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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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Hofmann JJ, Poulos VC, Zhou J, Sharma M, Parraga G, McIntosh MJ. Review of quantitative and functional lung imaging evidence of vaping-related lung injury. Front Med (Lausanne) 2024; 11:1285361. [PMID: 38327710 PMCID: PMC10847544 DOI: 10.3389/fmed.2024.1285361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction The pulmonary effects of e-cigarette use (or vaping) became a healthcare concern in 2019, following the rapid increase of e-cigarette-related or vaping-associated lung injury (EVALI) in young people, which resulted in the critical care admission of thousands of teenagers and young adults. Pulmonary functional imaging is well-positioned to provide information about the acute and chronic effects of vaping. We generated a systematic review to retrieve relevant imaging studies that describe the acute and chronic imaging findings that underly vaping-related lung structure-function abnormalities. Methods A systematic review was undertaken on June 13th, 2023 using PubMed to search for published manuscripts using the following criteria: [("Vaping" OR "e-cigarette" OR "EVALI") AND ("MRI" OR "CT" OR "Imaging")]. We included only studies involving human participants, vaping/e-cigarette use, and MRI, CT and/or PET. Results The search identified 445 manuscripts, of which 110 (668 unique participants) specifically mentioned MRI, PET or CT imaging in cases or retrospective case series of patients who vaped. This included 105 manuscripts specific to CT (626 participants), three manuscripts which mainly used MRI (23 participants), and two manuscripts which described PET findings (20 participants). Most studies were conducted in North America (n = 90), with the remaining studies conducted in Europe (n = 15), Asia (n = 4) and South America (n = 1). The vast majority of publications described case studies (n = 93) and a few described larger retrospective or prospective studies (n = 17). In e-cigarette users and patients with EVALI, key CT findings included ground-glass opacities, consolidations and subpleural sparing, MRI revealed abnormal ventilation, perfusion and ventilation/perfusion matching, while PET showed evidence of pulmonary inflammation. Discussion and conclusion Pulmonary structural and functional imaging abnormalities were common in patients with EVALI and in e-cigarette users with or without respiratory symptoms, which suggests that functional MRI may be helpful in the investigation of the pulmonary health effects associated with e-cigarette use.
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Affiliation(s)
| | | | - Jiahai Zhou
- Robarts Research Institute, London, ON, Canada
| | - Maksym Sharma
- Robarts Research Institute, London, ON, Canada
- Department of Medical Biophysics, London, ON, Canada
| | - Grace Parraga
- Robarts Research Institute, London, ON, Canada
- Department of Medical Biophysics, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
| | - Marrissa J. McIntosh
- Robarts Research Institute, London, ON, Canada
- Department of Medical Biophysics, London, ON, Canada
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Nakamura H, Hirai T, Kurosawa H, Hamada K, Matsunaga K, Shimizu K, Konno S, Muro S, Fukunaga K, Nakano Y, Kuwahira I, Hanaoka M. Current advances in pulmonary functional imaging. Respir Investig 2024; 62:49-65. [PMID: 37948969 DOI: 10.1016/j.resinv.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/26/2023] [Accepted: 09/07/2023] [Indexed: 11/12/2023]
Abstract
Recent advances in imaging analysis have enabled evaluation of ventilation and perfusion in specific regions by chest computed tomography (CT) and magnetic resonance imaging (MRI), in addition to modalities including dynamic chest radiography, scintigraphy, positron emission tomography (PET), ultrasound, and electrical impedance tomography (EIT). In this review, an overview of current functional imaging techniques is provided for each modality. Advances in chest CT have allowed for the analysis of local volume changes and small airway disease in addition to emphysema, using the Jacobian determinant and parametric response mapping with inspiratory and expiratory images. Airway analysis can reveal characteristics of airway lesions in chronic obstructive pulmonary disease (COPD) and bronchial asthma, and the contribution of dysanapsis to obstructive diseases. Chest CT is also employed to measure pulmonary blood vessels, interstitial lung abnormalities, and mediastinal and chest wall components including skeletal muscle and bone. Dynamic CT can visualize lung deformation in respective portions. Pulmonary MRI has been developed for the estimation of lung ventilation and perfusion, mainly using hyperpolarized 129Xe. Oxygen-enhanced and proton-based MRI, without a polarizer, has potential clinical applications. Dynamic chest radiography is gaining traction in Japan for ventilation and perfusion analysis. Single photon emission CT can be used to assess ventilation-perfusion (V˙/Q˙) mismatch in pulmonary vascular diseases and COPD. PET/CT V˙/Q˙ imaging has also been demonstrated using "Galligas". Both ultrasound and EIT can detect pulmonary edema caused by acute respiratory distress syndrome. Familiarity with these functional imaging techniques will enable clinicians to utilize these systems in clinical practice.
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Affiliation(s)
- Hidetoshi Nakamura
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan.
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Kurosawa
- Center for Environmental Conservation and Research Safety and Department of Occupational Health, Tohoku University School of Medicine, Sendai, Japan
| | - Kazuki Hamada
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Kaoruko Shimizu
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Shigeo Muro
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yasutaka Nakano
- Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Ichiro Kuwahira
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Tokyo Hospital, Tokyo, Japan
| | - Masayuki Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
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Hao Y, Wang T, Hou Y, Wang X, Yin Y, Liu Y, Han N, Ma Y, Li Z, Wei Y, Feng W, Jia Z, Qi H. Therapeutic potential of Lianhua Qingke in airway mucus hypersecretion of acute exacerbation of chronic obstructive pulmonary disease. Chin Med 2023; 18:145. [PMID: 37924136 PMCID: PMC10623880 DOI: 10.1186/s13020-023-00851-4] [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: 06/25/2023] [Accepted: 10/17/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Lianhua Qingke (LHQK) is an effective traditional Chinese medicine used for treating acute tracheobronchitis. In this study, we evaluated the effectiveness of LHQK in managing airway mucus hypersecretion in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS The AECOPD model was established by subjecting male Wistar rats to 12 weeks of cigarette smoke (CS) exposure (80 cigarettes/day, 5 days/week for 12 weeks) and intratracheal lipopolysaccharide (LPS) exposure (200 μg, on days 1, 14, and 84). The rats were divided into six groups: control (room air exposure), model (CS + LPS exposure), LHQK (LHQK-L, LHQK-M, and LHQK-H), and a positive control group (Ambroxol). H&E staining, and AB-PAS staining were used to evaluate lung tissue pathology, inflammatory responses, and goblet cell hyperplasia. RT-qPCR, immunohistochemistry, immunofluorescence and ELISA were utilized to analyze the transcription, expression and secretion of proteins related to mucus production in vivo and in the human airway epithelial cell line NCI-H292 in vitro. To predict and screen the active ingredients of LHQK, network pharmacology analysis and NF-κB reporter system analysis were employed. RESULTS LHQK treatment could ameliorate AECOPD-triggered pulmonary structure damage, inflammatory cell infiltration, and pro-inflammatory cytokine production. AB-PAS and immunofluorescence staining with CCSP and Muc5ac antibodies showed that LHQK reduced goblet cell hyperplasia, probably by inhibiting the transdifferentiation of Club cells into goblet cells. RT-qPCR and immunohistochemistry of Muc5ac and APQ5 showed that LHQK modulated mucus homeostasis by suppressing Muc5ac transcription and hypersecretion in vivo and in vitro, and maintaining the balance between Muc5ac and AQP5 expression. Network pharmacology analysis and NF-κB luciferase reporter system analysis provided insights into the active ingredients of LHQK that may help control airway mucus hypersecretion and regulate inflammation. CONCLUSION LHQK demonstrated therapeutic effects in AECOPD by reducing inflammation, suppressing goblet cell hyperplasia, preventing Club cell transdifferentiation, reducing Muc5ac hypersecretion, and modulating airway mucus homeostasis. These findings support the clinical use of LHQK as a potential treatment for AECOPD.
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Affiliation(s)
- Yuanjie Hao
- Graduate School, Hebei Medical University, Shijiazhuang, 050017, Hebei, China
| | - Tongxing Wang
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, 050035, Hebei, China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, China
| | - Yunlong Hou
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, 050035, Hebei, China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, China
| | - Xiaoqi Wang
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuan, 050090, Hebei, China
| | - Yujie Yin
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, 050035, Hebei, China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, China
| | - Yi Liu
- Graduate School, Hebei Medical University, Shijiazhuang, 050017, Hebei, China
| | - Ningxin Han
- Graduate School, Hebei Medical University, Shijiazhuang, 050017, Hebei, China
| | - Yan Ma
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuan, 050090, Hebei, China
| | - Zhen Li
- Graduate School, Hebei Medical University, Shijiazhuang, 050017, Hebei, China
| | - Yaru Wei
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuan, 050090, Hebei, China
| | - Wei Feng
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, 050035, Hebei, China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, China
| | - Zhenhua Jia
- Graduate School, Hebei Medical University, Shijiazhuang, 050017, Hebei, China.
- Affiliated Yiling Hospital of Hebei Medical University, Shijiazhuang, 050091, Hebei, China.
| | - Hui Qi
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, 050035, Hebei, China.
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, China.
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Chung SH, Huynh KM, Goralski JL, Chen Y, Yap PT, Ceppe AS, Powell MZ, Donaldson SH, Lee YZ. Feasibility of free-breathing 19 F MRI image acquisition to characterize ventilation defects in CF and healthy volunteers at wash-in. Magn Reson Med 2023; 90:79-89. [PMID: 36912481 PMCID: PMC10149612 DOI: 10.1002/mrm.29630] [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: 08/31/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE To explore the feasibility of measuring ventilation defect percentage (VDP) using 19 F MRI during free-breathing wash-in of fluorinated gas mixture with postacquisition denoising and to compare these results with those obtained through traditional Cartesian breath-hold acquisitions. METHODS Eight adults with cystic fibrosis and 5 healthy volunteers completed a single MR session on a Siemens 3T Prisma. 1 H Ultrashort-TE MRI sequences were used for registration and masking, and ventilation images with 19 F MRI were obtained while the subjects breathed a normoxic mixture of 79% perfluoropropane and 21% oxygen (O2 ). 19 F MRI was performed during breath holds and while free breathing with one overlapping spiral scan at breath hold for VDP value comparison. The 19 F spiral data were denoised using a low-rank matrix recovery approach. RESULTS VDP measured using 19 F VIBE and 19 F spiral images were highly correlated (r = 0.84) at 10 wash-in breaths. Second-breath VDPs were also highly correlated (r = 0.88). Denoising greatly increased SNR (pre-denoising spiral SNR, 2.46 ± 0.21; post-denoising spiral SNR, 33.91 ± 6.12; and breath-hold SNR, 17.52 ± 2.08). CONCLUSION Free-breathing 19 F lung MRI VDP analysis was feasible and highly correlated with breath-hold measurements. Free-breathing methods are expected to increase patient comfort and extend ventilation MRI use to patients who are unable to perform breath holds, including younger subjects and those with more severe lung disease.
