthesis, and fluorinated gas MRI. We provide an update on the clinical and/or research status of each technique, with a focus on sensitivity, early disease detection, and possibilities for monitoring treatment efficacy.
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Affiliation(s)
- Jennifer L Goralski
- UNC Cystic Fibrosis Center, Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Pulmonary and Critical Care Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Pediatric Pulmonology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neil J Stewart
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Infection, Immunity & Cardiovascular Disease, POLARIS Group, Imaging Sciences, University of Sheffield, Sheffield, UK
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.,Department of Radiology, Cincinnati Children's Hospital, Cincinnati, Ohio
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25
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Pippard BJ, Neal MA, Maunder AM, Hollingsworth KG, Biancardi A, Lawson RA, Fisher H, Matthews JNS, Simpson AJ, Wild JM, Thelwall PE. Reproducibility of 19 F-MR ventilation imaging in healthy volunteers. Magn Reson Med 2021; 85:3343-3352. [PMID: 33507591 PMCID: PMC7986730 DOI: 10.1002/mrm.28660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 01/23/2023]
Abstract
Purpose To assess the reproducibility of percentage ventilated lung volume (%VV) measurements in healthy volunteers acquired by fluorine (19F)‐MRI of inhaled perfluoropropane, implemented at two research sites. Methods In this prospective, ethically approved study, 40 healthy participants were recruited (May 2018‐June 2019) to one of two research sites. Participants underwent a single MRI scan session on a 3T scanner, involving periodic inhalation of a 79% perfluoropropane/21% oxygen gas mixture. Each gas inhalation session lasted about 30 seconds, consisting of three deep breaths of gas followed by a breath‐hold. Four 19F‐MR ventilation images were acquired per participant, each separated by approximately 6 minutes. The value of %VV was determined by registering separately acquired 1H images to ventilation images before semi‐automated image segmentation, performed independently by two observers. Reproducibility of %VV measurements was assessed by components of variance, intraclass correlation coefficients, coefficients of variation (CoV), and the Dice similarity coefficient. Results The MRI scans were well tolerated throughout, with no adverse events. There was a high degree of consistency in %VV measurements for each participant (CoVobserver1 = 0.43%; CoVobserver2 = 0.63%), with overall precision of %VV measurements determined to be within ± 1.7% (95% confidence interval). Interobserver agreement in %VV measurements revealed a high mean Dice similarity coefficient (SD) of 0.97 (0.02), with only minor discrepancies between observers. Conclusion We demonstrate good reproducibility of %VV measurements in a group of healthy participants using 19F‐MRI of inhaled perfluoropropane. Our methods have been successfully implemented across two different study sites, supporting the feasibility of performing larger multicenter clinical studies.
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Affiliation(s)
- Benjamin J. Pippard
- Newcastle Magnetic Resonance CentreNewcastle UniversityNewcastle upon TyneUnited Kingdom
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Mary A. Neal
- Newcastle Magnetic Resonance CentreNewcastle UniversityNewcastle upon TyneUnited Kingdom
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Adam M. Maunder
- POLARIS, Department of IICDUniversity of SheffieldRoyal Hallamshire HospitalSheffieldUnited Kingdom
| | - Kieren G. Hollingsworth
- Newcastle Magnetic Resonance CentreNewcastle UniversityNewcastle upon TyneUnited Kingdom
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Alberto Biancardi
- POLARIS, Department of IICDUniversity of SheffieldRoyal Hallamshire HospitalSheffieldUnited Kingdom
| | - Rod A. Lawson
- Respiratory MedicineSheffield Teaching Hospitals National Health Service Foundation TrustSheffieldUnited Kingdom
| | - Holly Fisher
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - John N. S. Matthews
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
- School of Mathematics, Statistics and PhysicsNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - A. John Simpson
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
- Respiratory MedicineNewcastle upon Tyne Hospitals National Health Service Foundation TrustNewcastle upon TyneUnited Kingdom
| | - Jim M. Wild
- POLARIS, Department of IICDUniversity of SheffieldRoyal Hallamshire HospitalSheffieldUnited Kingdom
| | - Peter E. Thelwall
- Newcastle Magnetic Resonance CentreNewcastle UniversityNewcastle upon TyneUnited Kingdom
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUnited Kingdom
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26
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Amzajerdian F, Ruppert K, Hamedani H, Baron R, Xin Y, Loza L, Achekzai T, Duncan IF, Qian Y, Pourfathi M, Kadlecek S, Rizi RR. Measuring pulmonary gas exchange using compartment-selective xenon-polarization transfer contrast (XTC) MRI. Magn Reson Med 2020; 85:2709-2722. [PMID: 33283943 DOI: 10.1002/mrm.28626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE To demonstrate the feasibility of generating red blood cell (RBC) and tissue/plasma (TP)-specific gas-phase (GP) depolarization maps using xenon-polarization transfer contrast (XTC) MR imaging. METHODS Imaging was performed in three healthy subjects, an asymptomatic smoker, and a chronic obstructive pulmonary disease (COPD) patient. Single-breath XTC data were acquired through a series of three GP images using a 2D multi-slice GRE during a 12 s breath-hold. A series of 8 ms Gaussian inversion pulses spaced 30 ms apart were applied in-between the images to quantify the exchange between the GP and dissolved-phase (DP) compartments. Inversion pulses were either centered on-resonance to generate contrast, or off-resonance to correct for other sources of signal loss. For an alternative scheme, inversions of both RBC and TP resonances were inserted in lieu of off-resonance pulses. Finally, this technique was extended to a multi-breath protocol consistent with tidal breathing, involving 30 consecutive acquisitions. RESULTS Inversion pulses shifted off-resonance by 20 ppm to mimic the distance between the RBC and TP resonances demonstrated selectivity, and initial GP depolarization maps illustrated stark magnitude and distribution differences between healthy and diseased subjects that were consistent with traditional approaches. CONCLUSION The proposed DP-compartment selective XTC MRI technique provides information on gas exchange between all three detectable states of xenon in the lungs and is sufficiently sensitive to indicate differences in lung function between the study subjects. Investigated extensions of this approach to imaging schemes that either minimize breath-hold duration or the overall number of breath-holds open avenues for future research to improve measurement accuracy and patient comfort.
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Affiliation(s)
- Faraz Amzajerdian
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kai Ruppert
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ryan Baron
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yi Xin
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Luis Loza
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tahmina Achekzai
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ian F Duncan
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yiwen Qian
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mehrdad Pourfathi
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rahim R Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Kim M, Doganay O, Hwang HJ, Seo JB, Gleeson FV. Lobar Ventilation in Patients with COPD Assessed with the Full-Scale Airway Network Flow Model and Xenon-enhanced Dual-Energy CT. Radiology 2020; 298:201-209. [PMID: 33231530 DOI: 10.1148/radiol.2020202485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background The full-scale airway network (FAN) flow model shows excellent agreement with limited functional imaging data but requires further validation prior to clinical use. Purpose To validate the ventilation distributions computed with the FAN flow model with xenon ventilation from xenon-enhanced dual-energy (DE) CT in participants with chronic obstructive pulmonary disease (COPD). Materials and Methods In this prospective study, the FAN model extracted structural data from xenon-enhanced DE CT images of men with COPD scanned between June 2012 and July 2013 to compute gas ventilation dynamics. The ventilation distributions on the middle cross-section plane, percentage lobar ventilation, and ventilation heterogeneity quantified by the coefficient of variation (CV) were compared between xenon-enhanced DE CT imaging and the FAN model. The relationship between the ventilation parameters with the densitometry and pulmonary function test results was demonstrated. The agreements and correlations between the parameters were measured using the concordance correlation coefficient and the Pearson correlation coefficient. Results Twenty-two men with COPD (mean age, 67 years ± 7 [standard deviation]) were evaluated. The percentage lobar ventilation computed with FAN showed a strong positive correlation with xenon-enhanced DE CT data (r = 0.7, P < .001). Ninety-five percent of lobar ventilation CV differences lay within 95% confidence intervals. Correlations of the percentage lobar ventilation were negative for percentage emphysema (xenon-enhanced DE CT: r = -0.38, P < .001; FAN: r = -0.23, P = .02) but were positive for percentage normal tissue volume (xenon-enhanced DE CT: r = 0.78, P < .001; FAN: r = 0.45, P < .001). Lung CVs of FAN revealed negative correlations with the spirometry results (CVFAN vs percentage predicted forced expiratory volume in 1 second: r = -0.75, P < .001; CVFAN vs ratio of forced expiratory volume in 1 second to forced vital capacity: r = -0.67, P < .001). Conclusion The full-scale airway network modeled lobar ventilation in patients with chronic obstructive pulmonary disease correlated with the xenon-enhanced dual-energy CT imaging data. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Parraga and Eddy in this issue.
