Hyperpolarized noble gases as contrast agents

Hyperpolarized Gas Imaging in Lung Diseases: Functional and Artificial Intelligence Perspective

Pathophysiologic changes in lung diseases are often accompanied by changes in ventilation and gas exchange. Comprehensive evaluation of lung function cannot be obtained through chest X-ray and computed tomography. Proton-based lung MRI is particularly challenging due to low proton density within the lung tissue. In this review, we discuss an emerging technology--hyperpolarized gas MRI with inhaled 129Xe, which provides functional and microstructural information and has the potential as a clinical tool for detecting the early stage and progression of certain lung diseases. We review the hyperpolarized 129Xe MRI studies in patients with a range of pulmonary diseases, including chronic obstructive pulmonary disease, asthma, cystic fibrosis, pulmonary hypertension, radiation-induced lung injury and interstitial lung disease, and the applications of artificial intelligence were reviewed as well.

Single breath-hold measurement of pulmonary gas exchange and diffusion in humans with hyperpolarized 129 Xe MR

Pulmonary diseases usually result in changes of the blood-gas exchange function in the early stages. Gas exchange across the respiratory membrane and gas diffusion in the alveoli can be quantified using hyperpolarized ¹²⁹ Xe MR via chemical shift saturation recovery (CSSR) and diffusion-weighted imaging (DWI), respectively. Generally, CSSR and DWI data have been collected in separate breaths in humans. Unfortunately, the lung inflation level cannot be the exactly same in different breaths, which causes fluctuations in blood-gas exchange and pulmonary microstructure. Here we combine CSSR and DWI obtained with compressed sensing, to evaluate the gas diffusion and exchange function within a single breath-hold in humans. A new parameter, namely the perfusion factor of the respiratory membrane (SVR_d/g ), is proposed to evaluate the gas exchange function. Hyperpolarized ¹²⁹ Xe MR data are compared with pulmonary function tests and computed tomography examinations in healthy young, age-matched control, and chronic obstructive pulmonary disease human cohorts. SVR_d/g decreases as the ventilation impairment and emphysema index increase. Our results indicate that the proposed method has the potential to detect the extent of lung parenchyma destruction caused by age and pulmonary diseases, and it would be useful in the early diagnosis of pulmonary diseases in clinical practice.

Quantitative evaluation of pulmonary gas-exchange function using hyperpolarized 129 Xe CEST MRS and MRI

Hyperpolarized ¹²⁹ Xe gas MR has been a powerful tool for evaluating pulmonary structure and function due to the extremely high enhancement in spin polarization, the good solubility in the pulmonary parenchyma, and the excellent chemical sensitivity to its surrounding environment. Generally, the quantitative structural and functional information of the lung are evaluated using hyperpolarized ¹²⁹ Xe by employing the techniques of chemical shift saturation recovery (CSSR) and xenon polarization transfer contrast (XTC). Hyperpolarized ¹²⁹ Xe chemical exchange saturation transfer (Hyper-CEST) is another method for quantifying the exchange information of hyperpolarized ¹²⁹ Xe by using the exchange of xenon signals according to its different chemical shifts, and it has been widely used in biosensor studies in vitro. However, the feasibility of using hyperpolarized ¹²⁹ Xe CEST to quantify the pulmonary gas exchange function in vivo is still unclear. In this study, the technique of CEST was used to quantitatively evaluate the gas exchange in the lung globally and regionally via hyperpolarized ¹²⁹ Xe MRS and MRI, respectively. A new parameter, the pulmonary apparent gas exchange time constant (T_app ), was defined, and it increased from 0.63 s to 0.95 s in chronic obstructive pulmonary disease (COPD) rats (induced by cigarette smoke and lipopolysaccharide exposure) versus the controls with a significant difference (P = 0.001). Additionally, the spatial distribution maps of T_app in COPD rats' pulmonary parenchyma showed a regionally obvious increase compared with healthy rats. These results indicated that hyperpolarized ¹²⁹ Xe CEST MR was an effective method for globally and regionally quantifying the pulmonary gas exchange function, which would be helpful in diagnosing lung diseases that are related to gas exchange, such as COPD.

Detection of the mild emphysema by quantification of lung respiratory airways with hyperpolarized xenon diffusion MRI

PURPOSE

To demonstrate the feasibility to quantify the lung respiratory airway in vivo with hyperpolarized xenon diffusion magnetic resonance imaging (MRI), which is able to detect mild emphysema in the rat model.

MATERIALS AND METHODS

The lung respiratory airways were quantified in vivo using hyperpolarized xenon diffusion MRI (7T) with eight b values (5, 10, 15, 20, 25, 30, 35, 40 s/cm² ) in five control rats and five mild emphysematous rats, which were induced by elastase. The morphological results from histology were acquired and used for comparison.

RESULTS

The parameters D_L (longitudinal diffusion coefficient), r (internal radius), h (alveolar sleeve depth), Lm (mean linear intercept), and S/V (surface area to lung volume ratio) derived from the hyperpolarized xenon diffusion MRI in the emphysematous group showed significant differences from those in the control group (P < 0.05). Additionally, these parameters correlated well with the Lm obtained by the traditional histological sections (Pearson's correlation coefficients >0.8).

