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Neder JA, Santyr G, Zanette B, Kirby M, Pourafkari M, James MD, Vincent SG, Ferguson C, Wang CY, Domnik NJ, Phillips DB, Porszasz J, Stringer WW, O'Donnell DE. Beyond Spirometry: Linking Wasted Ventilation to Exertional Dyspnea in the Initial Stages of COPD. COPD 2024; 21:2301549. [PMID: 38348843 DOI: 10.1080/15412555.2023.2301549] [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: 10/15/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024]
Abstract
Exertional dyspnea, a key complaint of patients with chronic obstructive pulmonary disease (COPD), ultimately reflects an increased inspiratory neural drive to breathe. In non-hypoxemic patients with largely preserved lung mechanics - as those in the initial stages of the disease - the heightened inspiratory neural drive is strongly associated with an exaggerated ventilatory response to metabolic demand. Several lines of evidence indicate that the so-called excess ventilation (high ventilation-CO2 output relationship) primarily reflects poor gas exchange efficiency, namely increased physiological dead space. Pulmonary function tests estimating the extension of the wasted ventilation and selected cardiopulmonary exercise testing variables can, therefore, shed unique light on the genesis of patients' out-of-proportion dyspnea. After a succinct overview of the basis of gas exchange efficiency in health and inefficiency in COPD, we discuss how wasted ventilation translates into exertional dyspnea in individual patients. We then outline what is currently known about the structural basis of wasted ventilation in "minor/trivial" COPD vis-à-vis the contribution of emphysema versus a potential impairment in lung perfusion across non-emphysematous lung. After summarizing some unanswered questions on the field, we propose that functional imaging be amalgamated with pulmonary function tests beyond spirometry to improve our understanding of this deeply neglected cause of exertional dyspnea. Advances in the field will depend on our ability to develop robust platforms for deeply phenotyping (structurally and functionally), the dyspneic patients showing unordinary high wasted ventilation despite relatively preserved FEV1.
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Affiliation(s)
- J Alberto Neder
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Canada
| | - Giles Santyr
- Translational Medicine Department, Faculty of Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Canada
| | - Brandon Zanette
- Translational Medicine Department, Faculty of Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Canada
| | - Miranda Kirby
- Department of Physics, Faculty of Science, Toronto Metropolitan University, Toronto, Canada
| | - Marina Pourafkari
- Department of Radiology and Diagnostic Imaging, Kingston Health Sciences Centre, Kingston, Canada
| | - Matthew D James
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Canada
| | - Sandra G Vincent
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Canada
| | - Carrie Ferguson
- The Lundquist Institute for Biomedical Innovation, Harbor U.C.L.A Medical Centre, Torrance, CA, USA
| | - Chu-Yi Wang
- The Lundquist Institute for Biomedical Innovation, Harbor U.C.L.A Medical Centre, Torrance, CA, USA
| | - Nicolle J Domnik
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Devin B Phillips
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Janos Porszasz
- The Lundquist Institute for Biomedical Innovation, Harbor U.C.L.A Medical Centre, Torrance, CA, USA
| | - William W Stringer
- The Lundquist Institute for Biomedical Innovation, Harbor U.C.L.A Medical Centre, Torrance, CA, USA
| | - Denis E O'Donnell
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, Canada
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Transue S, Lee DK, Choi JS, Choi S, Hong M, Choi MH. Flow-Field Inference for Turbulent Exhale Flow Measurement. Diagnostics (Basel) 2024; 14:1596. [PMID: 39125472 PMCID: PMC11311330 DOI: 10.3390/diagnostics14151596] [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: 05/31/2024] [Revised: 07/13/2024] [Accepted: 07/19/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Vision-based pulmonary diagnostics present a unique approach for tracking and measuring natural breathing behaviors through remote imaging. While many existing methods correlate chest and diaphragm movements to respiratory behavior, we look at how the direct visualization of thermal CO2 exhale flow patterns can be tracked to directly measure expiratory flow. METHODS In this work, we present a novel method for isolating and extracting turbulent exhale flow signals from thermal image sequences through flow-field prediction and optical flow measurement. The objective of this work is to introduce a respiratory diagnostic tool that can be used to capture and quantify natural breathing, to identify and measure respiratory metrics such as breathing rate, flow, and volume. One of the primary contributions of this work is a method for capturing and measuring natural exhale behaviors that describe individualized pulmonary traits. By monitoring subtle individualized respiratory traits, we can perform secondary analysis to identify unique personalized signatures and abnormalities to gain insight into pulmonary function. In our study, we perform data acquisition within a clinical setting to train an inference model (FieldNet) that predicts flow-fields to quantify observed exhale behaviors over time. RESULTS Expiratory flow measurements capturing individualized flow signatures from our initial cohort demonstrate how the proposed flow field model can be used to isolate and analyze turbulent exhale behaviors and measure anomalous behavior. CONCLUSIONS Our results illustrate that detailed spatial flow analysis can contribute to unique signatures for identifying patient specific natural breathing behaviors and abnormality detection. This provides the first-step towards a non-contact respiratory technology that directly captures effort-independent behaviors based on the direct measurement of imaged CO2 exhaled airflow patterns.
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Affiliation(s)
- Shane Transue
- Department of Computer Science and Engineering, University of Colorado Denver, Denver, CO 80204, USA; (S.T.); (M.-H.C.)
| | - Do-kyeong Lee
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea
| | - Jae-Sung Choi
- Department of Internal Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Seongjun Choi
- Department of Otolaryngology-Head and Neck Surgery, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Min Hong
- Department of Computer Software Engineering, Soonchunhyang University, Asan 31538, Republic of Korea
| | - Min-Hyung Choi
- Department of Computer Science and Engineering, University of Colorado Denver, Denver, CO 80204, USA; (S.T.); (M.-H.C.)
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Ozawa Y, Nagata H, Ueda T, Oshima Y, Hamabuchi N, Yoshikawa T, Takenaka D, Ohno Y. Chest Magnetic Resonance Imaging: Advances and Clinical Care. Clin Chest Med 2024; 45:505-529. [PMID: 38816103 DOI: 10.1016/j.ccm.2024.02.017] [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] [Indexed: 06/01/2024]
Abstract
Many promising study results as well as technical advances for chest magnetic resonance imaging (MRI) have demonstrated its academic and clinical potentials during the last few decades, although chest MRI has been used for relatively few clinical situations in routine clinical practice. However, the Fleischner Society as well as the Japanese Society of Magnetic Resonance in Medicine have published a few white papers to promote chest MRI in routine clinical practice. In this review, we present clinical evidence of the efficacy of chest MRI for 1) thoracic oncology and 2) pulmonary vascular diseases.