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Affiliation(s)
- Sang Hun Chung
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, USA
| | - Khoi Minh Huynh
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, USA
| | - Jennifer L. Goralski
- Division of Pulmonary and Critical Care Medicine, UNC-Chapel Hill
- Marsico Lung Institute/UNC Cystic Fibrosis Center, UNC-Chapel Hill
- Division of Pediatric Pulmonology, UNC-Chapel Hill
| | - Yong Chen
- Department of Radiology, Case Western Reserve University, Cleveland, USA
| | - Pew-Thian Yap
- Department of Radiology and Biomedical Research Imaging Center, UNC-Chapel Hill
| | - Agathe S. Ceppe
- Division of Pulmonary and Critical Care Medicine, UNC-Chapel Hill
- Marsico Lung Institute/UNC Cystic Fibrosis Center, UNC-Chapel Hill
| | | | - Scott H. Donaldson
- Division of Pulmonary and Critical Care Medicine, UNC-Chapel Hill
- Marsico Lung Institute/UNC Cystic Fibrosis Center, UNC-Chapel Hill
| | - Yueh Z. Lee
- Division of Pulmonary and Critical Care Medicine, UNC-Chapel Hill
- Department of Radiology and Biomedical Research Imaging Center, UNC-Chapel Hill
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6
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Garrison WJ, Qing K, He M, Zhao L, Tustison NJ, Patrie JT, Mata JF, Shim YM, Ropp AM, Altes TA, Mugler JP, Miller GW. Lung Volume Dependence and Repeatability of Hyperpolarized 129Xe MRI Gas Uptake Metrics in Healthy Volunteers and Participants with COPD. Radiol Cardiothorac Imaging 2023; 5:e220096. [PMID: 37404786 PMCID: PMC10316289 DOI: 10.1148/ryct.220096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 07/06/2023]
Abstract
Purpose To assess the effect of lung volume on measured values and repeatability of xenon 129 (129Xe) gas uptake metrics in healthy volunteers and participants with chronic obstructive pulmonary disease (COPD). Materials and Methods This Health Insurance Portability and Accountability Act-compliant prospective study included data (March 2014-December 2015) from 49 participants (19 with COPD [mean age, 67 years ± 9 (SD)]; nine women]; 25 older healthy volunteers [mean age, 59 years ± 10; 20 women]; and five young healthy women [mean age, 23 years ± 3]). Thirty-two participants underwent repeated 129Xe and same-breath-hold proton MRI at residual volume plus one-third forced vital capacity (RV+FVC/3), with 29 also undergoing one examination at total lung capacity (TLC). The remaining 17 participants underwent imaging at TLC, RV+FVC/3, and residual volume (RV). Signal ratios between membrane, red blood cell (RBC), and gas-phase compartments were calculated using hierarchical iterative decomposition of water and fat with echo asymmetry and least-squares estimation (ie, IDEAL). Repeatability was assessed using coefficient of variation and intraclass correlation coefficient, and volume relationships were assessed using Spearman correlation and Wilcoxon rank sum tests. Results Gas uptake metrics were repeatable at RV+FVC/3 (intraclass correlation coefficient = 0.88 for membrane/gas; 0.71 for RBC/gas, and 0.88 for RBC/membrane). Relative ratio changes were highly correlated with relative volume changes for membrane/gas (r = -0.97) and RBC/gas (r = -0.93). Membrane/gas and RBC/gas measured at RV+FVC/3 were significantly lower in the COPD group than the corresponding healthy group (P ≤ .001). However, these differences lessened upon correction for individual volume differences (P = .23 for membrane/gas; P = .09 for RBC/gas). Conclusion Dissolved-phase 129Xe MRI-derived gas uptake metrics were repeatable but highly dependent on lung volume during measurement.Keywords: Blood-Air Barrier, MRI, Chronic Obstructive Pulmonary Disease, Pulmonary Gas Exchange, Xenon Supplemental material is available for this article © RSNA, 2023.
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Affiliation(s)
- William J. Garrison
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Kun Qing
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Mu He
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Li Zhao
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Nicholas J. Tustison
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - James T. Patrie
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Jaime F. Mata
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Y. Michael Shim
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Alan M. Ropp
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - Talissa A. Altes
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - John P. Mugler
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
| | - G. Wilson Miller
- From the Departments of Biomedical Engineering (W.J.G., J.P.M.,
G.W.M.), Radiology and Medical Imaging (K.Q., N.J.T., J.F.M., A.M.R., J.P.M.,
G.W.M.), Medicine (M.H., Y.M.S.), Public Health Sciences (J.T.P.), and Physics
(G.W.M.), University of Virginia, 480 Ray C. Hunt Dr, Box 801339,
Charlottesville, VA 22908; Department of Radiation Oncology, City of Hope
National Medical Center, Duarte, Calif (K.Q.); Department of Biomedical
Engineering, Zhejiang University, Hangzhou, China (L.Z.); and Department of
Radiology, University of Missouri, Columbia, Mo (T.A.A.)
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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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8
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Perron S, Ouriadov A. Hyperpolarized 129Xe MRI at low field: Current status and future directions. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2023; 348:107387. [PMID: 36731353 DOI: 10.1016/j.jmr.2023.107387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/07/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Magnetic Resonance Imaging (MRI) is dictated by the magnetization of the sample, and is thus a low-sensitivity imaging method. Inhalation of hyperpolarized (HP) noble gases, such as helium-3 and xenon-129, is a non-invasive, radiation-risk free imaging technique permitting high resolution imaging of the lungs and pulmonary functions, such as the lung microstructure, diffusion, perfusion, gas exchange, and dynamic ventilation. Instead of increasing the magnetic field strength, the higher spin polarization achievable from this method results in significantly higher net MR signal independent of tissue/water concentration. Moreover, the significantly longer apparent transverse relaxation time T2* of these HP gases at low magnetic field strengths results in fewer necessary radiofrequency (RF) pulses, permitting larger flip angles; this allows for high-sensitivity imaging of in vivo animal and human lungs at conventionally low (<0.5 T) field strengths and suggests that the low field regime is optimal for pulmonary MRI using hyperpolarized gases. In this review, theory on the common spin-exchange optical-pumping method of hyperpolarization and the field dependence of the MR signal of HP gases are presented, in the context of human lung imaging. The current state-of-the-art is explored, with emphasis on both MRI hardware (low field scanners, RF coils, and polarizers) and image acquisition techniques (pulse sequences) advancements. Common challenges surrounding imaging of HP gases and possible solutions are discussed, and the future of low field hyperpolarized gas MRI is posed as being a clinically-accessible and versatile imaging method, circumventing the siting restrictions of conventional high field scanners and bringing point-of-care pulmonary imaging to global facilities.
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Affiliation(s)
- Samuel Perron
- Department of Physics and Astronomy, The University of Western Ontario, London, Ontario, Canada.
| | - Alexei Ouriadov
- Department of Physics and Astronomy, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, Ontario, Canada
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9
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Zanette B, Munidasa S, Friedlander Y, Ratjen F, Santyr G. A 3D stack-of-spirals approach for rapid hyperpolarized 129 Xe ventilation mapping in pediatric cystic fibrosis lung disease. Magn Reson Med 2023; 89:1083-1091. [PMID: 36433705 DOI: 10.1002/mrm.29505] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/14/2022] [Accepted: 10/09/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To demonstrate the feasibility of a rapid 3D stack-of-spirals (3D-SoS) imaging acquisition for hyperpolarized 129 Xe ventilation mapping in healthy pediatric participants and pediatric cystic fibrosis (CF) participants, in comparison to conventional Cartesian multislice (2D) gradient-recalled echo (GRE) imaging. METHODS The 2D-GRE and 3D-SoS acquisitions were performed in 13 pediatric participants (5 healthy, 8 CF) during separate breath-holds. Images from both sequences were compared on the basis of ventilation defect percent (VDP) and other measures of image similarity. The nadir of transient oxygen saturation (SpO2 ) decline due to xenon breath-holding was measured with pulse oximetry, and expressed as a percent change relative to baseline. RESULTS 129 Xe ventilation images were acquired in a breath-hold of 1.2-1.8 s with the 3D-SoS sequence, compared to 6.2-8.8 s for 2D-GRE. Mean ± SD VDP measures for 2D-GRE and 3D-SoS sequences were 5.02 ± 1.06% and 5.28 ± 1.08% in healthy participants, and 18.05 ± 8.26% and 18.75 ± 6.74% in CF participants, respectively. Across all participants, the intraclass correlation coefficient of VDP measures for both sequences was 0.98 (95% confidence interval: 0.94-0.99). The percent change in SpO2 was reduced to -2.1 ± 2.7% from -5.2 ± 3.5% with the shorter 3D-SoS breath-hold. CONCLUSION Hyperpolarized 129 Xe ventilation imaging with 3D-SoS yielded images approximately five times faster than conventional 2D-GRE, reducing SpO2 desaturation and improving tolerability of the xenon administration. Analysis of VDP and other measures of image similarity demonstrate excellent agreement between images obtained with both sequences. 3D-SoS holds significant potential for reducing the acquisition time of hyperpolarized 129 Xe MRI, and/or increasing spatial resolution while adhering to clinical breath-hold constraints.