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Affiliation(s)
- Minsuok Kim
- From the School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough LE11 3TU, England (M.K.); Healthy Science Institute, Ege University, Izmir, Turkey (O.D.); Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (H.J.H., J.B.S.); Department of Oncology, University of Oxford, Oxford, England (F.V.G.); and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (F.V.G.)
| | - Ozkan Doganay
- From the School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough LE11 3TU, England (M.K.); Healthy Science Institute, Ege University, Izmir, Turkey (O.D.); Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (H.J.H., J.B.S.); Department of Oncology, University of Oxford, Oxford, England (F.V.G.); and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (F.V.G.)
| | - Hye Jeon Hwang
- From the School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough LE11 3TU, England (M.K.); Healthy Science Institute, Ege University, Izmir, Turkey (O.D.); Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (H.J.H., J.B.S.); Department of Oncology, University of Oxford, Oxford, England (F.V.G.); and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (F.V.G.)
| | - Joon Beom Seo
- From the School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough LE11 3TU, England (M.K.); Healthy Science Institute, Ege University, Izmir, Turkey (O.D.); Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (H.J.H., J.B.S.); Department of Oncology, University of Oxford, Oxford, England (F.V.G.); and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (F.V.G.)
| | - Fergus V Gleeson
- From the School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough LE11 3TU, England (M.K.); Healthy Science Institute, Ege University, Izmir, Turkey (O.D.); Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (H.J.H., J.B.S.); Department of Oncology, University of Oxford, Oxford, England (F.V.G.); and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (F.V.G.)
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Tafti S, Garrison WJ, Mugler JP, Shim YM, Altes TA, Mata JF, de Lange EE, Cates GD, Ropp AM, Wang C, Miller GW. Emphysema Index Based on Hyperpolarized 3He or 129Xe Diffusion MRI: Performance and Comparison with Quantitative CT and Pulmonary Function Tests. Radiology 2020; 297:201-210. [PMID: 32779976 PMCID: PMC7526952 DOI: 10.1148/radiol.2020192804] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/31/2020] [Accepted: 06/12/2020] [Indexed: 12/19/2022]
Abstract
Background Apparent diffusion coefficient (ADC) maps of inhaled hyperpolarized gases have shown promise in the characterization of emphysema in patients with chronic obstructive pulmonary disease (COPD), yet an easily interpreted quantitative metric beyond mean and standard deviation has not been established. Purpose To introduce a quantitative framework with which to characterize emphysema burden based on hyperpolarized helium 3 (3He) and xenon 129 (129Xe) ADC maps and compare its diagnostic performance with CT-based emphysema metrics and pulmonary function tests (PFTs). Materials and Methods Twenty-seven patients with mild, moderate, or severe COPD and 13 age-matched healthy control subjects participated in this retrospective study. Participants underwent CT and multiple b value diffusion-weighted 3He and 129Xe MRI examinations and standard PFTs between August 2014 and November 2017. ADC-based emphysema index was computed separately for each gas and b value as the fraction of lung voxels with ADC values greater than in the healthy group 99th percentile. The resulting values were compared with quantitative CT results (relative lung area <-950 HU) as the reference standard. Diagnostic performance metrics included area under the receiver operating characteristic curve (AUC). Spearman rank correlations and Wilcoxon rank sum tests were performed between ADC-, CT-, and PFT-based metrics, and intraclass correlation was performed between repeated measurements. Results Thirty-six participants were evaluated (mean age, 60 years ± 6 [standard deviation]; 20 women). ADC-based emphysema index was highly repeatable (intraclass correlation coefficient > 0.99) and strongly correlated with quantitative CT (r = 0.86, P < .001 for 3He; r = 0.85, P < .001 for 129Xe) with high AUC (≥0.93; 95% confidence interval [CI]: 0.85, 1.00). ADC emphysema indices were also correlated with percentage of predicted diffusing capacity of lung for carbon monoxide (r = -0.81, P < .001 for 3He; r = -0.80, P < .001 for 129Xe) and percentage of predicted residual lung volume divided by total lung capacity (r = 0.65, P < .001 for 3He; r = 0.61, P < .001 for 129Xe). Conclusion Emphysema index based on hyperpolarized helium 3 or xenon 129 diffusion MRI provides a repeatable measure of emphysema burden, independent of gas or b value, with similar diagnostic performance as quantitative CT or pulmonary function metrics. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Schiebler and Fain in this issue.
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Affiliation(s)
- Sina Tafti
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - William J. Garrison
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - John P. Mugler
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Y. Michael Shim
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Talissa A. Altes
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Jaime F. Mata
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Eduard E. de Lange
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Gordon D. Cates
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Alan M. Ropp
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - Chengbo Wang
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
| | - G. Wilson Miller
- From the Departments of Physics (S.T., G.D.C.), Biomedical Engineering (W.J.G., J.P.M., G.W.M.), Radiology and Medical Imaging (J.P.M., J.F.M., E.E.d.L., A.M.R., G.W.M.), and Medicine (Y.M.S.), University of Virginia, Box 801339, Charlottesville, VA 22908; Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); and Department of Science and Engineering, University of Nottingham, Ningbo, China (C.W.)
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Cyst Ventilation Heterogeneity and Alveolar Airspace Dilation as Early Disease Markers in Lymphangioleiomyomatosis. Ann Am Thorac Soc 2020; 16:1008-1016. [PMID: 31038987 DOI: 10.1513/annalsats.201812-880oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Rationale: Lymphangioleiomyomatosis (LAM) is a rare disease associated with cystic destruction of the pulmonary parenchyma and chronic respiratory failure, and there are trials underway to determine if early intervention can prevent disease progression. An imaging technique that is sensitive to early regional disease would therefore be valuable for patient care and clinical trials.Objectives: We postulated that hyperpolarized 129Xe MRI would be sensitive to ventilation abnormalities and alveolar airspace dilation in patients with mild LAM disease and normal pulmonary function and that 129Xe MRI would reveal important features of cyst ventilation.Methods: 129Xe ventilation and diffusion-weighted MR images were acquired in 22 patients with LAM during two breath-holds of hyperpolarized 129Xe. 129Xe ventilation defect percentage (VDP; percentage of voxels <60% of the mean whole-lung 129Xe MRI signal) and apparent diffusion coefficient (ADC), a measure of alveolar airspace size, were quantified and compared with pulmonary function test parameters with Spearman statistics. Sixteen patients with LAM had a recent, clinical chest computed tomography (CT) scan available, and cyst ventilation was assessed by thresholding cysts on the CT images and registration to the 129Xe ventilation images.Results: Ventilation deficits were observed in all patients with LAM, including those with normal pulmonary function and few cysts, and the mean VDP was 19.2% (95% confidence interval [CI], 14.8-23.5%). 129Xe VDP was strongly correlated with forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio (r = -0.51, P = 0.02) and diffusing capacity of the lung for carbon monoxide (DlCO) (r = -0.60, P = 0.009) but not with FEV1 (r = -0.33, P = 0.13), likely because of the sensitivity of 129Xe MRI to mild LAM disease in patients with normal FEV1. The mean ADC was 0.048 cm2/s (95% CI, 0.042-0.053 cm2/s). In many cases, ADC was elevated relative to previously reported values in adults, and ADC was correlated with FEV1, FEV1/FVC ratio, and DlCO (P ≤ 0.02 for all). Co-registered 129Xe MRI and CT imaging revealed considerable ventilation heterogeneity within individual patients with LAM and across patients with similarly sized cysts.Conclusions: 129Xe MRI provides a means to assess the complex regional ventilation and alveolar airspace size changes of LAM with high sensitivity and may be a clinically useful future tool for screening, managing patients, and measuring treatment efficacy.