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Affiliation(s)
- Yoshiyuki Ozawa
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takahiro Ueda
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takeshi Yoshikawa
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Daisuke Takenaka
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Yoshiharu Ohno
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
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Ezegbogu M, Wilkinson E, Reid G, Rodger EJ, Brockway B, Russell-Camp T, Kumar R, Chatterjee A. Cell-free DNA methylation in the clinical management of lung cancer. Trends Mol Med 2024; 30:499-515. [PMID: 38582623 DOI: 10.1016/j.molmed.2024.03.007] [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: 12/07/2023] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/08/2024]
Abstract
The clinical use of cell-free DNA (cfDNA) methylation in managing lung cancer depends on its ability to differentiate between malignant and healthy cells, assign methylation changes to specific tissue sources, and elucidate opportunities for targeted therapy. From a technical standpoint, cfDNA methylation analysis is primed as a potential clinical tool for lung cancer screening, early diagnosis, prognostication, and treatment, pending the outcome of elaborate validation studies. Here, we discuss the current state of the art in cfDNA methylation analysis, examine the unique features and limitations of these new methods in a clinical context, propose two models for applying cfDNA methylation data for lung cancer screening, and discuss future research directions.
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Affiliation(s)
- Mark Ezegbogu
- Department of Pathology, Dunedin School of Medicine, University of Otago, New Zealand
| | - Emma Wilkinson
- Department of Pathology, Dunedin School of Medicine, University of Otago, New Zealand
| | - Glen Reid
- Department of Pathology, Dunedin School of Medicine, University of Otago, New Zealand
| | - Euan J Rodger
- Department of Pathology, Dunedin School of Medicine, University of Otago, New Zealand
| | - Ben Brockway
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Takiwai Russell-Camp
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Rajiv Kumar
- St George's Cancer Care Centre, 131 Leinster Road, Christchurch, 8014, New Zealand
| | - Aniruddha Chatterjee
- Department of Pathology, Dunedin School of Medicine, University of Otago, New Zealand; SoHST Faculty, UPES University, Dehradun 248007, India.
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Zhang M, Li H, Li H, Zhao X, Liu X, Han Y, Sun X, Ye C, Zhou X. Dynamic evaluation of acute lung injury using hyperpolarized 129 Xe magnetic resonance. NMR IN BIOMEDICINE 2024; 37:e5078. [PMID: 38086710 DOI: 10.1002/nbm.5078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 10/10/2023] [Accepted: 11/05/2023] [Indexed: 03/16/2024]
Abstract
Prognosticating acute lung injury (ALI) is challenging, in part because of a lack of sensitive biomarkers. Hyperpolarized gas magnetic resonance (MR) has unique advantages in pulmonary function measurement and can provide promising biomarkers for the assessment of lung injuries. Herein, we employ hyperpolarized 129 Xe MRI and generate a number of imaging biomarkers to detect the pulmonary physiological and morphological changes during the progression of ALI in an animal model. We find the measured ratio of 129 Xe in red blood cells to interstitial tissue/plasma (RBC/TP) is significantly lower in the ALI group on the second (0.32 ± 0.03, p = 0.004), seventh (0.23 ± 0.03, p < 0.001), and 14th (0.29 ± 0.04, p = 0.001) day after lipopolysaccharide treatment compared with that in the control group (0.41 ± 0.04). In addition, significant differences are also observed for RBC/TP measurements between the second and seventh day (p = 0.001) and between the seventh and 14th day (p = 0.018) in the ALI group after treatment. Besides RBC/TP, significant differences are also observed in the measured exchange time constant (T) on the second (p = 0.038) and seventh day (p = 0.009) and in the measured apparent diffusion coefficient (ADC) and alveolar surface-to-volume ratio (SVR) on the 14th day (ADC: p = 0.009 and SVR: p = 0.019) after treatment in the ALI group compared with that in the control group. These findings indicate that the parameters measured with 129 Xe MR can detect the dynamic changes in pulmonary structure and function in an ALI animal model.
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Affiliation(s)
- Ming Zhang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Haidong Li
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Hongchuang Li
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xiuchao Zhao
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoling Liu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yeqing Han
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xianping Sun
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Chaohui Ye
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xin Zhou
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
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Ohno Y, Yui M, Yamamoto K, Ikedo M, Oshima Y, Hamabuchi N, Hanamatsu S, Nagata H, Ueda T, Ikeda H, Takenaka D, Yoshikawa T, Ozawa Y, Toyama H. Pulmonary MRI with ultra-short TE using single- and dual-echo methods: comparison of capability for quantitative differentiation of non- or minimally invasive adenocarcinomas from other lung cancers with that of standard-dose thin-section CT. Eur Radiol 2024; 34:1065-1076. [PMID: 37580601 DOI: 10.1007/s00330-023-10105-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/05/2023] [Accepted: 06/25/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE The purpose of this study was thus to compare capabilities for quantitative differentiation of non- and minimally invasive adenocarcinomas from other of pulmonary MRIs with ultra-short TE (UTE) obtained with single- and dual-echo techniques (UTE-MRISingle and UTE-MRIDual) and thin-section CT for stage IA lung cancer patients. METHODS Ninety pathologically diagnosed stage IA lung cancer patients who underwent thin-section standard-dose CT, UTE-MRISingle, and UTE-MRIDual, surgical treatment and pathological examinations were included in this retrospective study. The largest dimension (Dlong), solid portion (solid Dlong), and consolidation/tumor (C/T) ratio of each nodule were assessed. Two-tailed Student's t-tests were performed to compare all indexes obtained with each method between non- and minimally invasive adenocarcinomas and other lung cancers. Receiver operating characteristic (ROC)-based positive tests were performed to determine all feasible threshold values for distinguishing non- or minimally invasive adenocarcinoma (MIA) from other lung cancers. Sensitivity, specificity, and accuracy were then compared by means of McNemar's test. RESULTS Each index showed significant differences between the two groups (p < 0.0001). Specificities and accuracies of solid Dlong for UTE-MRIDual2nd echo and CTMediastinal were significantly higher than those of solid Dlong for UTE-MRISingle and UTE-MRIDual1st echo and all C/T ratios except CTMediastinal (p < 0.05). Moreover, the specificities and accuracies of solid Dlong and C/T ratio were significantly higher than those of Dlong for each method (p < 0.05). CONCLUSION Pulmonary MRI with UTE is considered at least as valuable as thin-section CT for quantitative differentiation of non- and minimally invasive adenocarcinomas from other stage IA lung cancers. CLINICAL RELEVANCE STATEMENT Pulmonary MRI with UTE's capability for quantitative differentiation of non- and minimally invasive adenocarcinomas from other lung cancers in stage IA lung cancer patients is equal or superior to that of thin-section CT. KEY POINTS • Correlations were excellent for pathologically examined nodules with the largest dimensions (Dlong) and a solid component (solid Dlong) for all indexes (0.95 ≤ r ≤ 0.99, p < 0.0001). • Pathologically examined Dlong and solid Dlong obtained with all methods showed significant differences between non- and minimally invasive adenocarcinomas and other lung cancers (p < 0.0001). • Solid tumor components are most accurately measured by UTE-MRIDual2nd echo and CTMediastinal, whereas the ground-glass component is imaged by UTE-MRIDual1st echo and CTlung with high accuracy. UTE-MRIDual predicts tumor invasiveness with 100% sensitivity and 87.5% specificity at a C/T threshold of 0.5.