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Affiliation(s)
- Brandon Zanette
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Samal Munidasa
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Yonni Friedlander
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Felix Ratjen
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giles Santyr
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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10
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Schiebler ML, Tsuchiya N, Hahn A, Fain S, Denlinger L, Jarjour N, Hoffman EA. Imaging Regional Airway Involvement of Asthma: Heterogeneity in Ventilation, Mucus Plugs and Remodeling. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1426:163-184. [PMID: 37464121 DOI: 10.1007/978-3-031-32259-4_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
The imaging of asthma using chest computed tomography (CT) is well-established (Jarjour et al., Am J Respir Crit Care Med 185(4):356-62, 2012; Castro et al., J Allergy Clin Immunol 128:467-78, 2011). Moreover, recent advances in functional imaging of the lungs with advanced computer analysis of both CT and magnetic resonance images (MRI) of the lungs have begun to play a role in quantifying regional obstruction. Specifically, quantitative measurements of the airways for bronchial wall thickening, luminal narrowing and distortion, the amount of mucus plugging, parenchymal density, and ventilation defects that could contribute to the patient's disease course are instructive for the entire care team. In this chapter, we will review common imaging methods and findings that relate to the heterogeneity of asthma. This information can help to guide treatment decisions. We will discuss mucous plugging, quantitative assessment of bronchial wall thickening, delta lumen phenomenon, parenchymal low-density lung on CT, and ventilation defect percentage on MRI as metrics for assessing regional ventilatory dysfunction.
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Affiliation(s)
- Mark L Schiebler
- Cardiothoracic imaging, Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
| | - Nanae Tsuchiya
- Department of Radiology, School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Andrew Hahn
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Sean Fain
- Department of Radiology, Biomedical Engineering, and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Loren Denlinger
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Nizar Jarjour
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Eric A Hoffman
- Departments of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City, IA, USA
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11
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Nyilas S, Bauman G, Korten I, Pusterla O, Singer F, Ith M, Groen C, Schoeni A, Heverhagen JT, Christe A, Rodondi N, Bieri O, Geiser T, Auer R, Funke-Chambour M, Ebner L. MRI Shows Lung Perfusion Changes after Vaping and Smoking. Radiology 2022; 304:195-204. [PMID: 35380498 DOI: 10.1148/radiol.211327] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Evidence regarding short-term effects of electronic nicotine delivery systems (ENDS) and tobacco smoke on lung ventilation and perfusion is limited. Purpose To examine the immediate effect of ENDS exposure and tobacco smoke on lung ventilation and perfusion by functional MRI and lung function tests. Materials and Methods This prospective observational pilot study was conducted from November 2019 to September 2021 (substudy of randomized controlled trial NCT03589989). Included were 44 healthy adult participants (10 control participants, nine former tobacco smokers, 13 ENDS users, and 12 active tobacco smokers; mean age, 41 years ± 12 [SD]; 28 men) who underwent noncontrast-enhanced matrix pencil MRI and lung function tests before and immediately after the exposure to ENDS products or tobacco smoke. Baseline measurements were acquired after 2 hours of substance abstinence. Postexposure measurements were performed immediately after the exposure. MRI showed semiquantitative measured impairment of lung perfusion (RQ) and fractional ventilation (RFV) impairment as percentages of affected lung volume. Lung clearance index (LCI) was assessed by nitrogen multiple-breath washout to capture ventilation inhomogeneity and spirometry to assess airflow limitation. Absolute differences were calculated with paired Wilcoxon signed-rank test and differences between groups with unpaired Mann-Whitney test. Healthy control participants underwent two consecutive MRI measurements to assess MRI reproducibility. Results MRI was performed and lung function measurement was acquired in tobacco smokers and ENDS users before and after exposure. MRI showed a decrease of perfusion after exposure (RQ, 8.6% [IQR, 7.2%-10.0%] to 9.1% [IQR, 7.8%-10.7%]; P = .03) and no systematic change in RFV (P = .31) among tobacco smokers. Perfusion increased in participants who used ENDS after exposure (RQ, 9.7% [IQR, 7.1%-10.9%] to 9.0% [IQR, 6.9%-10.0%]; P = .01). RFV did not change (P = .38). Only in tobacco smokers was LCI elevated after smoking (P = .02). Spirometry indexes did not change in any participants. Conclusion MRI showed a decrease of lung perfusion after exposure to tobacco smoke and an increase of lung perfusion after use of electronic nicotine delivery systems. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Kligerman in this issue.
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Affiliation(s)
- Sylvia Nyilas
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Grzegorz Bauman
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Insa Korten
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Orso Pusterla
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Florian Singer
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Michael Ith
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Cindy Groen
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Anna Schoeni
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Johannes T Heverhagen
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Andreas Christe
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Nicolas Rodondi
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Oliver Bieri
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Thomas Geiser
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Reto Auer
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Manuela Funke-Chambour
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
| | - Lukas Ebner
- From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.)
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12
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Stewart NJ, Smith LJ, Chan HF, Eaden JA, Rajaram S, Swift AJ, Weatherley ND, Biancardi A, Collier GJ, Hughes D, Klafkowski G, Johns CS, West N, Ugonna K, Bianchi SM, Lawson R, Sabroe I, Marshall H, Wild JM. Lung MRI with hyperpolarised gases: current & future clinical perspectives. Br J Radiol 2022; 95:20210207. [PMID: 34106792 PMCID: PMC9153706 DOI: 10.1259/bjr.20210207] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The use of pulmonary MRI in a clinical setting has historically been limited. Whilst CT remains the gold-standard for structural lung imaging in many clinical indications, technical developments in ultrashort and zero echo time MRI techniques are beginning to help realise non-ionising structural imaging in certain lung disorders. In this invited review, we discuss a complementary technique - hyperpolarised (HP) gas MRI with inhaled 3He and 129Xe - a method for functional and microstructural imaging of the lung that has great potential as a clinical tool for early detection and improved understanding of pathophysiology in many lung diseases. HP gas MRI now has the potential to make an impact on clinical management by enabling safe, sensitive monitoring of disease progression and response to therapy. With reference to the significant evidence base gathered over the last two decades, we review HP gas MRI studies in patients with a range of pulmonary disorders, including COPD/emphysema, asthma, cystic fibrosis, and interstitial lung disease. We provide several examples of our experience in Sheffield of using these techniques in a diagnostic clinical setting in challenging adult and paediatric lung diseases.
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Affiliation(s)
- Neil J Stewart
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Laurie J Smith
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - James A Eaden
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Smitha Rajaram
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andrew J Swift
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Nicholas D Weatherley
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Alberto Biancardi
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - David Hughes
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | | | - Christopher S Johns
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Noreen West
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Kelechi Ugonna
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Stephen M Bianchi
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Rod Lawson
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Ian Sabroe
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Helen Marshall
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
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13
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Khan AS, Harvey RL, Birchall JR, Irwin RK, Nikolaou P, Schrank G, Emami K, Dummer A, Barlow MJ, Goodson BM, Chekmenev EY. Enabling Clinical Technologies for Hyperpolarized 129 Xenon Magnetic Resonance Imaging and Spectroscopy. Angew Chem Int Ed Engl 2021; 60:22126-22147. [PMID: 34018297 PMCID: PMC8478785 DOI: 10.1002/anie.202015200] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Indexed: 11/06/2022]
Abstract
Hyperpolarization is a technique that can increase nuclear spin polarization with the corresponding gains in nuclear magnetic resonance (NMR) signals by 4-8 orders of magnitude. When this process is applied to biologically relevant samples, the hyperpolarized molecules can be used as exogenous magnetic resonance imaging (MRI) contrast agents. A technique called spin-exchange optical pumping (SEOP) can be applied to hyperpolarize noble gases such as 129 Xe. Techniques based on hyperpolarized 129 Xe are poised to revolutionize clinical lung imaging, offering a non-ionizing, high-contrast alternative to computed tomography (CT) imaging and conventional proton MRI. Moreover, CT and conventional proton MRI report on lung tissue structure but provide little functional information. On the other hand, when a subject breathes hyperpolarized 129 Xe gas, functional lung images reporting on lung ventilation, perfusion and diffusion with 3D readout can be obtained in seconds. In this Review, the physics of SEOP is discussed and the different production modalities are explained in the context of their clinical application. We also briefly compare SEOP to other hyperpolarization methods and conclude this paper with the outlook for biomedical applications of hyperpolarized 129 Xe to lung imaging and beyond.
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Affiliation(s)
- Alixander S Khan
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Rebecca L Harvey
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Jonathan R Birchall
- Intergrative Biosciences (Ibio), Wayne State University, Karmanos Cancer Institute (KCI), 5101 Cass Avenue, Detroit, MI, 48202, USA
| | - Robert K Irwin
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2RD, UK
| | | | - Geoffry Schrank
- Northrup Grumman Space Systems, 45101 Warp Drive, Sterling, VA, 20166, USA
| | | | | | - Michael J Barlow
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Boyd M Goodson
- Department of Chemistry and Biochemistry, Southern Illinois University, 1245 Lincoln Drive, Carbondale, IL, 62901, USA
- Materials Technology Center, Southern Illinois University, 1245 Lincoln Drive, Carbondale, IL, 62901, USA
| | - Eduard Y Chekmenev
- Intergrative Biosciences (Ibio), Wayne State University, Karmanos Cancer Institute (KCI), 5101 Cass Avenue, Detroit, MI, 48202, USA
- Russian Academy of Sciences, Leninskiy Prospekt 14, Moscow, 119991, Russia
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14
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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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15
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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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16
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Shepelytskyi Y, Grynko V, Li T, Hassan A, Granberg K, Albert MS. The effects of an initial depolarization pulse on dissolved phase hyperpolarized 129 Xe brain MRI. Magn Reson Med 2021; 86:3147-3155. [PMID: 34254356 DOI: 10.1002/mrm.28918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/01/2021] [Accepted: 06/16/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the effect of an initial 90° depolarization RF pulse on the dissolved-phase hyperpolarized (HP) xenon-129 (129 Xe) brain imaging and to compare the SNR variability of HP 129 Xe images acquired without an initial depolarization RF pulse to those following the initial depolarization pulse. METHODS Five cognitive normal healthy volunteers were imaged using a Philips Achieva 3.0T MRI scanner during a single breath-hold following inhalation of 1 L of HP 129 Xe. Each participant underwent six HP 129 Xe scans. Three scans were performed using conventional single-slice projection HP 129 Xe brain imaging, and the other three scans were performed using the HP 129 Xe time-of-flight imaging with an initial rectangular depolarization pulse. RESULTS Although the utilization of an initial depolarization results in the reduction of the mean image SNR, the presence of an initial depolarization RF pulse reduces the SNR variability of the HP 129 Xe brain image by a factor of 2.26. The highest SNR variability was observed from the posterior brain region, where the anterior region possessed the lower level of signal variability. CONCLUSION An initial 90° depolarization RF pulse, applied prior to the HP 129 Xe image acquisition, reduced the HP 129 Xe signal variability more than two times between the different breath-hold images.