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Klimeš F, Voskrebenzev A, Gutberlet M, Kern AL, Behrendt L, Grimm R, Suhling H, Crisosto CG, Kaireit TF, Pöhler GH, Glandorf J, Wacker F, Vogel-Claussen J. 3D phase-resolved functional lung ventilation MR imaging in healthy volunteers and patients with chronic pulmonary disease. Magn Reson Med 2020; 85:912-925. [PMID: 32926451 DOI: 10.1002/mrm.28482] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/04/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To test the feasibility of 3D phase-resolved functional lung (PREFUL) MRI in healthy volunteers and patients with chronic pulmonary disease, to compare 3D to 2D PREFUL, and to investigate the required temporal resolution to obtain stable 3D PREFUL measurement. METHODS Sixteen participants underwent MRI using 2D and 3D PREFUL. Retrospectively, the spatial resolution of 3D PREFUL (4 × 4 × 4 mm3 ) was decreased to match the spatial resolution of 2D PREFUL (4 × 4 × 15 mm3 ), abbreviated as 3Dlowres . In addition to regional ventilation (RVent), flow-volume loops were computed and rated by a cross-correlation (CC). Ventilation defect percentage (VDP) maps were obtained. RVent, CC, VDPRVent , and VDPCC were compared for systematic differences between 2D, 3Dlowres , and 3D PREFUL. Dividing the 3D PREFUL data into 4- (≈ 20 phases), 8- (≈ 40 phases), and 12-min (≈ 60 phases) acquisition pieces, the ventilation parameter maps, including the heterogeneity of ventilation time to peak, were tested regarding the required temporal resolution. RESULTS RVent, CC, VDPRVent , and VDPCC presented significant correlations between 2D and 3D PREFUL (r = 0.64-0.94). CC and VDPCC of 2D and 3Dlowres PREFUL were significantly different (P < .0113). Comparing 3Dlowres and 3D PREFUL, all parameters were found to be statistically different (P < .0045). CONCLUSION 3D PREFUL MRI depicts the whole lung volume and breathing cycle with superior image resolution and with likely more precision compared to 2D PREFUL. Furthermore, 3D PREFUL is more sensitive to detect regions of hypoventilation and ventilation heterogeneity compared to 3Dlowres PREFUL, which is important for early detection and improved monitoring of patients with chronic lung disease.
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Affiliation(s)
- Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Marcel Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Agilo Luitger Kern
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Lea Behrendt
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | | | - Hendrik Suhling
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany.,Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Cristian Gonzales Crisosto
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Till Frederick Kaireit
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Gesa Helen Pöhler
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Julian Glandorf
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
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Hall CS, Quirk JD, Goss CW, Lew D, Kozlowski J, Thomen RP, Woods JC, Tustison NJ, Mugler JP, Gallagher L, Koch T, Schechtman KB, Ruset IC, Hersman FW, Castro M. Single-Session Bronchial Thermoplasty Guided by 129Xe Magnetic Resonance Imaging. A Pilot Randomized Controlled Clinical Trial. Am J Respir Crit Care Med 2020; 202:524-534. [PMID: 32510976 PMCID: PMC7427382 DOI: 10.1164/rccm.201905-1021oc] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/08/2020] [Indexed: 12/14/2022] Open
Abstract
Rationale: Adverse events have limited the use of bronchial thermoplasty (BT) in severe asthma.Objectives: We sought to evaluate the effectiveness and safety of using 129Xe magnetic resonance imaging (129Xe MRI) to prioritize the most involved airways for guided BT.Methods: Thirty subjects with severe asthma were imaged with volumetric computed tomography and 129Xe MRI to quantitate segmental ventilation defects. Subjects were randomized to treatment of the six most involved airways in the first session (guided group) or a standard three-session BT (unguided). The primary outcome was the change in Asthma Quality of Life Questionnaire score from baseline to 12 weeks after the first BT for the guided group compared with after three treatments for the unguided group.Measurements and Main Results: There was no significant difference in quality of life after one guided compared with three unguided BTs (change in Asthma Quality of Life Questionnaire guided = 0.91 [95% confidence interval, 0.28-1.53]; unguided = 1.49 [95% confidence interval, 0.84-2.14]; P = 0.201). After one BT, the guided group had a greater reduction in the percentage of poorly and nonventilated lung from baseline when compared with unguided (-17.2%; P = 0.009). Thirty-three percent experienced asthma exacerbations after one guided BT compared with 73% after three unguided BTs (P = 0.028).Conclusions: Results of this pilot study suggest that similar short-term improvements can be achieved with one BT treatment guided by 129Xe MRI when compared with standard three-treatment-session BT with fewer periprocedure adverse events.
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Affiliation(s)
- Chase S. Hall
- University of Kansas School of Medicine, Kansas City, Kansas
- Washington University School of Medicine, St. Louis, Missouri
| | - James D. Quirk
- Washington University School of Medicine, St. Louis, Missouri
| | - Charles W. Goss
- Washington University School of Medicine, St. Louis, Missouri
| | - Daphne Lew
- Washington University School of Medicine, St. Louis, Missouri
| | - Jim Kozlowski
- Washington University School of Medicine, St. Louis, Missouri
| | | | - Jason C. Woods
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | - John P. Mugler
- University of Virginia School of Medicine, Charlottesville, Virginia; and
| | - Lora Gallagher
- Washington University School of Medicine, St. Louis, Missouri
| | - Tammy Koch
- Washington University School of Medicine, St. Louis, Missouri
| | | | | | | | - Mario Castro
- University of Kansas School of Medicine, Kansas City, Kansas
- Washington University School of Medicine, St. Louis, Missouri
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He M, Wang Z, Rankine L, Luo S, Nouls J, Virgincar R, Mammarappallil J, Driehuys B. Generalized Linear Binning to Compare Hyperpolarized 129Xe Ventilation Maps Derived from 3D Radial Gas Exchange Versus Dedicated Multislice Gradient Echo MRI. Acad Radiol 2020; 27:e193-e203. [PMID: 31786076 DOI: 10.1016/j.acra.2019.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/02/2019] [Accepted: 10/16/2019] [Indexed: 12/27/2022]
Abstract
RATIONALE Hyperpolarized 129Xe ventilation MRI is typically acquired using multislice fast gradient recalled echo (GRE), but interleaved 3D radial 129Xe gas transfer MRI now provides dissolved-phase and ventilation images from a single breath. To investigate whether these ventilation images provide equivalent quantitative metrics, we introduce generalized linear binning analysis. METHODS This study included 36 patients who had undergone both multislice GRE ventilation and 3D radial gas exchange imaging. Images were then quantified by linear binning to classify voxels into one of four clusters: ventilation defect percentage (VDP), Low-, Medium- or High-ventilation percentage (LVP, MVP, HVP). For 3D radial images, linear binning thresholds were generalized using a Box-Cox rescaled reference histogram. We compared the cluster populations from the two ventilation acquisitions both numerically and spatially. RESULTS Interacquisition Bland-Altman limits of agreement for the clusters between 3D radial vs GRE were (-7% to 5%) for VDP, (-10% to 14%) for LVP, and (-8% to 8%) for HVP. While binning maps were qualitatively similar between acquisitions, their spatial overlap was modest for VDP (Dice = 0.5 ± 0.2), and relatively poor for LVP (0.3 ± 0.1) and HVP (0.2 ± 0.1). CONCLUSION Both acquisitions yield reasonably concordant VDP and qualitatively similar maps. However, poor regional agreement (Dice) suggests that the two acquisitions cannot yet be used interchangeably. However, further improvements in 3D radial resolution and reconciliation of bias field correction may well obviate the need for a dedicated ventilation scan in many cases.