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Affiliation(s)
- Yoshiharu Ohno
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
| | - Masao Yui
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Kaori Yamamoto
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Masato Ikedo
- Canon Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Satomu Hanamatsu
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirotaka Ikeda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Daisuke Takenaka
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Takeshi Yoshikawa
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Yoshiyuki Ozawa
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Radiology, Nagoya City University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
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Ohno Y, Ozawa Y, Nagata H, Ueda T, Yoshikawa T, Takenaka D, Koyama H. Lung Magnetic Resonance Imaging: Technical Advancements and Clinical Applications. Invest Radiol 2024; 59:38-52. [PMID: 37707840 DOI: 10.1097/rli.0000000000001017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
ABSTRACT Since lung magnetic resonance imaging (MRI) became clinically available, limited clinical utility has been suggested for applying MRI to lung diseases. Moreover, clinical applications of MRI for patients with lung diseases or thoracic oncology may vary from country to country due to clinical indications, type of health insurance, or number of MR units available. Because of this situation, members of the Fleischner Society and of the Japanese Society for Magnetic Resonance in Medicine have published new reports to provide appropriate clinical indications for lung MRI. This review article presents a brief history of lung MRI in terms of its technical aspects and major clinical indications, such as (1) what is currently available, (2) what is promising but requires further validation or evaluation, and (3) which developments warrant research-based evaluations in preclinical or patient studies. We hope this article will provide Investigative Radiology readers with further knowledge of the current status of lung MRI and will assist them with the application of appropriate protocols in routine clinical practice.
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Affiliation(s)
- Yoshiharu Ohno
- From the Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y. Ohno); Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y. Ohno and H.N.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y. Ozawa and T.U.); Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (T.Y., D.T.); and Department of Radiology, Advanced Diagnostic Medical Imaging, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (H.K.)
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Missimer JH, Emert F, Lomax AJ, Weber DC. Automatic lung segmentation of magnetic resonance images: A new approach applied to healthy volunteers undergoing enhanced Deep-Inspiration-Breath-Hold for motion-mitigated 4D proton therapy of lung tumors. Phys Imaging Radiat Oncol 2024; 29:100531. [PMID: 38292650 PMCID: PMC10825631 DOI: 10.1016/j.phro.2024.100531] [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: 03/31/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024] Open
Abstract
Background and purpose Respiratory suppression techniques represent an effective motion mitigation strategy for 4D-irradiation of lung tumors with protons. A magnetic resonance imaging (MRI)-based study applied and analyzed methods for this purpose, including enhanced Deep-Inspiration-Breath-Hold (eDIBH). Twenty-one healthy volunteers (41-58 years) underwent thoracic MR scans in four imaging sessions containing two eDIBH-guided MRIs per session to simulate motion-dependent irradiation conditions. The automated MRI segmentation algorithm presented here was critical in determining the lung volumes (LVs) achieved during eDIBH. Materials and methods The study included 168 MRIs acquired under eDIBH conditions. The lung segmentation algorithm consisted of four analysis steps: (i) image preprocessing, (ii) MRI histogram analysis with thresholding, (iii) automatic segmentation, (iv) 3D-clustering. To validate the algorithm, 46 eDIBH-MRIs were manually contoured. Sørensen-Dice similarity coefficients (DSCs) and relative deviations of LVs were determined as similarity measures. Assessment of intrasessional and intersessional LV variations and their differences provided estimates of statistical and systematic errors. Results Lung segmentation time for 100 2D-MRI planes was ∼ 10 s. Compared to manual lung contouring, the median DSC was 0.94 with a lower 95 % confidence level (CL) of 0.92. The relative volume deviations yielded a median value of 0.059 and 95 % CLs of -0.013 and 0.13. Artifact-based volume errors, mainly of the trachea, were estimated. Estimated statistical and systematic errors ranged between 6 and 8 %. Conclusions The presented analytical algorithm is fast, precise, and readily available. The results are comparable to time-consuming, manual segmentations and other automatic segmentation approaches. Post-processing to remove image artifacts is under development.
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Affiliation(s)
- John H. Missimer
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
| | - Frank Emert
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
| | - Antony J. Lomax
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
- Department of Physics, ETH Zurich, Zurich, Switzerland
| | - Damien C. Weber
- Center for Proton Therapy, Paul Scherrer Institute, Villigen PSI, Switzerland
- Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Blaskovic S, Anagnostopoulou P, Borisova E, Schittny D, Donati Y, Haberthür D, Zhou-Suckow Z, Mall MA, Schlepütz CM, Stampanoni M, Barazzone-Argiroffo C, Schittny JC. Airspace Diameter Map-A Quantitative Measurement of All Pulmonary Airspaces to Characterize Structural Lung Diseases. Cells 2023; 12:2375. [PMID: 37830589 PMCID: PMC10571657 DOI: 10.3390/cells12192375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023] Open
Abstract
(1) Background: Stereological estimations significantly contributed to our understanding of lung anatomy and physiology. Taking stereology fully 3-dimensional facilitates the estimation of novel parameters. (2) Methods: We developed a protocol for the analysis of all airspaces of an entire lung. It includes (i) high-resolution synchrotron radiation-based X-ray tomographic microscopy, (ii) image segmentation using the free machine-learning tool Ilastik and ImageJ, and (iii) calculation of the airspace diameter distribution using a diameter map function. To evaluate the new pipeline, lungs from adult mice with cystic fibrosis (CF)-like lung disease (βENaC-transgenic mice) or mice with elastase-induced emphysema were compared to healthy controls. (3) Results: We were able to show the distribution of airspace diameters throughout the entire lung, as well as separately for the conducting airways and the gas exchange area. In the pathobiological context, we observed an irregular widening of parenchymal airspaces in mice with CF-like lung disease and elastase-induced emphysema. Comparable results were obtained when analyzing lungs imaged with μCT, sugges-ting that our pipeline is applicable to different kinds of imaging modalities. (4) Conclusions: We conclude that the airspace diameter map is well suited for a detailed analysis of unevenly distri-buted structural alterations in chronic muco-obstructive lung diseases such as cystic fibrosis and COPD.