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Affiliation(s)
- Yurii Shepelytskyi
- Department of Chemistry, Lakehead University, Thunder Bay, Ontario, Canada.,Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
| | - Vira Grynko
- Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada.,Chemistry and Materials Science Program, Lakehead University, Thunder Bay, Ontario, Canada
| | - Tao Li
- Department of Chemistry, Lakehead University, Thunder Bay, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada.,Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Karl Granberg
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Mitchell S Albert
- Department of Chemistry, Lakehead University, Thunder Bay, Ontario, Canada.,Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada.,Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
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17
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Pokochueva EV, Burueva DB, Salnikov OG, Koptyug IV. Heterogeneous Catalysis and Parahydrogen-Induced Polarization. Chemphyschem 2021; 22:1421-1440. [PMID: 33969590 DOI: 10.1002/cphc.202100153] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/05/2021] [Indexed: 01/11/2023]
Abstract
Parahydrogen-induced polarization with heterogeneous catalysts (HET-PHIP) has been a subject of extensive research in the last decade since its first observation in 2007. While NMR signal enhancements obtained with such catalysts are currently below those achieved with transition metal complexes in homogeneous hydrogenations in solution, this relatively new field demonstrates major prospects for a broad range of advanced fundamental and practical applications, from providing catalyst-free hyperpolarized fluids for biomedical magnetic resonance imaging (MRI) to exploring mechanisms of industrially important heterogeneous catalytic processes. This review covers the evolution of the heterogeneous catalysts used for PHIP observation, from metal complexes immobilized on solid supports to bulk metals and single-atom catalysts and discusses the general visions for maximizing the obtained NMR signal enhancements using HET-PHIP. Various practical applications of HET-PHIP, both for catalytic studies and for potential production of hyperpolarized contrast agents for MRI, are described.
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Affiliation(s)
- Ekaterina V Pokochueva
- Laboratory of Magnetic Resonance Microimaging, International Tomography Center SB RAS, 3 A Institutskaya St., 630090, Novosibirsk, Russia.,Novosibirsk State University, 2 Pirogova St., 630090, Novosibirsk, Russia
| | - Dudari B Burueva
- Laboratory of Magnetic Resonance Microimaging, International Tomography Center SB RAS, 3 A Institutskaya St., 630090, Novosibirsk, Russia.,Novosibirsk State University, 2 Pirogova St., 630090, Novosibirsk, Russia
| | - Oleg G Salnikov
- Laboratory of Magnetic Resonance Microimaging, International Tomography Center SB RAS, 3 A Institutskaya St., 630090, Novosibirsk, Russia.,Novosibirsk State University, 2 Pirogova St., 630090, Novosibirsk, Russia.,Boreskov Institute of Catalysis SB RAS, 5 Acad. Lavrentiev Ave., 630090, Novosibirsk, Russia
| | - Igor V Koptyug
- Laboratory of Magnetic Resonance Microimaging, International Tomography Center SB RAS, 3 A Institutskaya St., 630090, Novosibirsk, Russia.,Boreskov Institute of Catalysis SB RAS, 5 Acad. Lavrentiev Ave., 630090, Novosibirsk, Russia
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18
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Khan AS, Harvey RL, Birchall JR, Irwin RK, Nikolaou P, Schrank G, Emami K, Dummer A, Barlow MJ, Goodson BM, Chekmenev EY. Enabling Clinical Technologies for Hyperpolarized
129
Xenon Magnetic Resonance Imaging and Spectroscopy. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202015200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Alixander S. Khan
- Sir Peter Mansfield Imaging Centre University of Nottingham Nottingham NG7 2RD UK
| | - Rebecca L. Harvey
- Sir Peter Mansfield Imaging Centre University of Nottingham Nottingham NG7 2RD UK
| | - Jonathan R. Birchall
- Intergrative Biosciences (Ibio) Wayne State University, Karmanos Cancer Institute (KCI) 5101 Cass Avenue Detroit MI 48202 USA
| | - Robert K. Irwin
- Sir Peter Mansfield Imaging Centre University of Nottingham Nottingham NG7 2RD UK
| | | | - Geoffry Schrank
- Northrup Grumman Space Systems 45101 Warp Drive Sterling VA 20166 USA
| | | | | | - Michael J. Barlow
- Sir Peter Mansfield Imaging Centre University of Nottingham Nottingham NG7 2RD UK
| | - Boyd M. Goodson
- Department of Chemistry and Biochemistry Southern Illinois University 1245 Lincoln Drive Carbondale IL 62901 USA
- Materials Technology Center Southern Illinois University 1245 Lincoln Drive Carbondale IL 62901 USA
| | - Eduard Y. Chekmenev
- Intergrative Biosciences (Ibio) Wayne State University, Karmanos Cancer Institute (KCI) 5101 Cass Avenue Detroit MI 48202 USA
- Russian Academy of Sciences Leninskiy Prospekt 14 Moscow 119991 Russia
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19
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Brooke JP, Hall IP. Novel Thoracic MRI Approaches for the Assessment of Pulmonary Physiology and Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1304:123-145. [PMID: 34019267 DOI: 10.1007/978-3-030-68748-9_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Excessive pulmonary inflammation can lead to damage of lung tissue, airway remodelling and established structural lung disease. Novel therapeutics that specifically target inflammatory pathways are becoming increasingly common in clinical practice, but there is yet to be a similar stepwise change in pulmonary diagnostic tools. A variety of thoracic magnetic resonance imaging (MRI) tools are currently in development, which may soon fulfil this emerging clinical need for highly sensitive assessments of lung structure and function. Given conventional MRI techniques are poorly suited to lung imaging, alternate strategies have been developed, including the use of inhaled contrast agents, intravenous contrast and specialized lung MR sequences. In this chapter, we discuss technical challenges of performing MRI of the lungs and how they may be overcome. Key thoracic MRI modalities are reviewed, namely, hyperpolarized noble gas MRI, oxygen-enhanced MRI (OE-MRI), ultrashort echo time (UTE) MRI and dynamic contrast-enhanced (DCE) MRI. Finally, we consider potential clinical applications of these techniques including phenotyping of lung disease, evaluation of novel pulmonary therapeutic efficacy and longitudinal assessment of specific patient groups.
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Affiliation(s)
- Jonathan P Brooke
- Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
| | - Ian P Hall
- Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
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20
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Hyperpolarized Gas MRI Technology Breaks Through: Advancing Our Understanding of Anti-Type 2 Inflammation Therapies in Severe Asthma. Chest 2021; 158:1293-1295. [PMID: 33036069 DOI: 10.1016/j.chest.2020.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 11/21/2022] Open
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21
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McLean MA, Hinks RS, Kaggie JD, Woitek R, Riemer F, Graves MJ, McIntyre DJO, Gallagher FA, Schulte RF. Characterization and correction of center-frequency effects in X-nuclear eddy current compensations on a clinical MR system. Magn Reson Med 2021; 85:2370-2376. [PMID: 33274790 PMCID: PMC7898706 DOI: 10.1002/mrm.28607] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of the study was to investigate whether incorrectly compensated eddy currents are the source of persistent X-nuclear spectroscopy and imaging artifacts, as well as methods to correct this. METHODS Pulse-acquire spectra were collected for 1 H and X-nuclei (23 Na or 31 P) using the minimum TR permitted on a 3T clinical MRI system. Data were collected in 3 orientations (axial, sagittal, and coronal) with the spoiler gradient at the end of the TR applied along the slice direction for each. Modifications to system calibration files to tailor eddy current compensation for each X-nucleus were developed and applied, and data were compared with and without these corrections for: slice-selective MRS (for 23 Na and 31 P), 2D spiral trajectories (for 13 C), and 3D cones trajectories (for 23 Na). RESULTS Line-shape distortions characteristic of eddy currents were demonstrated for X-nuclei, which were not seen for 1 H. The severity of these correlated with the amplitude of the eddy current frequency compensation term applied by the system along the axis of the applied spoiler gradient. A proposed correction to eddy current compensation, taking account of the gyromagnetic ratio, was shown to dramatically reduce these distortions. The same correction was also shown to improve data quality of non-Cartesian imaging (2D spiral and 3D cones trajectories). CONCLUSION A simple adaptation of the default compensation for eddy currents was shown to eliminate a range of artifacts detected on X-nuclear spectroscopy and imaging.
