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Kwok HM, Chau CM, Lee HCH, Wong T, Chan HF, Luk WH, Yung WTA, Cheng LF, Ma KFJ. Gadoxetic acid in hepatocellular carcinoma and liver metastases: pearls and pitfalls. Clin Radiol 2023; 78:715-723. [PMID: 37453807 DOI: 10.1016/j.crad.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/23/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023]
Abstract
Gadoxetic disodium (Primovist) is a hepatocyte-specific magnetic resonance imaging (MRI) contrast agent with increasing popularity with its unique dual dynamic and excretory properties in focal liver lesion detection and characterisation. In-depth knowledge of its diagnostic utility and pitfalls in hepatocellular carcinoma (HCC) and liver metastases is crucial in facilitating clinical management. The current article reviews the pearls and pitfalls in these aspects with highlights from the latest research evidence. Pearls for common usage of Primovist in HCC includes detection of precursor cancer lesions in cirrhotic patients. Hepatobiliary phase hypointensity precedes arterial phase hyperenhancement (APHE) in hepatocarcinogenesis. Hepatobiliary phase hypointense nodules without APHE can represent early or progressed hepatocellular carcinoma (HCC) and high-grade dysplastic nodules. In addition, Primovist is useful to differentiate HCC from pseudolesions. Pitfalls in diagnosing HCC include transient tachypnoea in the arterial phase, rare hepatobiliary phase hyperintense HCC, and decompensated liver cirrhosis compromising image quality. Primovist is currently the most sensitive technique in diagnosing liver metastases before curative hepatic resection. Other patterns of enhancement of liver metastases, "disappearing" liver metastases are important pitfalls. Radiologists should be aware of the diagnostic utility, limitations, and potential pitfalls for the common usage of hepatobiliary specific contrast agent in liver MRI.
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Affiliation(s)
- H M Kwok
- Department of Radiology, Princess Margaret Hospital, Hong Kong.
| | - C M Chau
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - H C H Lee
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - T Wong
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - H F Chan
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - W H Luk
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - W T A Yung
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - L F Cheng
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K F J Ma
- Department of Radiology, Princess Margaret Hospital, Hong Kong
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Saunders LC, Collier GJ, Chan HF, Hughes PJC, Smith LJ, Watson JGR, Meiring JE, Gabriel Z, Newman T, Plowright M, Wade P, Eaden JA, Thomas S, Strickland S, Gustafsson L, Bray J, Marshall H, Capener DA, Armstrong L, Rodgers J, Brook M, Biancardi AM, Rao MR, Norquay G, Rodgers O, Munro R, Ball JE, Stewart NJ, Lawrie A, Jenkins RG, Grist JT, Gleeson F, Schulte RF, Johnson KM, Wilson FJ, Cahn A, Swift AJ, Rajaram S, Mills GH, Watson L, Collini PJ, Lawson R, Thompson AAR, Wild JM. Longitudinal Lung Function Assessment of Patients Hospitalized With COVID-19 Using 1H and 129Xe Lung MRI. Chest 2023; 164:700-716. [PMID: 36965765 PMCID: PMC10036146 DOI: 10.1016/j.chest.2023.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Microvascular abnormalities and impaired gas transfer have been observed in patients with COVID-19. The progression of pulmonary changes in these patients remains unclear. RESEARCH QUESTION Do patients hospitalized with COVID-19 without evidence of architectural distortion on structural imaging exhibit longitudinal improvements in lung function measured by using 1H and 129Xe MRI between 6 and 52 weeks following hospitalization? STUDY DESIGN AND METHODS Patients who were hospitalized with COVID-19 pneumonia underwent a pulmonary 1H and 129Xe MRI protocol at 6, 12, 25, and 51 weeks following hospital admission in a prospective cohort study between November 2020 and February 2022. The imaging protocol was as follows: 1H ultra-short echo time, contrast-enhanced lung perfusion, 129Xe ventilation, 129Xe diffusion-weighted, and 129Xe spectroscopic imaging of gas exchange. RESULTS Nine patients were recruited (age 57 ± 14 [median ± interquartile range] years; six of nine patients were male). Patients underwent MRI at 6 (n = 9), 12 (n = 9), 25 (n = 6), and 51 (n = 8) weeks following hospital admission. Patients with signs of interstitial lung damage were excluded. At 6 weeks, patients exhibited impaired 129Xe gas transfer (RBC to membrane fraction), but lung microstructure was not increased (apparent diffusion coefficient and mean acinar airway dimensions). Minor ventilation abnormalities present in four patients were largely resolved in the 6- to 25-week period. At 12 weeks, all patients with lung perfusion data (n = 6) showed an increase in both pulmonary blood volume and flow compared with 6 weeks, although this was not statistically significant. At 12 weeks, significant improvements in 129Xe gas transfer were observed compared with 6-week examinations; however, 129Xe gas transfer remained abnormally low at weeks 12, 25, and 51. INTERPRETATION 129Xe gas transfer was impaired up to 1 year following hospitalization in patients who were hospitalized with COVID-19 pneumonia, without evidence of architectural distortion on structural imaging, whereas lung ventilation was normal at 52 weeks.