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Affiliation(s)
- Sanja Blaskovic
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (S.B.); (E.B.); (D.S.); (D.H.)
| | | | - Elena Borisova
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (S.B.); (E.B.); (D.S.); (D.H.)
| | - Dominik Schittny
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (S.B.); (E.B.); (D.S.); (D.H.)
| | - Yves Donati
- Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Genève, Switzerland; (Y.D.); (C.B.-A.)
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - David Haberthür
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (S.B.); (E.B.); (D.S.); (D.H.)
| | - Zhe Zhou-Suckow
- Department of Translational Pulmonology, University Hospital Heidelberg, Translational Lung Research Center (TLRC), A Member of German Center for Lung Research (DZL), 69120 Heidelberg, Germany;
| | - Marcus A. Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, 10115 Berlin, Germany;
- Berlin Institute of Health (BIH), Charité-Universitätsmedizin Berlin, 10115 Berlin, Germany
- German Center for Lung Research (DZL), Associated Partner Site, 10115 Berlin, Germany
| | - Christian M. Schlepütz
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen, Switzerland; (C.M.S.); (M.S.)
| | - Marco Stampanoni
- Swiss Light Source, Paul Scherrer Institute, 5232 Villigen, Switzerland; (C.M.S.); (M.S.)
- Institute for Biomedical Engineering, University and ETH Zürich, 8093 Zurich, Switzerland
| | - Constance Barazzone-Argiroffo
- Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, 4 rue Gabrielle-Perret-Gentil, 1211 Genève, Switzerland; (Y.D.); (C.B.-A.)
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Johannes C. Schittny
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (S.B.); (E.B.); (D.S.); (D.H.)
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10
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Bayat S, Wild J, Winkler T. Lung functional imaging. Breathe (Sheff) 2023; 19:220272. [PMID: 38020338 PMCID: PMC10644108 DOI: 10.1183/20734735.0272-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Pulmonary functional imaging modalities such as computed tomography, magnetic resonance imaging and nuclear imaging can quantitatively assess regional lung functional parameters and their distributions. These include ventilation, perfusion, gas exchange at the microvascular level and biomechanical properties, among other variables. This review describes the rationale, strengths and limitations of the various imaging modalities employed for lung functional imaging. It also aims to explain some of the most commonly measured parameters of regional lung function. A brief review of evidence on the role and utility of lung functional imaging in early diagnosis, accurate lung functional characterisation, disease phenotyping and advancing the understanding of disease mechanisms in major respiratory disorders is provided.
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Affiliation(s)
- Sam Bayat
- Department of Pulmonology and Physiology, CHU Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, STROBE Laboratory, INSERM UA07, Grenoble, France
| | - Jim Wild
- POLARIS, Imaging Group, Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
| | - Tilo Winkler
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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11
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Cazzola M, Page CP, Matera MG, Rogliani P, Hanania NA. Revisiting asthma pharmacotherapy: where do we stand and where do we want to go? Eur Respir J 2023; 62:2300700. [PMID: 37474159 DOI: 10.1183/13993003.00700-2023] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023]
Abstract
Several current guidelines/strategies outline a treatment approach to asthma, which primarily consider the goals of improving lung function and quality of life and reducing symptoms and exacerbations. They suggest a strategy of stepping up or down treatment, depending on the patient's overall current asthma symptom control and future risk of exacerbation. While this stepwise approach is undeniably practical for daily practice, it does not always address the underlying mechanisms of this heterogeneous disease. In the last decade, there have been attempts to improve the treatment of severe asthma, such as the addition of a long-acting antimuscarinic agent to the traditional inhaled corticosteroid/long-acting β2-agonist treatment and the introduction of therapies targeting key cytokines. However, despite such strategies several unmet needs in this population remain, motivating research to identify novel targets and develop improved therapeutic and/or preventative asthma treatments. Pending the availability of such therapies, it is essential to re-evaluate the current conventional "one-size-fits-all" approach to a more precise asthma management. Although challenging, identifying "treatable traits" that contribute to respiratory symptoms in individual patients with asthma may allow a more pragmatic approach to establish more personalised therapeutic goals.
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Affiliation(s)
- Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Clive P Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
| | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Rogliani
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA
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12
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Ohno Y, Ozawa Y, Nagata H, Bando S, Cong S, Takahashi T, Oshima Y, Hamabuchi N, Matsuyama T, Ueda T, Yoshikawa T, Takenaka D, Toyama H. Area-Detector Computed Tomography for Pulmonary Functional Imaging. Diagnostics (Basel) 2023; 13:2518. [PMID: 37568881 PMCID: PMC10416899 DOI: 10.3390/diagnostics13152518] [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: 06/05/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
An area-detector CT (ADCT) has a 320-detector row and can obtain isotropic volume data without helical scanning within an area of nearly 160 mm. The actual-perfusion CT data within this area can, thus, be obtained by means of continuous dynamic scanning for the qualitative or quantitative evaluation of regional perfusion within nodules, lymph nodes, or tumors. Moreover, this system can obtain CT data with not only helical but also step-and-shoot or wide-volume scanning for body CT imaging. ADCT also has the potential to use dual-energy CT and subtraction CT to enable contrast-enhanced visualization by means of not only iodine but also xenon or krypton for functional evaluations. Therefore, systems using ADCT may be able to function as a pulmonary functional imaging tool. This review is intended to help the reader understand, with study results published during the last a few decades, the basic or clinical evidence about (1) newly applied reconstruction methods for radiation dose reduction for functional ADCT, (2) morphology-based pulmonary functional imaging, (3) pulmonary perfusion evaluation, (4) ventilation assessment, and (5) biomechanical evaluation.