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Affiliation(s)
- Mary A. McLean
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUnited Kingdom
| | | | - Joshua D. Kaggie
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Ramona Woitek
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
| | - Frank Riemer
- MMIV, Department of RadiologyHaukeland University HospitalBergenNorway
| | - Martin J. Graves
- Department of RadiologyUniversity of CambridgeCambridgeUnited Kingdom
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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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Mahmutovic Persson I, von Wachenfeldt K, Waterton JC, Olsson LE. Imaging Biomarkers in Animal Models of Drug-Induced Lung Injury: A Systematic Review. J Clin Med 2020; 10:jcm10010107. [PMID: 33396865 PMCID: PMC7795017 DOI: 10.3390/jcm10010107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/24/2020] [Indexed: 12/28/2022] Open
Abstract
For drug-induced interstitial lung disease (DIILD) translational imaging biomarkers are needed to improve detection and management of lung injury and drug-toxicity. Literature was reviewed on animal models in which in vivo imaging was used to detect and assess lung lesions that resembled pathological changes found in DIILD, such as inflammation and fibrosis. A systematic search was carried out using three databases with key words “Animal models”, “Imaging”, “Lung disease”, and “Drugs”. A total of 5749 articles were found, and, based on inclusion criteria, 284 papers were selected for final data extraction, resulting in 182 out of the 284 papers, based on eligibility. Twelve different animal species occurred and nine various imaging modalities were used, with two-thirds of the studies being longitudinal. The inducing agents and exposure (dose and duration) differed from non-physiological to clinically relevant doses. The majority of studies reported other biomarkers and/or histological confirmation of the imaging results. Summary of radiotracers and examples of imaging biomarkers were summarized, and the types of animal models and the most used imaging modalities and applications are discussed in this review. Pathologies resembling DIILD, such as inflammation and fibrosis, were described in many papers, but only a few explicitly addressed drug-induced toxicity experiments.
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Affiliation(s)
- Irma Mahmutovic Persson
- Department of Translational Medicine, Medical Radiation Physics, Lund University, 20502 Malmö, Sweden;
- Correspondence: ; Tel.: +46-736839562
| | | | - John C. Waterton
- Bioxydyn Ltd., Science Park, Manchester M15 6SZ, UK;
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester M13 9PL, UK
| | - Lars E. Olsson
- Department of Translational Medicine, Medical Radiation Physics, Lund University, 20502 Malmö, Sweden;
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Pulmonary MRI: Applications and Use Cases. CURRENT PULMONOLOGY REPORTS 2020. [DOI: 10.1007/s13665-020-00257-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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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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McCallister A, Chung SH, Antonacci M, Z Powell M, Ceppe AS, Donaldson SH, Lee YZ, Branca RT, Goralski JL. Comparison of single breath hyperpolarized 129 Xe MRI with dynamic 19 F MRI in cystic fibrosis lung disease. Magn Reson Med 2020; 85:1028-1038. [PMID: 32770779 PMCID: PMC7689687 DOI: 10.1002/mrm.28457] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/28/2022]
Abstract
Purpose To quantitatively compare dynamic 19F and single breath hyperpolarized 129Xe MRI for the detection of ventilation abnormalities in subjects with mild cystic fibrosis (CF) lung disease. Methods Ten participants with stable CF and a baseline FEV1 > 70% completed a single imaging session where dynamic 19F and single breath 129Xe lung ventilation images were acquired on a 3T MRI scanner. Ventilation defect percentages (VDP) values between 19F early‐breath, 19F maximum‐ventilation, 129Xe low‐resolution, and 129Xe high‐resolution images were compared. Dynamic 19F images were used to determine gas wash‐in/out rates in regions of ventilation congruency and mismatch between 129Xe and 19F. Results VDP values from high‐resolution 129Xe images were greater than from low‐resolution images (P = .001), although these values were significantly correlated (r = 0.68, P = .03). Early‐breath 19F VDP and max‐vent 19F VDP also showed significant correlation (r = 0.75, P = .012), with early‐breath 19F VDP values being significantly greater (P < .001). No correlation in VDP values were detected between either 19F method or high‐res 129Xe images. In addition, the location and volume of ventilation defects were often different when comparing 129Xe and 19F images from the same subject. Areas of ventilation congruence displayed the expected ventilation kinetics, while areas of ventilation mismatch displayed abnormally slow gas wash‐in and wash‐out. Conclusion In CF subjects, ventilation abnormalities are identified by both 19F and HP 129Xe imaging. However, these ventilation abnormalities are not entirely congruent. 19F and HP 129Xe imaging provide complementary information that enable differentiation of normally ventilated, slowly ventilated, and non‐ventilated regions in the lungs.
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Affiliation(s)
- Andrew McCallister
- Department of Physics and Astronomy, The University of North Carolina, Chapel Hill, NC, USA.,Biomedical Research Imaging Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Sang Hun Chung
- Department of Biomedical Engineering, The University of North Carolina, Chapel Hill, NC, USA
| | - Michael Antonacci
- Department of Physics and Astronomy, The University of North Carolina, Chapel Hill, NC, USA.,Biomedical Research Imaging Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Margret Z Powell
- Marsico Lung Institute/UNC Cystic Fibrosis Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Agathe S Ceppe
- Marsico Lung Institute/UNC Cystic Fibrosis Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Scott H Donaldson
- Marsico Lung Institute/UNC Cystic Fibrosis Center, The University of North Carolina, Chapel Hill, NC, USA.,Division of Pulmonary and Critical Care Medicine, The University of North Carolina, Chapel Hill, NC, USA
| | - Yueh Z Lee
- Department of Physics and Astronomy, The University of North Carolina, Chapel Hill, NC, USA.,Biomedical Research Imaging Center, The University of North Carolina, Chapel Hill, NC, USA.,Department of Biomedical Engineering, The University of North Carolina, Chapel Hill, NC, USA.,Marsico Lung Institute/UNC Cystic Fibrosis Center, The University of North Carolina, Chapel Hill, NC, USA.,Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA
| | - Rosa Tamara Branca
- Department of Physics and Astronomy, The University of North Carolina, Chapel Hill, NC, USA.,Biomedical Research Imaging Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer L Goralski
- Marsico Lung Institute/UNC Cystic Fibrosis Center, The University of North Carolina, Chapel Hill, NC, USA.,Division of Pulmonary and Critical Care Medicine, The University of North Carolina, Chapel Hill, NC, USA.,Division of Pediatric Pulmonology, The University of North Carolina, Chapel Hill, NC, USA
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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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Kammerman J, Hahn AD, Cadman RV, Malkus A, Mummy D, Fain SB. Transverse relaxation rates of pulmonary dissolved-phase Hyperpolarized 129 Xe as a biomarker of lung injury in idiopathic pulmonary fibrosis. Magn Reson Med 2020; 84:1857-1867. [PMID: 32162357 DOI: 10.1002/mrm.28246] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The MR properties (chemical shifts and R 2 ∗ decay rates) of dissolved-phase hyperpolarized (HP) 129 Xe are confounded by the large magnetic field inhomogeneity present in the lung. This work improves measurements of these properties using a model-based image reconstruction to characterize the R 2 ∗ decay rates of dissolved-phase HP 129 Xe in healthy subjects and patients with idiopathic pulmonary fibrosis (IPF). METHODS Whole-lung MRS and 3D radial MRI with four gradient echoes were performed after inhalation of HP 129 Xe in healthy subjects and patients with IPF. A model-based image reconstruction formulated as a regularized optimization problem was solved iteratively to measure regional signal intensity in the gas, barrier, and red blood cell (RBC) compartments, while simultaneously measuring their chemical shifts and R 2 ∗ decay rates. RESULTS The estimation of spectral properties reduced artifacts in images of HP 129 Xe in the gas, barrier, and RBC compartments and improved image SNR by over 20%. R 2 ∗ decay rates of the RBC and barrier compartments were lower in patients with IPF compared to healthy subjects (P < 0.001 and P = 0.005, respectively) and correlated to DLCO (R = 0.71 and 0.64, respectively). Chemical shift of the RBC component measured with whole-lung spectroscopy was significantly different between IPF and normal subjects (P = 0.022). CONCLUSION Estimates for R 2 ∗ in both barrier and RBC dissolved-phase HP 129 Xe compartments using a regional signal model improved image quality for dissolved-phase images and provided additional biomarkers of lung injury in IPF.
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Affiliation(s)
- Jeff Kammerman
- Department of Medical Physics, Univsersity of Wisconsin, Madison, Wisconsin
| | - Andrew D Hahn
- Department of Medical Physics, Univsersity of Wisconsin, Madison, Wisconsin
| | - Robert V Cadman
- Department of Medical Physics, Univsersity of Wisconsin, Madison, Wisconsin
| | - Annelise Malkus
- Department of Medical Physics, Univsersity of Wisconsin, Madison, Wisconsin
| | - David Mummy
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina.,Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Sean B Fain
- Department of Medical Physics, Univsersity of Wisconsin, Madison, Wisconsin.,Department of Radiology, University of Wisconsin, Madison, Wisconsin.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
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30
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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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Thien F, Thompson BR. Precision Medicine in Asthma: Integrating Imaging and Inflammatory Biomarkers. Am J Respir Crit Care Med 2019; 197:845-846. [PMID: 29351001 DOI: 10.1164/rccm.201801-0031ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Francis Thien
- 1 Eastern Health Clinical School Monash University Melbourne, Australia.,2 Box Hill Hospital Melbourne, Australia
| | - Bruce R Thompson
- 3 Department of Allergy, Immunology and Respiratory Medicine Monash University Melbourne, Australia and.,4 Alfred Hospital Melbourne, Australia
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Bier EA, Nouls JC, Wang Z, He M, Schrank G, Morales-Medina N, Hashoian R, Svetlik H, Mugler JP, Driehuys B. A thermally polarized 129 Xe phantom for quality assurance in multi-center hyperpolarized gas MRI studies. Magn Reson Med 2019; 82:1961-1968. [PMID: 31218753 DOI: 10.1002/mrm.27836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/24/2019] [Accepted: 05/11/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE Hyperpolarized 129 Xe MR is increasingly being adopted worldwide, but no standards exist for assessing or comparing performance at different 129 Xe imaging centers. Therefore, we sought to develop a thermally polarized xenon phantom assembly, approximating the size of a human torso, along with an associated imaging protocol to enable rapid quality-assurance imaging. METHODS MR-compatible pressure vessels, with an internal volume of 5.85 L, were constructed from pressure-rated, engineering grade PE4710 high-density polyethylene. They were filled with a mixture of 61% natural xenon and 39% oxygen to approximately 11.6 bar and placed in a loader shell filled with a 0.56% saline solution to mimic the human chest. Imaging employed a 2D spoiled gradient-echo sequence using non-slice-selective excitation (TR/TE = 750/6.13 ms, flip angle = 74°, FOV = 40 × 440 mm, matrix = 64 × 32, bandwidth = 30 Hz/pixel, averages = 4), resulting in a 1.6 min acquisition. System characterization and imaging were performed at 8 different MRI centers. RESULTS At 3 Telsa, 129 Xe in the pressure vessels was characterized by T1 = 580.5 ± 8.3 ms, linewidth = 0.21 ppm, and chemical shift = +10.2 ppm. The phantom assembly was used to obtain transmit voltage calibrations and 2D and 3D images across multiple coil and scanner configurations at 8 sites. Across the 5 sites that employed a standard flexible chest coil, the SNR was 12.4 ± 1.8. CONCLUSION The high-density polyethylene pressure vessels filled with thermally polarized xenon and associated loader shell combine to form a phantom assembly that enables spectroscopic and imaging acquisitions that can be used for testing, quality assurance, and performance tracking-capabilities essential for standardizing hyperpolarized 129 Xe MRI within and across institutions.