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Affiliation(s)
- Mu He
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina; Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, NC 27710
| | - Ziyi Wang
- Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, NC 27710; Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Leith Rankine
- Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, NC 27710; Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina
| | - Sheng Luo
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - John Nouls
- Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, NC 27710; Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Rohan Virgincar
- Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, NC 27710; Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | | | - Bastiaan Driehuys
- Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, NC 27710; Department of Biomedical Engineering, Duke University, Durham, North Carolina; Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina; Department of Radiology, Duke University Medical Center, Durham, North Carolina.
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Eddy RL, Serajeddini H, Knipping D, Landman ST, Bosma KJ, Mackenzie CA, Dhaliwal I, Parraga G. Pulmonary Functional MRI and CT in a Survivor of Bronchiolitis and Respiratory Failure Caused by e-Cigarette Use. Chest 2020; 158:e147-e151. [PMID: 32544490 DOI: 10.1016/j.chest.2020.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 11/16/2022] Open
Abstract
Although nearly 3,000 e-cigarette-related hospitalizations have been reported in North America, the long-term outcomes in these patients have not been described. We followed an 18-year-old boy who survived acute critical illness and respiratory failure related to 5 months of e-cigarette use. Chronic irreversible airflow obstruction and markedly abnormal 129Xe MRI ventilation heterogeneity was observed and persisted 8 months after hospital discharge, despite improvement in quality-of-life and chest CT findings. Lung clearance index and oscillometry measures were also highly abnormal at 8 months postdischarge. Although 129Xe MRI ventilation abnormalities were dominant in the lung apices and central lung regions, the pattern of ventilation defects was dissimilar to ventilation heterogeneity observed in patients with obstructive lung disease, such as asthma and COPD. Our findings underscore the long-term functional impacts of e-cigarette-related lung injury in survivors of critical illness; longitudinal evaluations may shed light on the pathophysiologic mechanisms that drive e-cigarette-related lung disease.
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Affiliation(s)
- Rachel L Eddy
- Robarts Research Institute, Department of Medicine, Western University, London, ON, Canada; Department of Medical Biophysics, Department of Medicine, Western University, London, ON, Canada
| | - Hana Serajeddini
- Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada
| | - Danielle Knipping
- Robarts Research Institute, Department of Medicine, Western University, London, ON, Canada
| | - Simon T Landman
- Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada
| | - Karen J Bosma
- Critical Care, Department of Medicine, Western University, London, ON, Canada
| | - Constance A Mackenzie
- Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada; Clinical Pharmacology and Toxicology, Department of Medicine, Western University, London, ON, Canada; Nunavut Poison Centre, Ontario, MB, Canada
| | - Inderdeep Dhaliwal
- Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada
| | - Grace Parraga
- Robarts Research Institute, Department of Medicine, Western University, London, ON, Canada; Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada.
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MacNeil JL, Capaldi DPI, Westcott AR, Eddy RL, Barker AL, McCormack DG, Kirby M, Parraga G. Pulmonary Imaging Phenotypes of Chronic Obstructive Pulmonary Disease Using Multiparametric Response Maps. Radiology 2020; 295:227-236. [PMID: 32096708 DOI: 10.1148/radiol.2020191735] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Pulmonary imaging of chronic obstructive pulmonary disease (COPD) has focused on CT or MRI measurements, but these have not been evaluated in combination. Purpose To generate multiparametric response map (mPRM) measurements in ex-smokers with or without COPD by using volume-matched CT and hyperpolarized helium 3 (3He) MRI. Materials and Methods In this prospective study (https://clinicaltrials.gov, NCT02279329), participants underwent MRI and CT and completed pulmonary function tests, questionnaires, and the 6-minute walk test between December 2010 and January 2019. Disease status was determined by using Global initiative for chronic Obstructive Lung Disease (GOLD) criteria. The mPRM voxel values were generated by using co-registered MRI and CT labels. Kruskal-Wallis and Bonferroni tests were used to determine differences across disease severity, and correlations were determined by using Spearman coefficients. Results A total of 175 ex-smokers (mean age, 69 years ± 9 [standard deviation], 108 men) with or without COPD were evaluated. Ex-smokers without COPD had a larger fraction of normal mPRM voxels (60% vs 37%, 20%, and 7% for GOLD I, II, and III/IV disease, respectively; all P ≤ .001) and a smaller fraction of abnormal voxels, including small airways disease (normal CT, not ventilated: 5% vs 6% [not significant], 11%, and 19% [P ≤ .001 for both] for GOLD I, II, and III/IV disease, respectively) and mild emphysema (normal CT, abnormal apparent diffusion coefficient [ADC]: 33% vs 54%, 56%, and 54% for GOLD I, II, and III/IV disease respectively; all P ≤ .001). Normal mPRM measurements were positively correlated with forced expiratory volume in 1 second (FEV1) (r = 0.65, P < .001), the FEV1-to-forced vital capacity ratio (r = 0.81, P < .001), and diffusing capacity (r = 0.75, P < .001) and were negatively correlated with worse quality of life (r = -0.48, P < .001). Abnormal mPRM measurements of small airways disease (normal CT, not ventilated) and mild emphysema (normal CT, abnormal ADC) were negatively correlated with FEV1 (r = -0.65 and -0.42, respectively; P < .001) and diffusing capacity (r = -0.53 and -0.60, respectively; P < .001) and were positively correlated with worse quality of life (r = 0.45 and r = 0.33, respectively; P < .001), both of which were present in ex-smokers without COPD. Conclusion Multiparametric response maps revealed two abnormal structure-function results related to emphysema and small airways disease, both of which were unexpectedly present in ex-smokers with normal spirometry and CT findings. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Jonathan L MacNeil
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - Dante P I Capaldi
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - Andrew R Westcott
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - Rachel L Eddy
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - Andrea L Barker
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - David G McCormack
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - Miranda Kirby
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
| | - Grace Parraga
- From the Robarts Research Institute (J.L.M., A.R.W., R.L.E., A.L.B., G.P.), School of Biomedical Engineering (J.L.M., G.P.), Department of Medical Biophysics (A.R.W., R.L.E., A.L.B., G.P.), and Division of Respirology, Department of Medicine (D.G.M., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, Calif (D.P.I.C.); and Department of Physics, Ryerson University, Toronto, Ontario, Canada (M.K.)