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Affiliation(s)
- Yoshiharu Ohno
- Department of Diagnostic Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan;
| | - Yoshiyuki Ozawa
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Hiroyuki Nagata
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan;
| | - Shuji Bando
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Shang Cong
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Tomoki Takahashi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Yuka Oshima
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Nayu Hamabuchi
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Takahiro Matsuyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
| | - Takeshi Yoshikawa
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi 673-0021, Hyogo, Japan
| | - Daisuke Takenaka
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi 673-0021, Hyogo, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan; (Y.O.)
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13
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Karmali D, Sowho M, Bose S, Pearce J, Tejwani V, Diamant Z, Yarlagadda K, Ponce E, Eikelis N, Otvos T, Khan A, Lester M, Fouras A, Kirkness J, Siddharthan T. Functional imaging for assessing regional lung ventilation in preclinical and clinical research. Front Med (Lausanne) 2023; 10:1160292. [PMID: 37261124 PMCID: PMC10228734 DOI: 10.3389/fmed.2023.1160292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/17/2023] [Indexed: 06/02/2023] Open
Abstract
Dynamic heterogeneity in lung ventilation is an important measure of pulmonary function and may be characteristic of early pulmonary disease. While standard indices like spirometry, body plethysmography, and blood gases have been utilized to assess lung function, they do not provide adequate information on regional ventilatory distribution nor function assessments of ventilation during the respiratory cycle. Emerging technologies such as xenon CT, volumetric CT, functional MRI and X-ray velocimetry can assess regional ventilation using non-invasive radiographic methods that may complement current methods of assessing lung function. As a supplement to current modalities of pulmonary function assessment, functional lung imaging has the potential to identify respiratory disease phenotypes with distinct natural histories. Moreover, these novel technologies may offer an optimal strategy to evaluate the effectiveness of novel therapies and therapies targeting localized small airways disease in preclinical and clinical research. In this review, we aim to discuss the features of functional lung imaging, as well as its potential application and limitations to adoption in research.
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Affiliation(s)
- Dipan Karmali
- Division of Pulmonary and Critical Care, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Mudiaga Sowho
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Sonali Bose
- Division of Pulmonary and Critical Care, Icahn School of Medicine, Mount Sinai, NY, United States
| | - Jackson Pearce
- School of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Vickram Tejwani
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Zuzana Diamant
- Department of Microbiology Immunology and Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
- Department of Respiratory Medicine and Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Keerthi Yarlagadda
- Division of Pulmonary and Critical Care, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Erick Ponce
- Division of Pulmonary and Critical Care, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | | | | | - Akram Khan
- Division of Pulmonary and Critical Care, Oregon Health and Science University, Portland, OR, United States
| | - Michael Lester
- Department of Pulmonary and Critical Care Medicine, Vanderbilt Medical Center, Nashville, CA, United States
| | | | | | - Trishul Siddharthan
- Division of Pulmonary and Critical Care, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, United States
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14
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Obert AJ, Kern AL, Gutberlet M, Voskrebenzev A, Kaireit TF, Crisosto C, Greer M, Krause ET, Wacker F, Vogel-Claussen J. Volume-Controlled 19 F MR Ventilation Imaging of Fluorinated Gas. J Magn Reson Imaging 2023; 57:1114-1128. [PMID: 36129419 DOI: 10.1002/jmri.28385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND 19 F MRI of inhaled gas tracers has developed into a promising tool for pulmonary diagnostics. Prior to clinical use, the intersession repeatability of acquired ventilation parameters must be quantified and maximized. PURPOSE To evaluate repeatability of static and dynamic 19 F ventilation parameters and correlation with predicted forced expiratory volume in 1 second (FEV1 %pred) with and without inspiratory volume control. STUDY TYPE Prospective. POPULATION A total of 30 healthy subjects and 26 patients with chronic obstructive pulmonary disease (COPD). FIELD STRENGTH/SEQUENCE Three-dimensional (3D) gradient echo pulse sequence with golden-angle stack-of-stars k-space encoding at 1.5 T. ASSESSMENT All study participants underwent 19 F ventilation MRI over eight breaths with inspiratory volume control (w VC) and without inspiratory volume control (w/o VC), which was repeated within 1 week. Ventilated volume percentage (VVP), fractional ventilation (FV), and wash-in time (WI) were computed. Lung function testing was conducted on the first visit. STATISTICAL TESTS Correlation between imaging and FEV1 %pred was measured using Pearson correlation coefficient (r). Differences in imaging parameters between first and second visit were analyzed using paired t-test. Repeatability was quantified using intraclass correlation coefficient (ICC) and coefficient of variation (CoV). Minimum detectable effect size (MDES) was calculated with a power analysis for study size n = 30 and a power of 0.8. All hypotheses were tested with a significance level of 5% two sided. RESULTS Strong and moderate linear correlations with FEV1 %pred for COPD patients were found in almost all imaging parameters. The ICC w VC exceeds the ICC w/o VC for all imaging parameters. CoV was significantly lower w VC for initial VVP in COPD patients, FV, CoV FV, WI and standard deviation (SD) of WI. MDES of all imaging parameters were smaller w VC. DATA CONCLUSION 19 F gas wash-in MRI with inspiratory volume control increases the correlation and repeatability of imaging parameters with lung function testing. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Arnd J Obert
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Agilo L Kern
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Marcel Gutberlet
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Till F Kaireit
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Cristian Crisosto
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Mark Greer
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany.,Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - E Tobias Krause
- Institute of Animal Welfare and Animal Husbandry, Friedrich-Loeffler-Institute, Celle, Germany
| | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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15
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Seo JB. Computerized Tomographic Assessment for Phenotyping Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:122-124. [PMID: 37021500 PMCID: PMC10079513 DOI: 10.4168/aair.2023.15.2.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 04/07/2023]
Affiliation(s)
- Joon Beom Seo
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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16
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State of the Art MR Imaging for Lung Cancer TNM Stage Evaluation. Cancers (Basel) 2023; 15:cancers15030950. [PMID: 36765907 PMCID: PMC9913625 DOI: 10.3390/cancers15030950] [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: 12/07/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Since the Radiology Diagnostic Oncology Group (RDOG) report had been published in 1991, magnetic resonance (MR) imaging had limited clinical availability for thoracic malignancy, as well as pulmonary diseases. However, technical advancements in MR systems, such as sequence and reconstruction methods, and adjustments in the clinical protocol for gadolinium contrast media administration have provided fruitful results and validated the utility of MR imaging (MRI) for lung cancer evaluations. These techniques include: (1) contrast-enhanced MR angiography for T-factor evaluation, (2) short-time inversion recovery turbo spin-echo sequences as well as diffusion-weighted imaging (DWI) for N-factor assessment, and (3) whole-body MRI with and without DWI and with positron emission tomography fused with MRI for M-factor or TNM stage evaluation as well as for postoperative recurrence assessment of lung cancer or other thoracic tumors using 1.5 tesla (T) or 3T systems. According to these fruitful results, the Fleischner Society has changed its position to approve of MRI for lung or thoracic diseases. The purpose of this review is to analyze recent advances in lung MRI with a particular focus on lung cancer evaluation, clinical staging, and recurrence assessment evaluation.