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Affiliation(s)
- Elianna A Bier
- Department of Biomedical Engineering, Duke University, Durham, North Carolina.,Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina
| | - John C Nouls
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina.,Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Ziyi Wang
- Department of Biomedical Engineering, Duke University, Durham, North Carolina.,Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina
| | - Mu He
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina.,Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina
| | - Geoff Schrank
- Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina
| | | | | | | | - John P Mugler
- Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia
| | - Bastiaan Driehuys
- Department of Biomedical Engineering, Duke University, Durham, North Carolina.,Center for In Vivo Microscopy, Duke University Medical Center, Durham, North Carolina.,Department of Radiology, Duke University Medical Center, Durham, North Carolina
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Verbanck S, Vanderhelst E. The Respective Roles of Lung Clearance Index and Magnetic Resonance Imaging in the Clinical Management of Patients with Cystic Fibrosis. Am J Respir Crit Care Med 2019; 197:409. [PMID: 28800245 DOI: 10.1164/rccm.201706-1137le] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Petousi N, Talbot NP, Pavord I, Robbins PA. Measuring lung function in airways diseases: current and emerging techniques. Thorax 2019; 74:797-805. [PMID: 31036773 DOI: 10.1136/thoraxjnl-2018-212441] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/14/2019] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
Abstract
Chronic airways diseases, including asthma, COPD and cystic fibrosis, cause significant morbidity and mortality and are associated with high healthcare expenditure, in the UK and worldwide. For patients with these conditions, improvements in clinical outcomes are likely to depend on the application of precision medicine, that is, the matching of the right treatment to the right patient at the right time. In this context, the identification and targeting of 'treatable traits' is an important priority in airways disease, both to ensure the appropriate use of existing treatments and to facilitate the development of new disease-modifying therapy. This requires not only better understanding of airway pathophysiology but also an enhanced ability to make physiological measurements of disease activity and lung function and, if we are to impact on the natural history of these diseases, reliable measures in early disease. In this article, we outline some of the key challenges faced by the respiratory community in the management of airways diseases, including early diagnosis, disease stratification and monitoring of therapeutic response. In this context, we review the advantages and limitations of routine physiological measurements of respiratory function including spirometry, body plethysmography and diffusing capacity and discuss less widely used methods such as forced oscillometry, inert gas washout and the multiple inert gas elimination technique. Finally, we highlight emerging technologies including imaging methods such as quantitative CT and hyperpolarised gas MRI as well as quantification of lung inhomogeneity using precise in-airway gas analysis and mathematical modelling. These emerging techniques have the potential to enhance existing measures in the assessment of airways diseases, may be particularly valuable in early disease, and should facilitate the efforts to deliver precision respiratory medicine.
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Affiliation(s)
- Nayia Petousi
- Nuffield Department of Clinical Medicine Division of Experimental Medicine, University of Oxford, Oxford, UK .,Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.,Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Nick P Talbot
- Nuffield Department of Clinical Medicine Division of Experimental Medicine, University of Oxford, Oxford, UK.,Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.,Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Ian Pavord
- Nuffield Department of Clinical Medicine Division of Experimental Medicine, University of Oxford, Oxford, UK.,Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Peter A Robbins
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
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Zanette B, Santyr G. Accelerated interleaved spiral-IDEAL imaging of hyperpolarized 129 Xe for parametric gas exchange mapping in humans. Magn Reson Med 2019; 82:1113-1119. [PMID: 30989730 DOI: 10.1002/mrm.27765] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 01/22/2019] [Accepted: 03/18/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To demonstrate the feasibility of mapping gas exchange with single breath-hold hyperpolarized (HP) 129 Xe in humans, acquiring parametric maps of lung physiology. The potential benefit of acceleration using parallel imaging for this application is also explored. METHODS Six healthy volunteers were scanned with a modified spiral-IDEAL sequence to acquire gas exchange-weighted images using a single dose of 129 Xe. These images were fit with the model of xenon exchange (MOXE) on a voxel-wise basis calculating parametric maps of lung physiology, specifically: air-capillary barrier thickness (δ), alveolar septal thickness (d), capillary transit time (tx ), pulmonary hematocrit (HCT), and alveolar surface area-to-volume ratio (SVR). An accelerated version of the sequence was also tested in subset of 4 volunteers and compared to the fully sampled (FS) results. RESULTS Mean image-wide values calculated from MOXE parametric maps derived from FS dissolved 129 Xe spiral-IDEAL images were: δ = 0.89 ± 0.17 μm, d = 7.5 ± 0.5 μm, tx = 1.1 ± 0.2s, HCT = 28.8 ± 2.3%, and SVR = 140 ± 16 cm-1 , in good agreement with previously published values based on whole-lung spectroscopy of healthy human subjects. Parallel imaging sufficiently reduces artifacting in accelerated images, but increases disagreement with MOXE parameters derived from FS data with mean voxel-wise unsigned relative differences of: δ = 39 ± 9%, d = 22 ± 3%, tx = 117 ± 43%, HCT = 11 ± 2%, and SVR = 31 ± 12%. CONCLUSION Dissolved HP 129 Xe spiral-IDEAL imaging for gas exchange mapping is feasible in humans using a single breath-hold. Accelerated gas exchange mapping is also shown to be feasible but requires further improvements to increase quantitative accuracy.
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Affiliation(s)
- Brandon Zanette
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Translational Medicine Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giles Santyr
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,Translational Medicine Program, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
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Hahn AD, Kammerman J, Evans M, Zha W, Cadman RV, Meyer K, Sandbo N, Fain SB. Repeatability of regional pulmonary functional metrics of Hyperpolarized 129 Xe dissolved-phase MRI. J Magn Reson Imaging 2019; 50:1182-1190. [PMID: 30968993 DOI: 10.1002/jmri.26745] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND MRI of hyperpolarized 129 Xenon (HP 129 Xe) is increasingly utilized for investigating pulmonary function. The solubility of HP 129 Xe in lung tissue, blood plasma (Barrier), and red blood cells (RBC), with unique chemical shifts, enables spectroscopic imaging of potential imaging biomarkers of gas exchange and microstructural pulmonary physiology. PURPOSE To quantify global average and regional repeatability of Barrier:gas, RBC:gas, and RBC:Barrier ratios derived from dissolved-phase 129 Xe imaging and their dependence on intervisit changes in lung inflation volume. STUDY TYPE Prospective. POPULATION Fourteen healthy volunteers. One subject was unable to complete the study resulting in 13 subjects for analysis (eight female, five male, ages 24-69, 53.8 ± 13.9). FIELD STRENGTH 1.5T. ASSESSMENT Subjects were imaged using a 3D radial 1-point Dixon method to separate Barrier and RBC component signals, at two different timepoints, with ~1 month between visits. RBC:Gas, Barrier:Gas, and RBC:Barrier measures were compared across time and with pulmonary function tests (PFTs). STATISTICAL TESTS Repeatablilty was quantified using Bland-Altman plots, coefficient of repeatability, coefficient of variation (CV), and intraclass correlation coefficients (ICCs). Dependence of imaging measures on PFTs and lung volume was evaluated using Spearman and Pearson correlation coefficients, respectively. Statistical significance was determined by F-test for intraclass correlations, and t-test for Spearman correlations and regression. RESULTS Mean RBC:Gas, Barrier:Gas, and RBC:Barrier had CVs of 19.2%, 20.0%, and 11.5%, respectively, and had significant ICCs, equal to 0.78, 0.79, and 0.92, respectively. Intervisit differences in RBC:Barrier were significantly correlated with intervisit differences in DLCO (r = 0.93, P = 0.007). Significant correlations with intervisit lung volume differences and intervisit differences in mean RBC:Gas (r = -0.73, P = 0.005) and Barrier:Gas (r = -0.69, P = 0.009) were found. DATA CONCLUSION Three commonly used 129 Xe MRI-based measures of gas-exchange show good repeatability, particularly the Barrier:RBC ratio, which did not depend on lung inflation volume and was strongly associated with intervisit changes in DLCO . LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1182-1190.
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Affiliation(s)
- Andrew D Hahn
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Jeff Kammerman
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Michael Evans
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | - Wei Zha
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Robert V Cadman
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Keith Meyer
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Nathan Sandbo
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
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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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Mammarappallil JG, Rankine L, Wild JM, Driehuys B. New Developments in Imaging Idiopathic Pulmonary Fibrosis With Hyperpolarized Xenon Magnetic Resonance Imaging. J Thorac Imaging 2019; 34:136-150. [PMID: 30801449 PMCID: PMC6392051 DOI: 10.1097/rti.0000000000000392] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive pulmonary disease that is ultimately fatal. Although the diagnosis of IPF has been revolutionized by high-resolution computed tomography, this imaging modality still exhibits significant limitations, particularly in assessing disease progression and therapy response. The need for noninvasive regional assessment has become more acute in light of recently introduced novel therapies and numerous others in the pipeline. Thus, it will likely be valuable to complement 3-dimensional imaging of lung structure with 3-dimensional regional assessment of function. This challenge is well addressed by hyperpolarized (HP) Xe magnetic resonance imaging (MRI), exploiting the unique properties of this inert gas to image its distribution, not only in the airspaces, but also in the interstitial barrier tissues and red blood cells. This single-breath imaging exam could ultimately become the ideal, noninvasive tool to assess pulmonary gas-exchange impairment in IPF. This review article will detail the evolution of HP Xe MRI from its early development to its current state as a clinical research platform. It will detail the key imaging biomarkers that can be generated from the Xe MRI examination, as well as their potential in IPF for diagnosis, prognosis, and assessment of therapeutic response. We conclude by discussing the types of studies that must be performed for HP Xe MRI to be incorporated into the IPF clinical algorithm and begin to positively impact IPF disease diagnosis and management.
