Hyperpolarized helium-3 MR imaging of pulmonary function

Probing lung microstructure with hyperpolarized noble gas diffusion MRI: theoretical models and experimental results

The introduction of hyperpolarized gases ((3)He and (129)Xe) has opened the door to applications for which gaseous agents are uniquely suited-lung MRI. One of the pulmonary applications, diffusion MRI, relies on measuring Brownian motion of inhaled hyperpolarized gas atoms diffusing in lung airspaces. In this article we provide an overview of the theoretical ideas behind hyperpolarized gas diffusion MRI and the results obtained over the decade-long research. We describe a simple technique based on measuring gas apparent diffusion coefficient (ADC) and an advanced technique, in vivo lung morphometry, that quantifies lung microstructure both in terms of Weibel parameters (acinar airways radii and alveolar depth) and standard metrics (mean linear intercept, surface-to-volume ratio, and alveolar density) that are widely used by lung researchers but were previously available only from invasive lung biopsy. This technique has the ability to provide unique three-dimensional tomographic information on lung microstructure from a less than 15 s MRI scan with results that are in good agreement with direct histological measurements. These safe and sensitive diffusion measurements improve our understanding of lung structure and functioning in health and disease, providing a platform for monitoring the efficacy of therapeutic interventions in clinical trials.

A variability study of regional alveolar oxygen tension measurement in humans using hyperpolarized (3) He MRI

PURPOSE

A systematic study of the short-term and long-term variability of regional alveolar partial pressure of oxygen tension (pA O2 ) measurements using (3) He magnetic resonance imaging was presented. Additionally, the repeatability of the average evaluated pA O2 was compared with that of the standard pulmonary function tests.

METHODS

Pulmonary function test and pA O2 imaging were performed on 4 nonsmokers (1 M, 3 F, 56 ± 1.7 years) and 4 smokers (3 M, 1 F, 52 ± 7.5 years) during three visits over the course of 2 weeks. Two measurements were performed per visit. Variability of pA O2 was assessed using a mixed-effect model, with an intraclass correlation coefficient calculated for each group. The coefficient of variation of pA O2 over the 3-day period was also compared with the coefficient of variation of pulmonary function test results.

RESULTS

Short-term regional variability based on intraclass correlation coefficient was 0.71 for nonsmokers, and 0.63 for smokers, with long-term variability significantly lower at 0.59 and 0.47, respectively. While the coefficient of variation of the average pA O2 was similar to the repeatability of the diffusing capacity of CO, it was significantly higher than that of Forced Vital Capacity (P = 0.02).

CONCLUSION

Short-term and long-term pA O2 variability differences were used as an indication of true physiological changes in order to measure technical reproducibility. Smokers show higher physiologic variability and less technical reproducibility. The suggested pA O2 -imaging technique showed a reasonable regional repeatability in nonsmokers as well as the ability to detect differences between the two groups with similar reproducibility and superior discriminatory ability when compared with pulmonary function tests.

A multislice single breath-hold scheme for imaging alveolar oxygen tension in humans

Reliable, noninvasive, and high-resolution imaging of alveolar partial pressure of oxygen (p(A)O(2)) is a potentially valuable tool in the early diagnosis of pulmonary diseases. Several techniques have been proposed for regional measurement of p(A)O(2) based on the increased depolarization rate of hyperpolarized (3) He. In this study, we explore one such technique by applying a multislice p(A)O(2) -imaging scheme that uses interleaved-slice ordering to utilize interslice time-delays more efficiently. This approach addresses the low spatial resolution and long breath-hold requirements of earlier techniques, allowing p(A)O(2) measurements to be made over the entire human lung in 10-15 s with a typical resolution of 8.3 × 8.3 × 15.6 mm(3). PO(2) measurements in a glass syringe phantom were in agreement with independent gas analysis within 4.7 ± 4.1% (R = 0.9993). The technique is demonstrated in four human subjects (healthy nonsmoker, healthy former smoker, healthy smoker, and patient with COPD), each imaged six times on 3 different days during a 2-week span. Two independent measurements were performed in each session, consisting of 12 coronal slices. The overall p(A)O(2) mean across all subjects was 95.9 ± 12.2 Torr and correlated well with end-tidal O(2) (R = 0.805, P < 0.0001). The alveolar O(2) uptake rate was consistent with the expected range of 1-2 Torr/s. Repeatable visual features were observed in p(A)O(2) maps over different days, as were characteristic differences among the subjects and gravity-dependent effects.