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17
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Affiliation(s)
- Theresa C McLoud
- From the Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, MZ-FND 216, Boston, MA 02114-2696 (T.C.M.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Mayo Clinic Florida, Jacksonville, Fla (B.P.L.)
| | - Brent P Little
- From the Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, MZ-FND 216, Boston, MA 02114-2696 (T.C.M.); and Department of Radiology, Mayo Clinic College of Medicine and Science, Mayo Clinic Florida, Jacksonville, Fla (B.P.L.)
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18
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Nishino M, Schiebler ML. Advances in Thoracic Imaging: Key Developments in the Past Decade and Future Directions. Radiology 2023; 306:e222536. [PMID: 36625742 PMCID: PMC9885337 DOI: 10.1148/radiol.222536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Mizuki Nishino
- From the Department of Radiology, Brigham and Women’s Hospital
and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston MA (M.N.); and
Department of Radiology, University of Wisconsin–Madison School of
Medicine and Public Health, Madison, Wis (M.L.S.)
| | - Mark L. Schiebler
- From the Department of Radiology, Brigham and Women’s Hospital
and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston MA (M.N.); and
Department of Radiology, University of Wisconsin–Madison School of
Medicine and Public Health, Madison, Wis (M.L.S.)
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19
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Hsia CCW, Bates JHT, Driehuys B, Fain SB, Goldin JG, Hoffman EA, Hogg JC, Levin DL, Lynch DA, Ochs M, Parraga G, Prisk GK, Smith BM, Tawhai M, Vidal Melo MF, Woods JC, Hopkins SR. Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report. Ann Am Thorac Soc 2023; 20:161-195. [PMID: 36723475 PMCID: PMC9989862 DOI: 10.1513/annalsats.202211-915st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Multiple thoracic imaging modalities have been developed to link structure to function in the diagnosis and monitoring of lung disease. Volumetric computed tomography (CT) renders three-dimensional maps of lung structures and may be combined with positron emission tomography (PET) to obtain dynamic physiological data. Magnetic resonance imaging (MRI) using ultrashort-echo time (UTE) sequences has improved signal detection from lung parenchyma; contrast agents are used to deduce airway function, ventilation-perfusion-diffusion, and mechanics. Proton MRI can measure regional ventilation-perfusion ratio. Quantitative imaging (QI)-derived endpoints have been developed to identify structure-function phenotypes, including air-blood-tissue volume partition, bronchovascular remodeling, emphysema, fibrosis, and textural patterns indicating architectural alteration. Coregistered landmarks on paired images obtained at different lung volumes are used to infer airway caliber, air trapping, gas and blood transport, compliance, and deformation. This document summarizes fundamental "good practice" stereological principles in QI study design and analysis; evaluates technical capabilities and limitations of common imaging modalities; and assesses major QI endpoints regarding underlying assumptions and limitations, ability to detect and stratify heterogeneous, overlapping pathophysiology, and monitor disease progression and therapeutic response, correlated with and complementary to, functional indices. The goal is to promote unbiased quantification and interpretation of in vivo imaging data, compare metrics obtained using different QI modalities to ensure accurate and reproducible metric derivation, and avoid misrepresentation of inferred physiological processes. The role of imaging-based computational modeling in advancing these goals is emphasized. Fundamental principles outlined herein are critical for all forms of QI irrespective of acquisition modality or disease entity.
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20
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Qin K, Fu X. [Research Progress in Imaging-based Diagnosis of Benign and Malignant
Enlarged Lymph Nodes in Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2023; 26:31-37. [PMID: 36792078 PMCID: PMC9987091 DOI: 10.3779/j.issn.1009-3419.2023.101.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Non-small cell lung cancer (NSCLC) can be detected with enlarged lymph nodes on imaging, but their benignity and malignancy are difficult to determine directly, making it difficult to stage the tumor and design radiotherapy target volumes. The clinical diagnosis of malignant lymph nodes is often based on the short diameter of lymph nodes ≥1 cm or the maximum standard uptake value ≥2.5, but the sensitivity and specificity of these criteria are too low to meet the clinical needs. In recent years, many advances have been made in diagnosing benign and malignant lymph nodes using other imaging parameters, and with the development of radiomics, deep learning and other technologies, models of mining the image information of enlarged lymph node regions further improve the diagnostic accuracy. The purpose of this paper is to review recent advances in imaging-based diagnosis of benign and malignant enlarged lymph nodes in NSCLC for more accurate and noninvasive assessment of lymph node status in clinical practice.
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Affiliation(s)
- Kai Qin
- Department of Radiotherapy, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiaolong Fu
- Department of Radiotherapy, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
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21
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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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22
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Ahookhosh K, Vanoirbeek J, Vande Velde G. Lung function measurements in preclinical research: What has been done and where is it headed? Front Physiol 2023; 14:1130096. [PMID: 37035677 PMCID: PMC10073442 DOI: 10.3389/fphys.2023.1130096] [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: 12/22/2022] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
Due to the close interaction of lung morphology and functions, repeatable measurements of pulmonary function during longitudinal studies on lung pathophysiology and treatment efficacy have been a great area of interest for lung researchers. Spirometry, as a simple and quick procedure that depends on the maximal inspiration of the patient, is the most common lung function test in clinics that measures lung volumes against time. Similarly, in the preclinical area, plethysmography techniques offer lung functional parameters related to lung volumes. In the past few decades, many innovative techniques have been introduced for in vivo lung function measurements, while each one of these techniques has their own advantages and disadvantages. Before each experiment, depending on the sensitivity of the required pulmonary functional parameters, it should be decided whether an invasive or non-invasive approach is desired. On one hand, invasive techniques offer sensitive and specific readouts related to lung mechanics in anesthetized and tracheotomized animals at endpoints. On the other hand, non-invasive techniques allow repeatable lung function measurements in conscious, free-breathing animals with readouts related to the lung volumes. The biggest disadvantage of these standard techniques for lung function measurements is considering the lung as a single unit and providing only global readouts. However, recent advances in lung imaging modalities such as x-ray computed tomography and magnetic resonance imaging opened new doors toward obtaining both anatomical and functional information from the same scan session, without the requirement for any extra pulmonary functional measurements, in more regional and non-invasive manners. Consequently, a new field of study called pulmonary functional imaging was born which focuses on introducing new techniques for regional quantification of lung function non-invasively using imaging-based techniques. This narrative review provides first an overview of both invasive and non-invasive conventional methods for lung function measurements, mostly focused on small animals for preclinical research, including discussions about their advantages and disadvantages. Then, we focus on those newly developed, non-invasive, imaging-based techniques that can provide either global or regional lung functional readouts at multiple time-points.