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Affiliation(s)
| | - Leith Rankine
- Department of Radiology, Duke University Medical Center, Durham, NC
| | - Jim M Wild
- Department of Infection, Immunity & Cardiovascular Disease, Academic Radiology, University of Sheffield, Western Bank, UK
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Romei C, Turturici L, Tavanti L, Miedema J, Fiorini S, Marletta M, Wielopolski P, Tiddens H, Falaschi F, Ciet P. The use of chest magnetic resonance imaging in interstitial lung disease: a systematic review. Eur Respir Rev 2018; 27:27/150/180062. [PMID: 30567932 DOI: 10.1183/16000617.0062-2018] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 10/23/2018] [Indexed: 01/09/2023] Open
Abstract
Thin-slices multi-detector computed tomography (MDCT) plays a key role in the differential diagnosis of interstitial lung disease (ILD). However, thin-slices MDCT has a limited ability to detect active inflammation, which is an important target of newly developed ILD drug therapy. Magnetic resonance imaging (MRI), thanks to its multi-parameter capability, provides better tissue characterisation than thin-slices MDCT.Our aim was to summarise the current status of MRI applications in ILD and to propose an ILD-MRI protocol. A systematic literature search was conducted for relevant studies on chest MRI in patients with ILD.We retrieved 1246 papers of which 55 original papers were selected for the review. We identified 24 studies comparing image quality of thin-slices MDCT and MRI using several MRI sequences. These studies described new MRI sequences to assess ILD parenchymal abnormalities, such as honeycombing, reticulation and ground-glass opacity. Thin-slices MDCT remains superior to MRI for morphological imaging. However, recent studies with ultra-short echo-time MRI showed image quality comparable to thin-slices MDCT. Several studies demonstrated the added value of chest MRI by using functional imaging, especially to detect and quantify inflammatory changes.We concluded that chest MRI could play a role in ILD patients to differentiate inflammatory and fibrotic changes and to assess efficacy of new ILD drugs.
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Affiliation(s)
- Chiara Romei
- 2nd Radiology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Laura Turturici
- Radiology, Azienda USL Toscana nord ovest Sede di Viareggio, Viareggio, Italy
| | - Laura Tavanti
- Dept of Surgical, Medical, Molecular Pathology and Critical Care, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Jelle Miedema
- Dept of Respiratory Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sara Fiorini
- 1st Radiology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Massimo Marletta
- 1st Radiology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Piotr Wielopolski
- Dept of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Harm Tiddens
- Dept of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Pediatric Pulmonology and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Fabio Falaschi
- 2nd Radiology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Pierluigi Ciet
- Dept of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Dept of Pediatric Pulmonology and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Doganay O, Chen M, Matin T, Rigolli M, Phillips JA, McIntyre A, Gleeson FV. Magnetic resonance imaging of the time course of hyperpolarized 129Xe gas exchange in the human lungs and heart. Eur Radiol 2018; 29:2283-2292. [PMID: 30519929 PMCID: PMC6443604 DOI: 10.1007/s00330-018-5853-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/27/2018] [Accepted: 10/23/2018] [Indexed: 12/23/2022]
Abstract
Purpose To perform magnetic resonance imaging (MRI), human lung imaging, and quantification of the gas-transfer dynamics of hyperpolarized xenon-129 (HPX) from the alveoli into the blood plasma. Materials and methods HPX MRI with iterative decomposition of water and fat with echo asymmetry and least-square estimation (IDEAL) approach were used with multi-interleaved spiral k-space sampling to obtain HPX gas and dissolved phase images. IDEAL time-series images were then obtained from ten subjects including six normal subjects and four patients with pulmonary emphysema to test the feasibility of the proposed technique for capturing xenon-129 gas-transfer dynamics (XGTD). The dynamics of xenon gas diffusion over the entire lung was also investigated by measuring the signal intensity variations between three regions of interest, including the left and right lungs and the heart using Welch’s t test. Results The technique enabled the acquisition of HPX gas and dissolved phase compartment images in a single breath-hold interval of 8 s. The y-intersect of the XGTD curves were also found to be statistically lower in the patients with lung emphysema than in the healthy group (p < 0.05). Conclusion This time-series IDEAL technique enables the visualization and quantification of inhaled xenon from the alveoli to the left ventricle with a clinical gradient strength magnet during a single breath-hold, in healthy and diseased lungs. Key Points • The proposed hyperpolarized xenon-129 gas and dissolved magnetic resonance imaging technique can provide regional and temporal measurements of xenon-129 gas-transfer dynamics. • Quantitative measurement of xenon-129 gas-transfer dynamics from the alveolar to the heart was demonstrated in normal subjects and pulmonary emphysema. • Comparison of gas-transfer dynamics in normal subjects and pulmonary emphysema showed that the proposed technique appears sensitive to changes affecting the alveoli, pulmonary interstitium, and capillaries. Electronic supplementary material The online version of this article (10.1007/s00330-018-5853-9) 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, Oxford, OX3 7DQ, UK. .,Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, Oxford, OX3 7LE, UK.
| | - Mitchell Chen
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, Oxford, OX3 7LE, UK
| | - Tahreema Matin
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, Oxford, OX3 7LE, UK
| | - Marzia Rigolli
- University of Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Julie-Ann Phillips
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, Oxford, OX3 7LE, UK
| | - Anthony McIntyre
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, Oxford, OX3 7LE, UK
| | - Fergus V Gleeson
- Department of Oncology, University of Oxford, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK.,Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Trust, Old Rd, Oxford, OX3 7LE, UK
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Hahn AD, Kammerman J, Fain SB. Removal of hyperpolarized 129 Xe gas-phase contamination in spectroscopic imaging of the lungs. Magn Reson Med 2018; 80:2586-2597. [PMID: 29893992 PMCID: PMC6291357 DOI: 10.1002/mrm.27349] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/26/2018] [Accepted: 04/16/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE A novel technique is presented for retrospective estimation and removal of gas-phase hyperpolarized Xenon-129 (HP 129 Xe) from images of HP 129 Xe dissolved in the barrier (comprised of parenchymal lung tissue and blood plasma) and red blood cell (RBC) phases. The primary aim is mitigating RF pulse performance limitations on measures of gas exchange (e.g., barrier-gas and RBC-gas ratios). Correction for gas contamination would simplify technical dissemination of HP 129 Xe applications across sites with varying hardware performance, scanner vendors, and models. METHODS Digital lung phantom and human subject experiments (N = 8 healthy; N = 1 with idiopathic pulmonary fibrosis) were acquired with 3D radial trajectory and 1-point Dixon spectroscopic imaging to assess the correction method for mitigating barrier and RBC imaging artifacts. Dependence of performance on TE, image SNR, and gas contamination level were characterized. Inter- and intra-subject variation in the dissolved-phase ratios were quantified and compared to human subject experiments before and after correction. RESULTS Gas contamination resulted in image artifacts similar to those in disease that were mitigated after correction in both simulated and human subject data; for simulation experiments performance varied with TE, but was independent of image SNR and the amount of gas contamination. Artifacts and variation of barrier and RBC components were reduced after correction in both simulation and healthy human lungs (barrier, P = 0.01; RBC, P = 0.045). CONCLUSION The proposed technique significantly reduced regional variations in barrier and RBC ratios, separated using a 1-point Dixon approach, with improved accuracy of dissolved-phase HP 129 Xe images confirmed in simulation experiments.
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Affiliation(s)
- Andrew D Hahn
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Jeff Kammerman
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
- Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
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Higano NS, Spielberg DR, Fleck RJ, Schapiro AH, Walkup LL, Hahn AD, Tkach JA, Kingma PS, Merhar SL, Fain SB, Woods JC. Neonatal Pulmonary Magnetic Resonance Imaging of Bronchopulmonary Dysplasia Predicts Short-Term Clinical Outcomes. Am J Respir Crit Care Med 2018; 198:1302-1311. [PMID: 29790784 PMCID: PMC6290936 DOI: 10.1164/rccm.201711-2287oc] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 05/23/2018] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Bronchopulmonary dysplasia (BPD) is a serious neonatal pulmonary condition associated with premature birth, but the underlying parenchymal disease and trajectory are poorly characterized. The current National Institute of Child Health and Human Development (NICHD)/NHLBI definition of BPD severity is based on degree of prematurity and extent of oxygen requirement. However, no clear link exists between initial diagnosis and clinical outcomes. OBJECTIVES We hypothesized that magnetic resonance imaging (MRI) of structural parenchymal abnormalities will correlate with NICHD-defined BPD disease severity and predict short-term respiratory outcomes. METHODS A total of 42 neonates (20 severe BPD, 6 moderate, 7 mild, 9 non-BPD control subjects; 40 ± 3-wk postmenstrual age) underwent quiet-breathing structural pulmonary MRI (ultrashort echo time and gradient echo) in a neonatal ICU-sited, neonatal-sized 1.5 T scanner, without sedation or respiratory support unless already clinically prescribed. Disease severity was scored independently by two radiologists. Mean scores were compared with clinical severity and short-term respiratory outcomes. Outcomes were predicted using univariate and multivariable models, including clinical data and scores. MEASUREMENTS AND MAIN RESULTS MRI scores significantly correlated with severities and predicted respiratory support at neonatal ICU discharge (P < 0.0001). In multivariable models, MRI scores were by far the strongest predictor of respiratory support duration over clinical data, including birth weight and gestational age. Notably, NICHD severity level was not predictive of discharge support. CONCLUSIONS Quiet-breathing neonatal pulmonary MRI can independently assess structural abnormalities of BPD, describe disease severity, and predict short-term outcomes more accurately than any individual standard clinical measure. Importantly, this nonionizing technique can be implemented to phenotype disease, and has potential to serially assess efficacy of individualized therapies.