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Affiliation(s)
- Laura C Saunders
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Guilhem J Collier
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Ho-Fung Chan
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Paul J C Hughes
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Laurie J Smith
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - J G R Watson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - James E Meiring
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Zoë Gabriel
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Thomas Newman
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Megan Plowright
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Phillip Wade
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - James A Eaden
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Siby Thomas
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | | | - Lotta Gustafsson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Jody Bray
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Helen Marshall
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - David A Capener
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Leanne Armstrong
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Jennifer Rodgers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Martin Brook
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Alberto M Biancardi
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Madhwesha R Rao
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Graham Norquay
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Oliver Rodgers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Ryan Munro
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - James E Ball
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Neil J Stewart
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Allan Lawrie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - R Gisli Jenkins
- National Heart and Lung Institute, Imperial College London, London, England
| | - James T Grist
- Department of Radiology, Oxford University Hospitals, Oxford, England; Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, England; Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, England
| | - Fergus Gleeson
- Department of Oncology, University of Oxford, Oxford, England; Department of Radiology, Oxford University Hospitals, Oxford, England
| | | | - Kevin M Johnson
- Department of Medical Physics, University of Madison, Madison, WI, USA
| | | | | | - Andrew J Swift
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Smitha Rajaram
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Gary H Mills
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Lisa Watson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Paul J Collini
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England
| | - Rod Lawson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - A A Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
| | - Jim M Wild
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, England.
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Eaden JA, Weatherley ND, Chan HF, Collier G, Norquay G, Swift AJ, Rajaram S, Smith LJ, Bartholmai BJ, Bianchi SM, Wild JM. Hyperpolarised xenon-129 diffusion-weighted magnetic resonance imaging for assessing lung microstructure in idiopathic pulmonary fibrosis. ERJ Open Res 2023; 9:00048-2023. [PMID: 37650085 PMCID: PMC10463035 DOI: 10.1183/23120541.00048-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/12/2023] [Indexed: 09/01/2023] Open
Abstract
Background Hyperpolarised 129-xenon (129Xe) magnetic resonance imaging (MRI) shows promise in monitoring the progression of idiopathic pulmonary fibrosis (IPF) due to the lack of ionising radiation and the ability to quantify functional impairment. Diffusion-weighted (DW)-MRI with hyperpolarised gases can provide information about lung microstructure. The aims were to compare 129Xe DW-MRI measurements with pulmonary function tests (PFTs), and to assess whether they can detect early signs of disease progression in patients with newly diagnosed IPF. Methods This is a prospective, single-centre, observational imaging study of patients presenting with IPF to Northern General Hospital (Sheffield, UK). Hyperpolarised 129Xe DW-MRI was performed at 1.5 T on a whole-body General Electric HDx scanner and PFTs were performed on the same day as the MRI scan. Results There was an increase in global 129Xe apparent diffusion coefficient (ADC) between the baseline and 12-month visits (mean 0.043 cm2·s-1, 95% CI 0.040-0.047 cm2·s-1 versus mean 0.045 cm2·s-1, 95% CI 0.040-0.049 cm2·s-1; p=0.044; n=20), with no significant change in PFTs over the same time period. There was also an increase in 129Xe ADC in the lower zone (p=0.027), and an increase in 129Xe mean acinar dimension in the lower zone (p=0.033) between the baseline and 12-month visits. 129Xe DW-MRI measurements correlated strongly with diffusing capacity of the lung for carbon monoxide (% predicted), transfer coefficient of the lung for carbon monoxide (KCO) and KCO (% predicted). Conclusions 129Xe DW-MRI measurements appear to be sensitive to early changes of microstructural disease that are consistent with progression in IPF at 12 months. As new drug treatments are developed, the ability to quantify subtle changes using 129Xe DW-MRI could be particularly valuable.