Ventilation defects observed with hyperpolarized 3He magnetic resonance imaging in a mouse model of acute lung injury

Regions of diminished ventilation are often evident during functional pulmonary imaging studies, including hyperpolarized gas magnetic resonance imaging (MRI), positron emission tomography, and computed tomography (CT). The objective of this study was to characterize the hypointense regions observed via (3)He MRI in a murine model of acute lung injury. LPS at doses ranging from 15-50 μg was intratracheally administered to C57BL/6 mice under anesthesia. Four hours after exposure to either LPS or saline vehicle, mice were imaged via hyperpolarized (3)He MRI. All images were evaluated to identify regions of hypointense signals. Lungs were then characterized by conventional histology, or used to obtain tissue samples from regions of normal and hypointense (3)He signals and analyzed for cytokine content. The characterization of (3)He MRI images identified three distinct types of hypointense patterns: persistent defects, atelectatic defects, and dorsal lucencies. Persistent defects were associated with the administration of LPS. The number of persistent defects depended on the dose of LPS, with a significant increase in mean number of defects in 30-50-μg LPS-dosed mice versus saline-treated control mice. Atelectatic defects predominated in LPS-dosed mice under conditions of low-volume ventilation, and could be reversed with deep inspiration. Dorsal lucencies were present in nearly all mice studied, regardless of the experimental conditions, including control animals that did not receive LPS. A comparison of (3)He MRI with histopathology did not identify tissue abnormalities in regions of low (3)He signal, with the exception of a single region of atelectasis in one mouse. Furthermore, no statistically significant differences were evident in concentrations of IL-1β, IL-6, macrophage inflammatory protein (MIP)-1α, MIP-2, chemokine (C-X-C motif) ligand 1 (KC), TNFα, and monocyte chemotactic protein (MCP)-1 between hypointense and normally ventilated lung regions in LPS-dosed mice. Thus, this study defines the anatomic, functional, and biochemical characteristics of ventilation defects associated with the administration of LPS in a murine model of acute lung injury.

Design and evaluation of a 32-channel phased-array coil for lung imaging with hyperpolarized 3-helium

Imaging with hyperpolarized 3-helium is becoming an increasingly important technique for MRI diagnostics of the lung but is hampered by long breath holds (>20 sec), which are not always applicable in patients with severe lung disease like chronic obstructive pulmonary disease (COPD) or alpha-1-anti-trypsin deficiency. Additionally, oxygen-induced depolarization decay during the long breath holds complicates interpretation of functional data such as apparent diffusion coefficients. To address these issues, we describe and validate a 1.5-T, 32-channel array coil for accelerated (3)He lung imaging and demonstrate its ability to speed up imaging (3)He. A signal-to-noise ratio increase of up to a factor of 17 was observed compared to a conventional double-resonant birdcage for unaccelerated imaging, potentially allowing increased image resolution or decreased gas production requirements. Accelerated imaging of the whole lung with one-dimensional and two-dimensional acceleration factors of 4 and 4 x 2, respectively, was achieved while still retaining excellent image quality. Finally, the potential of highly parallel detection in lung imaging is demonstrated with high-resolution morphologic and functional images.

Molecular imaging without radiopharmaceuticals?