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Wang Z, Bier EA, Swaminathan A, Parikh K, Nouls J, He M, Mammarappallil JG, Luo S, Driehuys B, Rajagopal S. Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures. Eur Respir J 2019; 54:13993003.00831-2019. [PMID: 31619473 DOI: 10.1183/13993003.00831-2019] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/12/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND As an increasing number of patients exhibit concomitant cardiac and pulmonary disease, limitations of standard diagnostic criteria are more frequently encountered. Here, we apply noninvasive 129Xe magnetic resonance imaging (MRI) and spectroscopy to identify patterns of regional gas transfer impairment and haemodynamics that are uniquely associated with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), left heart failure (LHF) and pulmonary arterial hypertension (PAH). METHODS Healthy volunteers (n=23) and patients with COPD (n=8), IPF (n=12), LHF (n=6) and PAH (n=10) underwent 129Xe gas transfer imaging and dynamic spectroscopy. For each patient, three-dimensional maps were generated to depict ventilation, barrier uptake (129Xe dissolved in interstitial tissue) and red blood cell (RBC) transfer (129Xe dissolved in RBCs). Dynamic 129Xe spectroscopy was used to quantify cardiogenic oscillations in the RBC signal amplitude and frequency shift. RESULTS Compared with healthy volunteers, all patient groups exhibited decreased ventilation and RBC transfer (both p≤0.01). Patients with COPD demonstrated more ventilation and barrier defects compared with all other groups (both p≤0.02). In contrast, IPF patients demonstrated elevated barrier uptake compared with all other groups (p≤0.007), and increased RBC amplitude and shift oscillations compared with healthy volunteers (p=0.007 and p≤0.01, respectively). Patients with COPD and PAH both exhibited decreased RBC amplitude oscillations (p=0.02 and p=0.005, respectively) compared with healthy volunteers. LHF was distinguishable from PAH by enhanced RBC amplitude oscillations (p=0.01). CONCLUSION COPD, IPF, LHF and PAH each exhibit unique 129Xe MRI and dynamic spectroscopy signatures. These metrics may help with diagnostic challenges in cardiopulmonary disease and increase understanding of regional lung function and haemodynamics at the alveolar-capillary level.
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Affiliation(s)
- Ziyi Wang
- Dept of Biomedical Engineering, Duke University, Durham, NC, USA.,Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA.,These two authors are joint first authors
| | - Elianna A Bier
- Dept of Biomedical Engineering, Duke University, Durham, NC, USA.,Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA.,These two authors are joint first authors
| | - Aparna Swaminathan
- Division of Pulmonary, Allergy, and Critical Care, Dept of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Kishan Parikh
- Division of Pulmonary, Allergy, and Critical Care, Dept of Medicine, Duke University Medical Center, Durham, NC, USA
| | - John Nouls
- Dept of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Mu He
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA.,Dept of Electrical and Computer Engineering, Duke University, Durham, NC, USA
| | | | - Sheng Luo
- Dept of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Bastiaan Driehuys
- Dept of Biomedical Engineering, Duke University, Durham, NC, USA.,Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, USA.,Dept of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Sudarshan Rajagopal
- Division of Cardiology, Dept of Medicine, Duke University Medical Center, Durham, NC, USA
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Willmering MM, Niedbalski PJ, Wang H, Walkup LL, Robison RK, Pipe JG, Cleveland ZI, Woods JC. Improved pulmonary 129 Xe ventilation imaging via 3D-spiral UTE MRI. Magn Reson Med 2019; 84:312-320. [PMID: 31788858 DOI: 10.1002/mrm.28114] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE Hyperpolarized 129 Xe MRI characterizes regional lung ventilation in a variety of disease populations, with high sensitivity to airway obstruction in early disease. However, ventilation images are usually limited to a single breath-hold and most-often acquired using gradient-recalled echo sequences with thick slices (~10-15 mm), which increases partial-volume effects, limits ability to observe small defects, and suffers from imperfect slice selection. We demonstrate higher-resolution ventilation images, in shorter breath-holds, using FLORET (Fermat Looped ORthogonally Encoded Trajectories), a center-out 3D-spiral UTE sequence. METHODS In vivo human adult (N = 4; 2 healthy, 2 with cystic fibrosis) 129 Xe images were acquired using 2D gradient-recalled echo, 3D radial, and FLORET. Each sequence was acquired at its highest possible resolution within a 16-second breath-hold with a minimum voxel dimension of 3 mm. Images were compared using 129 Xe ventilation defect percentage, SNR, similarity coefficients, and vasculature cross-sections. RESULTS The FLORET sequence obtained relative normalized SNR, 40% greater than 2D gradient-recalled echo (P = .012) and 26% greater than 3D radial (P = .067). Moreover, the FLORET images were acquired with 3-fold-higher nominal resolution in a 15% shorter breath-hold. Finally, vasculature was less prominent in FLORET, likely due to diminished susceptibility-induced dephasing at shorter TEs afforded by UTE sequences. CONCLUSION The FLORET sequence yields higher SNR for a given resolution with a shorter breath-hold than traditional ventilation imaging techniques. This sequence more accurately measures ventilation abnormalities and enables reduced scan times in patients with poor compliance and severe lung disease.
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Affiliation(s)
- Matthew M Willmering
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Peter J Niedbalski
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Hui Wang
- Clinical Science, Philips, Cincinnati, Ohio.,Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio
| | - Ryan K Robison
- Department of Radiology, Phoenix Children's Hospital, Phoenix, Arizona
| | - James G Pipe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio.,Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, Ohio
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Eddy RL, Parraga G. Pulmonary xenon-129 MRI: new opportunities to unravel enigmas in respiratory medicine. Eur Respir J 2019; 55:13993003.01987-2019. [PMID: 31699844 DOI: 10.1183/13993003.01987-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/24/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Rachel L Eddy
- Robarts Research Institute, London, ON, Canada.,Dept of Medical Biophysics, Western University, London, ON, Canada
| | - Grace Parraga
- Robarts Research Institute, London, ON, Canada .,Dept of Medical Biophysics, Western University, London, ON, Canada.,Division of Respirology, Dept of Medicine, Western University, London, ON, Canada
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Kim M, Doganay O, Matin TN, Povey T, Gleeson FV. CT-based Airway Flow Model to Assess Ventilation in Chronic Obstructive Pulmonary Disease: A Pilot Study. Radiology 2019; 293:666-673. [PMID: 31617794 DOI: 10.1148/radiol.2019190395] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The lack of functional information in thoracic CT remains a limitation of its use in the clinical management of chronic obstructive pulmonary disease (COPD). Purpose To compare the distribution of pulmonary ventilation assessed by a CT-based full-scale airway network (FAN) flow model with hyperpolarized xenon 129 (129Xe) MRI (hereafter, 129Xe MRI) and technetium 99m-diethylenetriaminepentaacetic acid aerosol SPECT ventilation imaging (hereafter, V-SPECT) in participants with COPD. Materials and Methods In this prospective study performed between May and August 2017, pulmonary ventilation in participants with COPD was computed by using the FAN flow model. The modeled pulmonary ventilation was compared with functional imaging data from breath-hold time-series 129Xe MRI and V-SPECT. FAN-derived ventilation images on the coronal plane and volumes of interest were compared with functional lung images. Percentage lobar ventilation estimated by the FAN model was compared with that measured at 129Xe MRI and V-SPECT. The statistical significance of ventilation distribution between FAN and functional images was demonstrated with the Spearman correlation coefficient and χ2 distance. Results For this study, nine participants (seven men [mean age, 65 years ± 5 {standard deviation}] and two women [mean age, 63 years ± 7]) with COPD that was Global Initiative for Chronic Obstructive Lung Disease stage II-IV were enrolled. FAN-modeled ventilation profile showed strong positive correlation with images from 129Xe MRI (ρ = 0.67; P < .001) and V-SPECT (ρ = 0.65; P < .001). The χ2 distances of the ventilation histograms in the volumes of interest between the FAN and 129Xe MRI and FAN and V-SPECT were 0.16 ± 0.08 and 0.28 ± 0.14, respectively. The ratios of lobar ventilations in the models were linearly correlated to images from 129Xe MRI (ρ = 0.67; P < .001) and V-SPECT (ρ = 0.59; P < .001). Conclusion A CT-based full-scale airway network flow model provided regional pulmonary ventilation information for chronic obstructive pulmonary disease and correlates with hyperpolarized xenon 129 MRI and technetium 99m-diethylenetriaminepentaacetic acid aerosol SPECT ventilation imaging. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Schiebler and Parraga in this issue.