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Affiliation(s)
- Kaveh Ahookhosh
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Jeroen Vanoirbeek
- Centre of Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Greetje Vande Velde
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- *Correspondence: Greetje Vande Velde,
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Tanabe Y, Tanaka H. Statistical evaluation of the effectiveness of dual amplitude-gated stereotactic body radiotherapy using fiducial markers and lung volume. Phys Imaging Radiat Oncol 2022; 24:82-87. [PMID: 36267878 PMCID: PMC9576976 DOI: 10.1016/j.phro.2022.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Approximately 30% of the fiducial markers demonstrated a low correlation on comparing lung volumes. Monitoring of lung volume can achieve stable tracking of lung tumors. Dual monitoring by employing the marker and lung volume may possibly avoid the deterioration of monitoring accuracy.
Background and purpose The low tracking accuracy of lung stereotactic body radiotherapy (SBRT) risks reduced treatment efficacy. We used four-dimensional computed tomography (4DCT) images to determine the correlation between changes in fiducial marker positions and lung volume for lung tumors, and we evaluated the effectiveness of the combined use of these images in lung SBRT. Materials and methods Data of 30 patients who underwent fiducial marker placement were retrospectively analyzed. We calculated the motion amplitudes of the center of gravity coordinates of the lung tumor and fiducial markers in each phase and the ipsilateral, contralateral, and bilateral lung volumes using 4DCT. Moreover, we calculated the cross-correlation coefficient between the fiducial marker position and the lung volume changes waveform for the motion amplitude waveform of the lung tumor over three gating windows (all phases, ≤2 mm3, and ≤3 mm3). Results Compared with the lung volume, approximately 30 % of the fiducial markers demonstrated a low correlation with the lung tumor. In the ≤2 mm3 and ≤3 mm3 gating windows, the cross-correlation coefficients between the lung tumor and the optimal marker (r > 0.9: 83 % and 86 %) were significantly different for all fiducial markers (r > 0.9: 39 %, 53 %) and the ipsilateral (r > 0.9: 35 % and 40 %), contralateral (r > 0.9: 44 % and 41 %), and bilateral (r > 0.9: 39 % and 45 %) lung volumes. Conclusions Some of the fiducial markers showed a low correlation with the lung tumor. This study indicated that the combined use of lung volume monitoring can improve tracking accuracy.
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Affiliation(s)
- Yoshinori Tanabe
- Department of Radiological Technology, Graduate School of Health Sciences, Okayama University, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama-shi, 700-8558, Japan,Corresponding author.
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
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Li Z, Le Roux PY, Callahan J, Hardcastle N, Hofman MS, Siva S, Yamamoto T. Quantitative assessment of ventilation-perfusion relationships with gallium-68 positron emission tomography/computed tomography imaging in lung cancer patients. Phys Imaging Radiat Oncol 2022; 22:8-12. [PMID: 35465222 PMCID: PMC9018442 DOI: 10.1016/j.phro.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/30/2022] Open
Abstract
Voxel-wise correlations between gallium-68 (68Ga) positron emission tomography/computed tomography (PET/CT)-measured ventilation and perfusion varied widely among 19 patients with lung cancer (range: 0.26–0.88). 68Ga PET/CT-measured percent gas exchanging lung volume was moderately correlated with diffusing capacity of the lung for carbon monoxide (DLCO) as the reference standard, with the highest correlation coefficient of 0.59 (P < 0.01). 68Ga PET/CT ventilation/perfusion imaging may provide a reasonable surrogate for regional gas exchange.
Pulmonary functional imaging has demonstrated potential to improve thoracic radiotherapy. The purpose of this study was twofold: 1) to quantify ventilation/perfusion relationships in lung cancer patients using a new functional imaging approach, gallium-68 (68Ga)-positron emission tomography/computed tomography (PET/CT); and 2) to compare ventilation/perfusion matching with diffusing capacity of the lung for carbon monoxide (DLCO). Voxel-wise correlations between ventilation and perfusion varied widely among 19 patients (range: 0.26–0.88). 68Ga-PET/CT-measured percent gas exchanging lung volume was moderately correlated with DLCO (≤0.59). Our findings suggested that 68Ga-PET/CT ventilation/perfusion imaging provided complementary information and a reasonable surrogate for gas exchange in lung cancer patients.
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Affiliation(s)
- Zhuorui Li
- Department of Biomedical Engineering, University of California Davis, Davis, CA, USA
| | - Pierre-Yves Le Roux
- Department of Nuclear Medicine, Brest University Hospital, EA3878 (GETBO), Brest, France
| | - Jason Callahan
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicholas Hardcastle
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - Michael S. Hofman
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - Shankar Siva
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Tokihiro Yamamoto
- Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
- Corresponding author at: Department of Radiation Oncology, University of California Davis School of Medicine, 4501 X St., Sacramento, CA 95817, USA.