The limitations on the sensitivity for detecting small changes in MRI, CT, and ultrasound pulse-echo images are used to estimate the practical requirements for molecular imaging and targeted contrast enhancement for these modalities. These types of imaging are highly unlikely to approach the sensitivity for detecting molecular processes of radionuclear methods, and the prospects for achieving sufficient concentrations of appropriate agents in vivo are poor for several types of applications such as small-molecule targeting of specific receptors. However, using relatively large carrier systems such as particles and liposomes, sufficient concentrations of paramagnetic agents may be delivered to achieve MR-signal changes adequate for detection. The use of higher-resolution MR images will aid the prospects for molecular imaging in small animals. Theoretic considerations also predict that a similar approach, using rather large particles or carriers of materials with a high atomic number, may also be successful for CT, especially with additional developments such as the use of monochromatic x-rays. The prospects of molecular imaging by x-ray imaging may not be as bleak as has been predicted. For ultrasound detection, gas-filled bubbles can provide a sufficient backscattered sound intensity to be detectable at concentrations and sizes not much different from agents designed for these other modalities.

Calibration of RF transmitter voltages for hyperpolarized gas MRI

MRI with hyperpolarized gases, (3)He, (129)Xe, (13)C, and others, has the potential to become an important diagnostic technique for clinical imaging. Due to the nonreversible loss of magnetization in hyperpolarized gas imaging, the choice of the flip angle is a major factor that influences the signal intensity, and hence, the signal-to-noise ratio. Conventional automated radiofrequency (RF) calibration procedures for (1)H imaging are not suitable for hyperpolarized gas imaging. Herein, we have demonstrated a simple procedure for RF calibration for magnetic resonance imaging (MRI) with hyperpolarized gases that is easily adaptable to clinical settings. We have demonstrated that there exists a linear relationship between the RF transmitter voltages required to obtain the same nutation angle for protons (V(1H)) and hyperpolarized gas nuclei (V(3He)). For our (1)H and (3)He coils we found that V(3He) = 1.937 . V(1H) with correlation coefficient r(2) = 0.97. This calibration can be done as a one-time procedure during the routine quality assurance (QA) protocol. The proposed procedure was found to be extremely robust in routine scanning and provided an efficient method to achieve a desired flip angle, thus allowing optimum image quality.

Assessment of the lung microstructure in patients with asthma using hyperpolarized 3He diffusion MRI at two time scales: comparison with healthy subjects and patients with COPD

PURPOSE

To investigate short- and long-time-scale (3)He diffusion in asthma.

MATERIALS AND METHODS

A hybrid MRI sequence was developed to obtain co-registered short- and long-time-scale apparent diffusion coefficient (ADC) maps during a single breath-hold. The study groups were: asthma (n = 14); healthy (n = 14); chronic obstructive pulmonary disease (COPD) (n = 9). Correlations were made between mean-ADC and %ADC-abn (abnormal) (%pixels with ADC > mean +2 SD of healthy) at both time scales and spirometry. Sensitivities were determined using receiver operating characteristic (ROC) analysis.

RESULTS

For asthmatics, the short- and long-time-scale group-mean ADCs were 0.254 +/- 0.032 cm(2)/s and 0.0237 +/- 0.0055 cm(2)/s, respectively, representing a 9% and 27% (P = 0.038 and P = 0.005) increase compared to the healthy group. The group-mean %ADC-abn were 6.4% +/- 3.7% and 17.5% +/- 14.2%, representing a 107% and 272% (P = 0.004 and P = 0.006) increase. For COPD much greater elevations were observed. %ADC-abn provided better discrimination than mean-ADC between asthmatic and healthy subjects. In asthmatics ADC did not correlate with spirometry.

CONCLUSION

With long-time scale (3)He diffusion magnetic resonance imaging (MRI) changes in lung microstructure were detected in asthma that more conspicuous regionally than at the short time scale. The hybrid diffusion method is a novel means of identifying small airway disease.