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Affiliation(s)
- Minsuok Kim
- From the Departments of Engineering Science (M.K., T.P.) and Oncology (O.D., F.V.G.), University of Oxford, Parks Road, Oxford OX1 3PJ, England; and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (O.D., T.N.M., F.V.G.)
| | - Ozkan Doganay
- From the Departments of Engineering Science (M.K., T.P.) and Oncology (O.D., F.V.G.), University of Oxford, Parks Road, Oxford OX1 3PJ, England; and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (O.D., T.N.M., F.V.G.)
| | - Tahreema N Matin
- From the Departments of Engineering Science (M.K., T.P.) and Oncology (O.D., F.V.G.), University of Oxford, Parks Road, Oxford OX1 3PJ, England; and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (O.D., T.N.M., F.V.G.)
| | - Thomas Povey
- From the Departments of Engineering Science (M.K., T.P.) and Oncology (O.D., F.V.G.), University of Oxford, Parks Road, Oxford OX1 3PJ, England; and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (O.D., T.N.M., F.V.G.)
| | - Fergus V Gleeson
- From the Departments of Engineering Science (M.K., T.P.) and Oncology (O.D., F.V.G.), University of Oxford, Parks Road, Oxford OX1 3PJ, England; and Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, England (O.D., T.N.M., F.V.G.)
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He M, Zha W, Tan F, Rankine L, Fain S, Driehuys B. A Comparison of Two Hyperpolarized 129Xe MRI Ventilation Quantification Pipelines: The Effect of Signal to Noise Ratio. Acad Radiol 2019; 26:949-959. [PMID: 30269957 DOI: 10.1016/j.acra.2018.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 12/25/2022]
Abstract
RATIONALE Hyperpolarized 129Xe MRI enables quantitative evaluation of regional ventilation. To this end, multiple classifiers have been proposed to determine ventilation defect percentage (VDP) as well as other cluster populations. However, consensus has not yet been reached regarding which of these methods to deploy for multicenter clinical trials. Here, we compare two published classification techniques-linear-binning and adaptive K-means-to establish their limits of agreement and their robustness against reduced signal-to-noise ratio (SNR). METHODS A total of 29 subjects (age: 38.4 ± 19.0 years) were retrospectively identified for inter-method comparison. For each 129Xe ventilation image, 7 images with reduced SNR were generated with equal decrements relative to the native SNR. All 8 sets of images were then analyzed using both methods independently to classify all lung voxels into four clusters: VDP, low-, medium-, and high-ventilation-percentage (LVP, MVP and HVP). For each cluster, the percentage of the lung it comprised was compared between the two methods, as well as how these values persisted as SNR was degraded. RESULTS The limits of agreement for calculating VDP were [+0.2%, +4.0%] with a +1.5% bias for binning relative to K-means. However, the inter-method agreement for the other clusters was moderate, with biases of -5.7%, 8.1%, and -4.0% for LVP, MVP, and HVP, respectively. As SNR decreased below ∼4, both methods began reporting values that deviated substantially from the native image. By requiring VDP to remain within ≤1.8% of that calculated from the native image, the minimum tolerable SNR values were 2.4 ± 1.0 for the linear-binning, and 3.5 ± 1.5 for the K-means. CONCLUSIONS Both methods agree well in quantifying VDP, but agreement for LVP and MVP remains variable. We suggest a required SNR threshold be two standard deviations above the minimum value of 3.5 ± 1.5 for robust determination of VDP, suggesting a minimum SNR of 6.6. However, robust quantification of the ventilated clusters required an SNR of 13.4.
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Walkup LL, Myers K, El-Bietar J, Nelson A, Willmering MM, Grimley M, Davies SM, Towe C, Woods JC. Xenon-129 MRI detects ventilation deficits in paediatric stem cell transplant patients unable to perform spirometry. Eur Respir J 2019; 53:1801779. [PMID: 30846475 PMCID: PMC6945824 DOI: 10.1183/13993003.01779-2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Early detection of pulmonary morbidity following haematopoietic stem cell transplantation (HSCT) remains an important challenge for intervention, primarily due to the insensitivity of spirometry to early change, and in paediatrics, patient compliance provides additional challenges. Regional lung ventilation abnormalities in paediatric HSCT patients were quantified using hyperpolarised xenon-129 (129Xe) magnetic resonance imaging (MRI) and compared to spirometry. METHODS Medically stable, paediatric allogeneic HSCT patients (n=23, ages 6-16 years) underwent an outpatient MRI scan where regional ventilation was quantified with a breath-hold of hyperpolarised 129Xe gas. Ventilation deficits, regions of the lung that ventilate poorly due to obstruction, were quantified as a ventilation defect percentage (VDP) and compared to forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC) ratio, and forced expiratory flow at 25-75% of FVC (FEF25-75%) from spirometry using linear regression. RESULTS The mean±sd 129Xe VDP was 10.5±9.4% (range 2.6-41.4%). 129Xe VDP correlated with FEV1, FEV1/FVC ratio and FEF25-75% (p≤0.02 for all comparisons). Ventilation deficits were detected in patients with normal spirometry (i.e. FEV1 >80%), supporting the sensitivity of 129Xe MRI to early obstruction reported in other pulmonary conditions. Seven (30%) patients could not perform spirometry, yet ventilation deficits were observed in five of these patients, detecting abnormalities that otherwise may have gone undetected and untreated until advanced. CONCLUSION Lung ventilation deficits were detected using hyperpolarised 129Xe gas MRI in asymptomatic paediatric HSCT patients and in a subgroup who were unable to perform reliable spirometry. 129Xe MRI provides a reliable imaging-based assessment of pulmonary involvement in this potentially difficult to diagnose paediatric population.
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Affiliation(s)
- Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Dept of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kasiani Myers
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Javier El-Bietar
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Deceased 19 December 2017
| | - Adam Nelson
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Dept of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Michael Grimley
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Stella M Davies
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher Towe
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Dept of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Nouls JC, Virgincar RS, Culbert AG, Morand N, Bobbert DW, Yoder AD, Schopler RS, Bashir MR, Badea A, Hochgeschwender U, Driehuys B. Applications of 3D printing in small animal magnetic resonance imaging. J Med Imaging (Bellingham) 2019; 6:021605. [PMID: 31131288 PMCID: PMC6519666 DOI: 10.1117/1.jmi.6.2.021605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 04/15/2019] [Indexed: 11/14/2022] Open
Abstract
Three-dimensional (3D) printing has significantly impacted the quality, efficiency, and reproducibility of preclinical magnetic resonance imaging. It has vastly expanded the ability to produce MR-compatible parts that readily permit customization of animal handling, achieve consistent positioning of anatomy and RF coils promptly, and accelerate throughput. It permits the rapid and cost-effective creation of parts customized to a specific imaging study, animal species, animal weight, or even one unique animal, not routinely used in preclinical research. We illustrate the power of this technology by describing five preclinical studies and specific solutions enabled by different 3D printing processes and materials. We describe fixtures, assemblies, and devices that were created to ensure the safety of anesthetized lemurs during an MR examination of their brain or to facilitate localized, contrast-enhanced measurements of white blood cell concentration in a mouse model of pancreatitis. We illustrate expansive use of 3D printing to build a customized birdcage coil and components of a ventilator to enable imaging of pulmonary gas exchange in rats using hyperpolarizedXe 129 . Finally, we present applications of 3D printing to create high-quality, dual RF coils to accelerate brain connectivity mapping in mouse brain specimens and to increase the throughput of brain tumor examinations in a mouse model of pituitary adenoma.