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Neder JA, Kirby M, Santyr G, Pourafkari M, Smyth R, Phillips DB, Crinion S, de-Torres JP, O’Donnell DE. V̇/Q̇ Mismatch. Chest 2022; 162:1030-1047. [DOI: 10.1016/j.chest.2022.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/14/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022] Open
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Bak SH, Kim C, Kim CH, Ohno Y, Lee HY. Magnetic resonance imaging for lung cancer: a state-of-the-art review. PRECISION AND FUTURE MEDICINE 2022. [DOI: 10.23838/pfm.2021.00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kooner HK, McIntosh MJ, Desaigoudar V, Rayment JH, Eddy RL, Driehuys B, Parraga G. Pulmonary functional MRI: Detecting the structure-function pathologies that drive asthma symptoms and quality of life. Respirology 2022; 27:114-133. [PMID: 35008127 PMCID: PMC10025897 DOI: 10.1111/resp.14197] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/09/2021] [Accepted: 12/12/2021] [Indexed: 12/21/2022]
Abstract
Pulmonary functional MRI (PfMRI) using inhaled hyperpolarized, radiation-free gases (such as 3 He and 129 Xe) provides a way to directly visualize inhaled gas distribution and ventilation defects (or ventilation heterogeneity) in real time with high spatial (~mm3 ) resolution. Both gases enable quantitative measurement of terminal airway morphology, while 129 Xe uniquely enables imaging the transfer of inhaled gas across the alveolar-capillary tissue barrier to the red blood cells. In patients with asthma, PfMRI abnormalities have been shown to reflect airway smooth muscle dysfunction, airway inflammation and remodelling, luminal occlusions and airway pruning. The method is rapid (8-15 s), cost-effective (~$300/scan) and very well tolerated in patients, even in those who are very young or very ill, because unlike computed tomography (CT), positron emission tomography and single-photon emission CT, there is no ionizing radiation and the examination takes only a few seconds. However, PfMRI is not without limitations, which include the requirement of complex image analysis, specialized equipment and additional training and quality control. We provide an overview of the three main applications of hyperpolarized noble gas MRI in asthma research including: (1) inhaled gas distribution or ventilation imaging, (2) alveolar microstructure and finally (3) gas transfer into the alveolar-capillary tissue space and from the tissue barrier into red blood cells in the pulmonary microvasculature. We highlight the evidence that supports a deeper understanding of the mechanisms of asthma worsening over time and the pathologies responsible for symptoms and disease control. We conclude with a summary of approaches that have the potential for integration into clinical workflows and that may be used to guide personalized treatment planning.
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Affiliation(s)
- Harkiran K Kooner
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Marrissa J McIntosh
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Vedanth Desaigoudar
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jonathan H Rayment
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rachel L Eddy
- Centre of Heart Lung Innovation, Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bastiaan Driehuys
- Center for In Vivo Microscopy, Duke University Medical Centre, Durham, North Carolina, USA
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- Division of Respirology, Department of Medicine, Western University, London, Ontario, Canada
- School of Biomedical Engineering, Western University, London, Ontario, Canada
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Hatabu H, Madore B. Dark-Field Chest Radiography in the Detection of Emphysema. Radiology 2022; 303:128-129. [PMID: 35014909 DOI: 10.1148/radiol.212910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
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Wu F, Chen L, Huang J, Fan W, Yang J, Zhang X, Jin Y, Yang F, Zheng C. Total Lung and Lobar Quantitative Assessment Based on Paired Inspiratory-Expiratory Chest CT in Healthy Adults: Correlation with Pulmonary Ventilatory Function. Diagnostics (Basel) 2021; 11:diagnostics11101791. [PMID: 34679488 PMCID: PMC8534441 DOI: 10.3390/diagnostics11101791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: To provide the quantitative volumetric data of the total lung and lobes in inspiration and expiration from healthy adults, and to explore the value of paired inspiratory–expiratory chest CT scan in pulmonary ventilatory function and further explore the influence of each lobe on ventilation. Methods: A total of 65 adults (29 males and 36 females) with normal clinical pulmonary function test (PFT) and paired inspiratory–expiratory chest CT scan were retrospectively enrolled. The inspiratory and expiratory volumetric indexes of the total lung (TL) and 5 lobes (left upper lobe [LUL], left lower lobe [LLL], right upper lobe [RUL], right middle lobe [RML], and right lower lobe [RLL]) were obtained by Philips IntelliSpace Portal image postprocessing workstation, including inspiratory lung volume (LVin), expiratory lung volume (LVex), volume change (∆LV), and well-aerated lung volume (WAL, lung tissue with CT threshold between −950 and −750 HU in inspiratory scan). Spearman correlation analysis was used to explore the correlation between CT quantitative indexes of the total lung and ventilatory function indexes (including total lung capacity [TLC], residual volume [RV], and force vital capacity [FVC]). Multiple stepwise regression analysis was used to explore the influence of each lobe on ventilation. Results: At end-inspiratory phase, the LVin-TL was 4664.6 (4282.7, 5916.2) mL, the WALTL was 4173 (3639.6, 5250.9) mL; both showed excellent correlation with TLC (LVin-TL: r = 0.890, p < 0.001; WALTL: r = 0.879, p < 0.001). From multiple linear regression analysis with lobar CT indexes as variables, the LVin and WAL of these two lobes, LLL and RUL, showed a significant relationship with TLC. At end-expiratory phase, the LVex-TL was 2325.2 (1969.7, 2722.5) mL with good correlation with RV (r = 0.811, p < 0.001), of which the LVex of RUL and RML had a significant relationship with RV. For the volumetric change within breathing, the ∆LVTL was 2485.6 (2169.8, 3078.1) mL with good correlation with FVC (r = 0.719, p < 0.001), moreover, WALTL showed a better correlation with FVC (r = 0.817, p < 0.001) than that of ∆LVTL. Likewise, there was also a strong association between ∆LV, WAL of these two lobes (LLL and RUL), and FVC. Conclusions: The quantitative indexes derived from paired inspiratory–expiratory chest CT could reflect the clinical pulmonary ventilatory function, LLL, and RUL give greater impact on ventilation. Thus, the pulmonary functional evaluation needs to be more precise and not limited to the total lung level.
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Affiliation(s)
- Feihong Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Leqing Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jia Huang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jinrong Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Xiaohui Zhang
- Clinical Science, Philips Healthcare, No. 718 Daning Rd., Jingan District, Shanghai 200233, China;
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China;
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Correspondence: (F.Y.); (C.Z.); Tel.: +86-027-8535-3238 (C.Z.)
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; (F.W.); (L.C.); (J.H.); (W.F.); (J.Y.)
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Correspondence: (F.Y.); (C.Z.); Tel.: +86-027-8535-3238 (C.Z.)
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Hatabu H, Madore B. Dark-Field Chest X-ray Imaging: An Evolving Technique in the Century-Old History of Chest X-ray Imaging. Radiology 2021; 301:396-397. [PMID: 34427468 DOI: 10.1148/radiol.2021211603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hiroto Hatabu
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, 75 Francis St, Boston, MA 02215
| | - Bruno Madore
- From the Center for Pulmonary Functional Imaging (H.H.) and Department of Radiology (H.H., B.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, 75 Francis St, Boston, MA 02215
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