A robust method for estimating regional pulmonary parameters in presence of noise

RATIONALE AND OBJECTIVES

Estimation of regional lung function parameters from hyperpolarized gas magnetic resonance images can be very sensitive to presence of noise. Clustering pixels and averaging over the resulting groups is an effective method for reducing the effects of noise in these images, commonly performed by grouping proximal pixels together, thus creating large groups called "bins." This method has several drawbacks, primarily that it can group dissimilar pixels together, and it degrades spatial resolution. This study presents an improved approach to simplifying data via principal component analysis (PCA) when noise level prohibits a pixel-by-pixel treatment of data, by clustering them based on similarity to one another rather than spatial proximity. The application to this technique is demonstrated in measurements of regional lung oxygen tension using hyperpolarized (3)He magnetic resonance imaging (MRI).

MATERIALS AND METHODS

A synthetic dataset was generated from an experimental set of oxygen tension measurements by treating the experimentally derived parameters as "true" values, and then solving backwards to generate "noiseless" images. Artificial noise was added to the synthetic data, and both traditional binning and PCA-based clustering were performed. For both methods, the root-mean-square (RMS) error between each pixel's "estimated" and "true" parameters was computed and the resulting effects were compared.

RESULTS

At high signal-to-noise ratios (SNRs), clustering did not enhance accuracy. Clustering did, however, improve parameter estimations for moderate SNR values (below 100). For SNR values between 100 and 20, the PCA-based K-means clustering analysis yielded greater accuracy than Cartesian binning. In extreme cases (SNR<5), Cartesian binning can be more accurate.

CONCLUSIONS

The reliability of parameters estimation in imaging-based regional functional measurements can be improved in the presence of noise by utilizing principal component analysis-based clustering without sacrificing spatial resolution compared to Cartesian binning. Results suggest that this approach has a great potential for robust grouping of pixels in hyperpolarized (3)He MRI maps of lung oxygen tension.

Application of an optical flow method to inspiratory and expiratory lung MDCT to assess regional air trapping: a feasibility study

OBJECTIVE

We describe the application of an optical flow method to inspiratory and expiratory high-resolution volumetric lung MDCT for the assessment of regional air trapping.

CONCLUSION

Qualitative and quantitative assessment of regional air trapping is feasible using an optical flow method to align volumetric MDCT data sets.

Detection of small pulmonary nodules in high-field MR at 3 T: evaluation of different pulse sequences using porcine lung explants

To evaluate two MR imaging sequences for the detection of artificial pulmonary nodules inside porcine lung explants. 67 agarose nodules ranging 3-20 mm were injected into ten porcine lungs within a dedicated chest phantom. The signal on T1-weighted images and radiopacity were adjusted by adding 0.125 mmol/l Gd-DTPA and 1.5 g/l of iodine. A T1-weighted three-dimensional gradient-echo (T1-3D-GRE; TR/TE:3.3/1.1 ms, slice:8 mm, flip-angle:10 degrees ) and a T2-weighted half-Fourier fast-spin echo sequence (T2-HF-FSE; TR/TE:2000/66 ms, slice:7 mm, flip-angle:90 degrees ) were applied in axial orientation using a 3-T system (Intera, Philips Medical Systems, Best, The Netherlands), followed by CT (16x0.5 mm) as reference. Nodule sizes and locations were assessed by three blinded observers. In nodules of >10 mm, sensitivity was 100% using 3D-GRE-MRI and 94% using the HF-FSE sequence. For nodules 6-10 mm, the sensitivity of MRI was lower than with CT (3D-GRE:92%; T2-HF-FSE:83%). In lesions smaller than 5 mm, the sensitivity declined to 80% (3D-GRE) and 53% (HF-FSE). Small lesion diameters were overestimated with both sequences, particularly with HF-FSE. This study confirms the feasibility of 3 T-MRI for lung nodule detection. In lesions greater than 5 mm, the sensitivity of the 3D-GRE sequence approximated CT (>90%), while sensitivity and PPV with the HF-FSE sequence were slightly inferior.