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Affiliation(s)
- John C. Nouls
- Duke University Medical Center, Department of Radiology, Durham, North Carolina, United States
| | - Rohan S. Virgincar
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Alexander G. Culbert
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | | | - Dana W. Bobbert
- Duke University, Office of Information Technology, Durham, North Carolina, United States
| | - Anne D. Yoder
- Duke University, Department of Biology, Durham, North Carolina, United States
- Duke University, Lemur Center, Durham, North Carolina, United States
| | | | - Mustafa R. Bashir
- Duke University Medical Center, Department of Radiology, Durham, North Carolina, United States
| | - Alexandra Badea
- Duke University Medical Center, Department of Radiology, Durham, North Carolina, United States
| | - Ute Hochgeschwender
- Central Michigan University, College of Medicine, Mount Pleasant, Michigan, United States
| | - Bastiaan Driehuys
- Duke University Medical Center, Department of Radiology, Durham, North Carolina, United States
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
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42
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Ebner L, Virgincar RS, He M, Choudhury KR, Robertson SH, Christe A, Mileto A, Mammarapallil JG, McAdams HP, Driehuys B, Roos JE. Multireader Determination of Clinically Significant Obstruction Using Hyperpolarized 129Xe-Ventilation MRI. AJR Am J Roentgenol 2019; 212:758-765. [PMID: 30779661 PMCID: PMC7079551 DOI: 10.2214/ajr.18.20036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to identify the magnitude and distribution of ventilation defect scores (VDSs) derived from hyperpolarized (HP) 129Xe-MRI associated with clinically relevant airway obstruction. MATERIALS AND METHODS From 2012 to 2015, 76 subjects underwent HP 129Xe-MRI (48 healthy volunteers [mean age ± SD, 54 ± 17 years]; 20 patients with asthma [mean age, 44 ± 20 years]; eight patients with chronic obstructive pulmonary disease [mean age, 67 ± 5 years]). All subjects underwent spirometry 1 day before MRI to establish the presence of airway obstruction (forced expiratory volume in 1 second-to-forced vital capacity ratio [FEV1/FVC] < 70%). Five blinded readers assessed the degree of ventilation impairment and assigned a VDS (range, 0-100%). Interreader agreement was assessed using the Fleiss kappa statistic. Using FEV1/FVC as the reference standard, the optimum VDS threshold for the detection of airway obstruction was estimated using ROC curve analysis with 10-fold cross-validation. RESULTS Compared with the VDSs in healthy subjects, VDSs in patients with airway obstruction were significantly higher (p < 0.0001) and significantly correlated with disease severity (r = 0.66, p < 0.0001). Ventilation defects in subjects with airway obstruction did not show a location-specific pattern (p = 0.158); however, defects in healthy control subjects were more prevalent in the upper lungs (p = 0.014). ROC curve analysis yielded an optimal threshold of 12.4% ± 6.1% (mean ± SD) for clinically significant VDS. Interreader agreement for 129Xe-MRI was substantial (κ = 0.71). CONCLUSION This multireader study of a diverse cohort of patients and control subjects suggests a 129Xe-ventilation MRI VDS of 12.4% or greater represents clinically significant obstruction.
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Affiliation(s)
- Lukas Ebner
- 1 Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710
- 2 Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Rohan S Virgincar
- 3 Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC
| | - Mu He
- 3 Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC
- 4 Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Kingshuk R Choudhury
- 1 Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - Scott H Robertson
- 3 Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC
- 4 Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Andreas Christe
- 2 Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Achille Mileto
- 5 Department of Radiology, Cantonal Hospital, Lucerne, Switzerland
| | - Joseph G Mammarapallil
- 1 Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - H Page McAdams
- 1 Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - Bastiaan Driehuys
- 1 Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710
- 2 Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- 3 Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC
- 5 Department of Radiology, Cantonal Hospital, Lucerne, Switzerland
| | - Justus E Roos
- 6 Department of Radiology and Nuclear Medicine, Cantonal Hospital, Lucerne, Switzerland
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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
129
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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Doganay O, Matin T, Chen M, Kim M, McIntyre A, McGowan DR, Bradley KM, Povey T, Gleeson FV. Time-series hyperpolarized xenon-129 MRI of lobar lung ventilation of COPD in comparison to V/Q-SPECT/CT and CT. Eur Radiol 2018; 29:4058-4067. [PMID: 30552482 PMCID: PMC6610266 DOI: 10.1007/s00330-018-5888-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/08/2018] [Accepted: 11/13/2018] [Indexed: 12/23/2022]
Abstract
Purpose To derive lobar ventilation in patients with chronic obstructive pulmonary disease (COPD) using a rapid time-series hyperpolarized xenon-129 (HPX) magnetic resonance imaging (MRI) technique and compare this to ventilation/perfusion single-photon emission computed tomography (V/Q-SPECT), correlating the results with high-resolution computed tomography (CT) and pulmonary function tests (PFTs). Materials and methods Twelve COPD subjects (GOLD stages I–IV) participated in this study and underwent HPX-MRI, V/Q-SPECT/CT, high-resolution CT, and PFTs. HPX-MRI was performed using a novel time-series spiral k-space sampling approach. Relative percentage ventilations were calculated for individual lobe for comparison to the relative SPECT lobar ventilation and perfusion. The absolute HPX-MRI percentage ventilation in each lobe was compared to the absolute CT percentage emphysema score calculated using a signal threshold method. Pearson’s correlation and linear regression tests were performed to compare each imaging modality. Results Strong correlations were found between the relative lobar percentage ventilation with HPX-MRI and percentage ventilation SPECT (r = 0.644; p < 0.001) and percentage perfusion SPECT (r = 0.767; p < 0.001). The absolute CT percentage emphysema and HPX percentage ventilation correlation was also statistically significant (r = 0.695, p < 0.001). The whole lung HPX percentage ventilation correlated with the PFT measurements (FEV1 with r = − 0.886, p < 0.001*, and FEV1/FVC with r = − 0.861, p < 0.001*) better than the whole lung CT percentage emphysema score (FEV1 with r = − 0.635, p = 0.027; and FEV1/FVC with r = − 0.652, p = 0.021). Conclusion Lobar ventilation with HPX-MRI showed a strong correlation with lobar ventilation and perfusion measurements derived from SPECT/CT, and is better than the emphysema score obtained with high-resolution CT. Key Points • The ventilation hyperpolarized xenon-129 MRI correlates well with ventilation and perfusion with SPECT/CT with the advantage of higher temporal and spatial resolution. • The hyperpolarized xenon-129 MRI correlates with the PFT measurements better than the high-resolution CT with the advantage of avoiding the use of ionizing radiation. Electronic supplementary material The online version of this article (10.1007/s00330-018-5888-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ozkan Doganay
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, OX3 7DQ, Oxford, UK.