CONCLUSION

The lung respiratory airways can be quantified by hyperpolarized xenon diffusion MRI, showing the potential for mild emphysema diagnosis. Also, the study suggested that the hyperpolarized xenon D_L is more sensitive than D_T (transverse diffusion coefficient) to detect mild emphysema.

LEVEL OF EVIDENCE

1 J. Magn. Reson. Imaging 2017;45:879-888.

Oxygen-dependent hyperpolarized (129) Xe brain MR

Hyperpolarized (HP) (129) Xe MR offers unique advantages for brain functional imaging (fMRI) because of its extremely high sensitivity to different chemical environments and the total absence of background noise in biological tissues. However, its advancement and applications are currently plagued by issues of signal strength. Generally, xenon atoms found in the brain after inhalation are transferred from the lung via the bloodstream. The longitudinal relaxation time (T1 ) of HP (129) Xe is inversely proportional to the pulmonary oxygen concentration in the lung because oxygen molecules are paramagnetic. However, the T1 of (129) Xe is proportional to the pulmonary oxygen concentration in the blood, because the higher pulmonary oxygen concentration will result in a higher concentration of diamagnetic oxyhemoglobin. Accordingly, there should be an optimal pulmonary oxygen concentration for a given quantity of HP (129) Xe in the brain. In this study, the relationship between pulmonary oxygen concentration and HP (129) Xe signal in the brain was analyzed using a theoretical model and measured through in vivo experiments. The results from the theoretical model and experiments in rats are found to be in good agreement with each other. The optimal pulmonary oxygen concentration predicted by the theoretical model was 21%, and the in vivo experiments confirmed the presence of such an optimal ratio by reporting measurements between 25% and 35%. These findings are helpful for improving the (129) Xe signal in the brain and make the most of the limited spin polarization available for brain experiments. Copyright © 2016 John Wiley & Sons, Ltd.

Quantitative evaluation of radiation-induced lung injury with hyperpolarized xenon magnetic resonance

PURPOSE

To demonstrate the feasibility of quantitative and comprehensive global evaluation of pulmonary function and microstructural changes in rats with radiation-induced lung injury (RILI) using hyperpolarized xenon MR.

METHODS

Dissolved xenon spectra were dynamically acquired using a modified chemical shift saturation recovery pulse sequence in five rats with RILI (bilaterally exposed by 6-MV x-ray with a dose of 14 Gy 3 mo. prior to MR experiments) and five healthy rats. The dissolved xenon signals were quantitatively analyzed, and the pulmonary physiological parameters were extracted with the model of xenon exchange.

RESULTS

The obtained pulmonary physiological parameters and the ratio of (129) Xe signal in red blood cells (RBCs) versus barrier showed a significant difference between the groups. In RILI rats versus controls, the exchange time increased from 44.5 to 112 ms, the pulmonary capillary transit time increased from 0.51 to 1.48 s, and the ratio of (129) Xe spectroscopic signal in RBCs versus barrier increased from 0.294 to 0.484.

CONCLUSION

Hyperpolarized xenon MR is effective for quantitative and comprehensive global evaluation of pulmonary function and structural changes without the use of radiation. This may open the door for its use in the diagnosis of lung diseases that are related to gas exchange. Magn Reson Med 76:408-416, 2016. © 2015 Wiley Periodicals, Inc.

NMR of hyperpolarised probes

Increasing the sensitivity of NMR experiments is an ongoing field of research to help realise the exquisite molecular specificity of this technique. Hyperpolarisation of various nuclei is a powerful approach that enables the use of NMR for molecular and cellular imaging. Substantial progress has been achieved over recent years in terms of both tracer preparation and detection schemes. This review summarises recent developments in probe design and optimised signal encoding, and promising results in sensitive disease detection and efficient therapeutic monitoring. The different methods have great potential to provide molecular specificity not available by other diagnostic modalities.

Hyperpolarized xenon for NMR and MRI applications

Nuclear magnetic resonance (NMR) spectroscopy and imaging (MRI) suffer from intrinsic low sensitivity because even strong external magnetic fields of ~10 T generate only a small detectable net-magnetization of the sample at room temperature (1). Hence, most NMR and MRI applications rely on the detection of molecules at relative high concentration (e.g., water for imaging of biological tissue) or require excessive acquisition times. This limits our ability to exploit the very useful molecular specificity of NMR signals for many biochemical and medical applications. However, novel approaches have emerged in the past few years: Manipulation of the detected spin species prior to detection inside the NMR/MRI magnet can dramatically increase the magnetization and therefore allows detection of molecules at much lower concentration (2). Here, we present a method for polarization of a xenon gas mixture (2-5% Xe, 10% N2, He balance) in a compact setup with a ca. 16000-fold signal enhancement. Modern line-narrowed diode lasers allow efficient polarization (7) and immediate use of gas mixture even if the noble gas is not separated from the other components. The SEOP apparatus is explained and determination of the achieved spin polarization is demonstrated for performance control of the method. The hyperpolarized gas can be used for void space imaging, including gas flow imaging or diffusion studies at the interfaces with other materials (8,9). Moreover, the Xe NMR signal is extremely sensitive to its molecular environment (6). This enables the option to use it as an NMR/MRI contrast agent when dissolved in aqueous solution with functionalized molecular hosts that temporarily trap the gas (10,11). Direct detection and high-sensitivity indirect detection of such constructs is demonstrated in both spectroscopic and imaging mode.