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Affiliation(s)
- Nara S. Higano
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology
| | - David R. Spielberg
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology
| | | | | | - Laura L. Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology
| | | | | | - Paul S. Kingma
- Division of Neonatology and Pulmonary Biology, Cincinnati Children’s Hospital, Cincinnati, Ohio; and
| | - Stephanie L. Merhar
- Division of Neonatology and Pulmonary Biology, Cincinnati Children’s Hospital, Cincinnati, Ohio; and
| | - Sean B. Fain
- Department of Medical Physics and
- Department of Radiology, University of Wisconsin–Madison, Madison, Wisconsin
| | - Jason C. Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology
- Department of Radiology, and
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Zaccagna F, Grist JT, Deen SS, Woitek R, Lechermann LMT, McLean MA, Basu B, Gallagher FA. Hyperpolarized carbon-13 magnetic resonance spectroscopic imaging: a clinical tool for studying tumour metabolism. Br J Radiol 2018; 91:20170688. [PMID: 29293376 PMCID: PMC6190784 DOI: 10.1259/bjr.20170688] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 01/09/2023] Open
Abstract
Glucose metabolism in tumours is reprogrammed away from oxidative metabolism, even in the presence of oxygen. Non-invasive imaging techniques can probe these alterations in cancer metabolism providing tools to detect tumours and their response to therapy. Although Positron Emission Tomography with (18F)2-fluoro-2-deoxy-D-glucose (18F-FDG PET) is an established clinical tool to probe cancer metabolism, it has poor spatial resolution and soft tissue contrast, utilizes ionizing radiation and only probes glucose uptake and phosphorylation and not further downstream metabolism. Magnetic Resonance Spectroscopy (MRS) has the capability to non-invasively detect and distinguish molecules within tissue but has low sensitivity and can only detect selected nuclei. Dynamic Nuclear Polarization (DNP) is a technique which greatly increases the signal-to-noise ratio (SNR) achieved with MR by significantly increasing nuclear spin polarization and this method has now been translated into human imaging. This review provides a brief overview of this process, also termed Hyperpolarized Carbon-13 Magnetic Resonance Spectroscopic Imaging (HP 13C-MRSI), its applications in preclinical imaging, an outline of the current human trials that are ongoing, as well as future potential applications in oncology.
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Affiliation(s)
- Fulvio Zaccagna
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - James T Grist
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Surrin S Deen
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | - Mary A McLean
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Bristi Basu
- Department of Oncology, University of Cambridge, Cambridge, UK
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Hodono S, Shimokawa A, Stewart NJ, Yamauchi Y, Nishimori R, Yamane M, Imai H, Fujiwara H, Kimura A. Ethyl Pyruvate Improves Pulmonary Function in Mice with Bleomycin-induced Lung Injury as Monitored with Hyperpolarized 129Xe MR Imaging. Magn Reson Med Sci 2018. [PMID: 29526883 PMCID: PMC6196297 DOI: 10.2463/mrms.mp.2017-0163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: High Mobility Group Box1 (HMGB1), which is one of the damage-associated molecular pattern molecules relating to various inflammatory diseases, has gained interest as a therapeutic target because of its involvement in wound healing processes. In the present study, we investigated HMGB1 as a potential therapeutic target in a model of lung fibrosis using a preclinical hyperpolarized 129Xe (HPXe) MRI system. Methods: Lung injury was induced by intra-peritoneal injection of bleomycin (BLM) in 19 mice. Three weeks post-injection (when fibrosis was confirmed histologically), administration of ethyl pyruvate (EP) and alogliptin (ALG), which are down- and up-regulators of HMGB1, respectively, was commenced in six and seven of the 19 mice, respectively, and continued for a further 3 weeks. A separate sham-instilled group was formed of five mice, which were administered with saline for 6 weeks. Over the second 3-week period, the effects of disease progression and pharmacological therapy in the four groups of mice were monitored by HPXe MRI metrics of fractional ventilation and gas-exchange function. Results: Gas-exchange function in BLM mice was significantly reduced after 3 weeks of BLM challenge compared to sham-instilled mice (P < 0.05). Ethyl pyruvate was found to improve HPXe MRI metrics of both ventilation and gas exchange, and repair tissue damage (assessed histologically), to a similar level as sham-instilled mice (P < 0.05), whilst ALG treatment caused no significant improvement of pulmonary function. Conclusion: This study demonstrates the down-regulator of HMGB1, EP, as a potential therapeutic agent for pulmonary fibrosis, as assessed by a non-invasive HPXe MRI protocol.
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Affiliation(s)
- Shota Hodono
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
| | - Akihiro Shimokawa
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
| | - Neil J Stewart
- Division of Bioengineering and Bioinformatics, Graduate School of Information Science and Technology, Hokkaido University
| | - Yukiko Yamauchi
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
| | - Renya Nishimori
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
| | - Mami Yamane
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
| | - Hirohiko Imai
- Department of Systems Science, Graduate School of Informatics, Kyoto University
| | - Hideaki Fujiwara
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
| | - Atsuomi Kimura
- Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University
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45
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Zanette B, Stirrat E, Jelveh S, Hope A, Santyr G. Physiological gas exchange mapping of hyperpolarized 129
Xe using spiral-IDEAL and MOXE in a model of regional radiation-induced lung injury. Med Phys 2018; 45:803-816. [DOI: 10.1002/mp.12730] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/17/2017] [Accepted: 11/28/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Brandon Zanette
- Department of Medical Biophysics; University of Toronto, Toronto; 101 College St Toronto ON M5G1L7 Canada
- Translational Medicine Program; Peter Gilgan Centre for Research and Learning; The Hospital for Sick Children; 686 Bay St Toronto ON M5G0A4 Canada
| | - Elaine Stirrat
- Translational Medicine Program; Peter Gilgan Centre for Research and Learning; The Hospital for Sick Children; 686 Bay St Toronto ON M5G0A4 Canada
| | - Salomeh Jelveh
- Radiation Medicine Program; Princess Margaret Cancer Centre; 610 University Ave Toronto ON M5G2M9 Canada
| | - Andrew Hope
- Radiation Medicine Program; Princess Margaret Cancer Centre; 610 University Ave Toronto ON M5G2M9 Canada
- Department of Radiation Oncology; University of Toronto; 149 College St Toronto ON M5T1P5 Canada
| | - Giles Santyr
- Department of Medical Biophysics; University of Toronto, Toronto; 101 College St Toronto ON M5G1L7 Canada
- Translational Medicine Program; Peter Gilgan Centre for Research and Learning; The Hospital for Sick Children; 686 Bay St Toronto ON M5G0A4 Canada
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Ball L, Vercesi V, Costantino F, Chandrapatham K, Pelosi P. Lung imaging: how to get better look inside the lung. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:294. [PMID: 28828369 DOI: 10.21037/atm.2017.07.20] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the last years, imaging has played a key role in the diagnosis and monitoring and critical illness, including acute respiratory distress syndrome (ARDS). Chest X-ray (CXR) and computed tomography (CT) are the conventional techniques most performed in the critically ill patients, the latter being the gold standard to assess lung aeration in ARDS patients. In addition, two bedside techniques are now gaining popularity alongside the conventional ones: lung ultrasound (LUS) and electrical impedance tomography (EIT). These techniques do not involve the use of ionizing radiations, are non-invasive and relatively easy to use, and are under extensive investigation as a complement, and for some application a substitution of conventional techniques. At last, positron emission tomography (PET) and magnetic resonance imaging (MRI) can provide functional information on the lung and respiratory function, and are increasingly used in research to improve the understanding of the pathophysiological mechanisms underlying ARDS. The purpose of this review is to give an up-to-date overview of the conventional and emerging imaging techniques available the diagnosis and management of patients with ARDS.
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Affiliation(s)
- Lorenzo Ball
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy
| | - Veronica Vercesi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy
| | - Federico Costantino
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy
| | - Karthikka Chandrapatham
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l'Oncologia, Genoa, Italy
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47
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Adamson EB, Ludwig KD, Mummy DG, Fain SB. Magnetic resonance imaging with hyperpolarized agents: methods and applications. Phys Med Biol 2017; 62:R81-R123. [PMID: 28384123 DOI: 10.1088/1361-6560/aa6be8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the past decade, hyperpolarized (HP) contrast agents have been under active development for MRI applications to address the twin challenges of functional and quantitative imaging. Both HP helium (3He) and xenon (129Xe) gases have reached the stage where they are under study in clinical research. HP 129Xe, in particular, is poised for larger scale clinical research to investigate asthma, chronic obstructive pulmonary disease, and fibrotic lung diseases. With advances in polarizer technology and unique capabilities for imaging of 129Xe gas exchange into lung tissue and blood, HP 129Xe MRI is attracting new attention. In parallel, HP 13C and 15N MRI methods have steadily advanced in a wide range of pre-clinical research applications for imaging metabolism in various cancers and cardiac disease. The HP [1-13C] pyruvate MRI technique, in particular, has undergone phase I trials in prostate cancer and is poised for investigational new drug trials at multiple institutions in cancer and cardiac applications. This review treats the methodology behind both HP gases and HP 13C and 15N liquid state agents. Gas and liquid phase HP agents share similar technologies for achieving non-equilibrium polarization outside the field of the MRI scanner, strategies for image data acquisition, and translational challenges in moving from pre-clinical to clinical research. To cover the wide array of methods and applications, this review is organized by numerical section into (1) a brief introduction, (2) the physical and biological properties of the most common polarized agents with a brief summary of applications and methods of polarization, (3) methods for image acquisition and reconstruction specific to improving data acquisition efficiency for HP MRI, (4) the main physical properties that enable unique measures of physiology or metabolic pathways, followed by a more detailed review of the literature describing the use of HP agents to study: (5) metabolic pathways in cancer and cardiac disease and (6) lung function in both pre-clinical and clinical research studies, concluding with (7) some future directions and challenges, and (8) an overall summary.
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Affiliation(s)
- Erin B Adamson
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States of America
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