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK.
| | - Tahreema Matin
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK
| | - Mitchell Chen
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK
| | - Minsuok Kim
- Department of Engineering Science, University of Oxford, OX1 3PJ, Oxford, UK
| | - Anthony McIntyre
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK
| | - Daniel R McGowan
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, OX3 7DQ, Oxford, UK
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK
| | - Kevin M Bradley
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK
| | - Thomas Povey
- Department of Engineering Science, University of Oxford, OX1 3PJ, Oxford, UK
| | - Fergus V Gleeson
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, OX3 7DQ, Oxford, UK
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, OX3 7LE, Oxford, UK
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Ruppert K, Amzajerdian F, Hamedani H, Xin Y, Loza L, Achekzai T, Duncan IF, Profka H, Siddiqui S, Pourfathi M, Sertic F, Cereda MF, Kadlecek S, Rizi RR. Assessment of flip angle-TR equivalence for standardized dissolved-phase imaging of the lung with hyperpolarized 129Xe MRI. Magn Reson Med 2018; 81:1784-1794. [PMID: 30346083 DOI: 10.1002/mrm.27538] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/20/2018] [Accepted: 08/27/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate the feasibility of describing the impact of any flip angle-TR combination on the resulting distribution of the hyperpolarized xenon-129 (HXe) dissolved-phase magnetization in the chest using a single virtual parameter, TR90°,equiv . METHODS HXe MRI scans with simultaneous gas- (GP) and dissolved-phase (DP) excitation were performed using 2D projection scans in mechanically ventilated rabbits. Measurements with DP flip angles ranging from 6-90° and TRs ranging from 8.3-500 ms were conducted. DP maps based on acquisitions of similar radio frequency pulse-induced relaxation rates were compared. RESULTS The observed distribution of the DP magnetization was strongly affected by acquisition flip angle and TR. However, for flip angles up to 60°, measurements with the same radio frequency pulse-induced relaxation rates, resulted in very similar DP images despite the presence of significant macroscopic gas transport processes. For flip angles approaching 90°, the downstream signal component decreased noticeably relative to acquisitions with lower flip angles. Nevertheless, the total DP signal continued to follow an empirically verified conversion equation over the entire investigated parameter range, which yields the equivalent TR of a hypothetical 90° measurement for any experimental flip angle-TR combination. CONCLUSION We have introduced a method for converting the flip angle and TR of a given HXe DP measurement to a standardized metric based on the virtual quantity, TR90°,equiv , using their equivalent RF relaxation rates. This conversion permits the comparison of measurements obtained with different pulse sequence types or by different research groups using various acquisition parameters.
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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
| | - Federico Sertic
- Department of Radiology, 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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Virgincar RS, Dahlke J, Robertson SH, Morand N, Qi Y, Degan S, Driehuys B, Nouls JC. A portable ventilator with integrated physiologic monitoring for hyperpolarized 129Xe MRI in rodents. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2018; 295:63-71. [PMID: 30125865 PMCID: PMC6719309 DOI: 10.1016/j.jmr.2018.07.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/13/2018] [Accepted: 07/21/2018] [Indexed: 05/09/2023]
Abstract
Hyperpolarized (HP) 129Xe MRI is emerging as a powerful, non-invasive method to image lung function and is beginning to find clinical application across a range of conditions. As clinical implementation progresses, it becomes important to translate back to well-defined animal models, where novel disease signatures can be characterized longitudinally and validated against histology. To date, preclinical 129Xe MRI has been limited to only a few sites worldwide with 2D imaging that is not generally sufficient to fully capture the heterogeneity of lung disease. To address these limitations and facilitate broader dissemination, we report on a compact and portable HP gas ventilator that integrates all the gas-delivery and physiologic monitoring capabilities required for high-resolution 3D hyperpolarized 129Xe imaging. This ventilator is MR- and HP-gas compatible, driven by inexpensive microcontrollers and open source code, and allows for precise control of the tidal volume and breathing cycle in perorally intubated mice and rats. We use the system to demonstrate data acquisition over multiple breath-holds, during which lung motion is suspended to enable high-resolution 3D imaging of gas-phase and dissolved-phase 129Xe in the lungs. We demonstrate the portability and versatility of the ventilator by imaging a mouse model of lung cancer longitudinally at 2 Tesla, and a healthy rat at 7 Tesla. We also report the detection of subtle spectroscopic fluctuations in phase with the heart rate, superimposed onto larger variations stemming from the respiratory cycle. This ventilator was developed to facilitate duplication and gain broad adoption to accelerate preclinical 129Xe MRI research.
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Affiliation(s)
| | - Jerry Dahlke
- Radiology, Duke University Medical Center, Durham, NC, USA
| | | | | | - Yi Qi
- Radiology, Duke University Medical Center, Durham, NC, USA
| | - Simone Degan
- Radiology, Duke University Medical Center, Durham, NC, USA
| | - Bastiaan Driehuys
- Biomedical Engineering, Duke University, Durham, NC, USA; Radiology, Duke University Medical Center, Durham, NC, USA; Medical Physics Graduate Program, Duke University, Durham, NC, USA
| | - John C Nouls
- Radiology, Duke University Medical Center, Durham, NC, USA.
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47
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Zhang H, Xie J, Xiao S, Zhao X, Zhang M, Shi L, Wang K, Wu G, Sun X, Ye C, Zhou X. Lung morphometry using hyperpolarized
129
Xe multi‐
b
diffusion
MRI
with compressed sensing in healthy subjects and patients with
COPD. Med Phys 2018; 45:3097-3108. [DOI: 10.1002/mp.12944] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 12/11/2022] Open
Affiliation(s)
- Huiting Zhang
- School of Physics Huazhong University of Science and Technology Wuhan 430074China
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Junshuai Xie
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Sa Xiao
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Xiuchao Zhao
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Ming Zhang
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Lei Shi
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Ke Wang
- Department of Magnetic Resonance Imaging Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Guangyao Wu
- Department of Magnetic Resonance Imaging Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Xianping Sun
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Chaohui Ye
- School of Physics Huazhong University of Science and Technology Wuhan 430074China
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
| | - Xin Zhou
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics National Center for Magnetic Resonance in Wuhan Wuhan Institute of Physics and Mathematics Chinese Academy of Sciences Wuhan 430071China
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49
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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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Gutberlet M, Kaireit TF, Voskrebenzev A, Lasch F, Freise J, Welte T, Wacker F, Hohlfeld JM, Vogel-Claussen J. Free-breathing Dynamic 19F Gas MR Imaging for Mapping of Regional Lung Ventilation in Patients with COPD. Radiology 2017; 286:1040-1051. [PMID: 28972817 DOI: 10.1148/radiol.2017170591] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose To quantify regional lung ventilation in patients with chronic obstructive pulmonary disease (COPD) by using free-breathing dynamic fluorinated (fluorine 19 [19F]) gas magnetic resonance (MR) imaging. Materials and Methods In this institutional review board-approved prospective study, 27 patients with COPD were examined by using breath-hold 19F gas wash-in MR imaging during inhalation of a normoxic fluorinated gas mixture (perfluoropropane) and by using free-breathing dynamic 19F gas washout MR imaging after inhalation of the gas mixture was finished for a total of 25-30 L. Regional lung ventilation was quantified by using volume defect percentage (VDP), washout time, number of breaths, and fractional ventilation (FV). To compare different lung function parameters, Pearson correlation coefficient and Fisher z transformation were used, which were corrected for multiple comparisons with the Bonferroni method. Results Statistically significant correlations were observed for all evaluated lung function test parameters compared with median and interquartile range of 19F washout parameters. An inverse linear correlation of median number of breaths (r = -0.82; P < .0001) and median washout times (r = -0.77; P < .0001) with percentage predicted of forced expiratory volume in 1 second (FEV1) was observed; correspondingly median FV (r = 0.86; P < .0001) correlated positively with percentage predicted FEV1. Comparing initial with late phase, median VDP of all subjects decreased from 49% (25th-75th percentile, 35%-62%) to 6% (25th-75th percentile, 2%-10%; P < .0001). VDP at the beginning of the gas wash-in phase (VDPinitial) significantly correlated with percentage predicted FEV1 (r = -0.74; P = .0028) and FV (r = 0.74; P = .0002). Median FV was significantly increased in ventilated regions (11.1% [25th-75th percentile, 6.8%-14.5%]) compared with the defect regions identified by VDPinitial (5.8% [25th-75th percentile, 4.0%-7.4%]; P < .0001). Conclusion Quantification of regional lung ventilation by using dynamic 19F gas washout MR imaging in free breathing is feasible at 1.5 T even in obstructed lung segments. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Marcel Gutberlet
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Till F Kaireit
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Andreas Voskrebenzev
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Florian Lasch
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Julia Freise
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Tobias Welte
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Frank Wacker
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Jens M Hohlfeld
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
| | - Jens Vogel-Claussen
- From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.)
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