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Affiliation(s)
- James A. Eaden
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Nicholas D. Weatherley
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem Collier
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andrew J. Swift
- Department of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Smitha Rajaram
- Department of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Laurie J. Smith
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | | | - Stephen M. Bianchi
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jim M. Wild
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for In-Silico Medicine, University of Sheffield, Sheffield, UK
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Ebrahimi BS, Khwaounjoo P, Argus F, Chan HF, Nash MP, McGiffin D, Kaye D, Doi A, Joseph T, Whitford H, Tawhai MH. Predicting Patient Status in Chronic Thromboembolic Pulmonary Hypertension Using a Biophysical Model. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083065 DOI: 10.1109/embc40787.2023.10340433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) involves abnormally high blood pressure in the pulmonary vessels and is associated with small vessel vasculopathy and pre-capillary proximal occlusions. Management of CTEPH disease is challenging, therefore accurate diagnosis is crucial in ensuring effective treatment and improved patient outcomes. The treatment of choice for CTEPH is pulmonary endarterectomy, which is an invasive surgical intervention to remove thrombi. Following PEA, a number of patients experience poor outcomes or worse-than-expected improvements, which may indicate that they have significant small vessel disease. A method that can predict the extent of distal remodelling may provide useful clinical information to plan appropriate CTEPH patient treatment. Here, a novel biophysical modelling approach has been developed to estimate and quantify the extent of distal remodelling. This method includes a combination of mathematical modelling and computed tomography pulmonary angiography to first model the geometry of the pulmonary arteries and to identify the under-perfused regions in CTEPH. The geometric model is then used alongside haemodynamic measurements from right heart catheterisation to predict distal remodelling. In this study, the method is tested and validated using synthetically generated remodelling data. Then, a preliminary application of this technique to patient data is shown to demonstrate the potential of the approach for use in the clinical setting.Clinical relevance- Patient-specific modelling can help provide useful information regarding the extent of distal vasculopathy on a per-patient basis, which remains challenging. Physicians can be unsure of outcomes following pulmonary endarterectomy. Therefore, the predictive aspect of the patient's response to surgery can help with clinical decision-making.
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Chan HF, Smith LJ, Biancardi AM, Bray J, Marshall H, Hughes PJC, Collier GJ, Rao M, Norquay G, Swift AJ, Hart K, Cousins M, Watkins WJ, Wild JM, Kotecha S. Image Phenotyping of Preterm-Born Children Using Hyperpolarized 129Xe Lung Magnetic Resonance Imaging and Multiple-Breath Washout. Am J Respir Crit Care Med 2023; 207:89-100. [PMID: 35972833 PMCID: PMC9952860 DOI: 10.1164/rccm.202203-0606oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/16/2022] [Indexed: 02/03/2023] Open
Abstract
Rationale: Preterm birth is associated with low lung function in childhood, but little is known about the lung microstructure in childhood. Objectives: We assessed the differential associations between the historical diagnosis of bronchopulmonary dysplasia (BPD) and current lung function phenotypes on lung ventilation and microstructure in preterm-born children using hyperpolarized 129Xe ventilation and diffusion-weighted magnetic resonance imaging (MRI) and multiple-breath washout (MBW). Methods: Data were available from 63 children (aged 9-13 yr), including 44 born preterm (⩽34 weeks' gestation) and 19 term-born control subjects (⩾37 weeks' gestation). Preterm-born children were classified, using spirometry, as prematurity-associated obstructive lung disease (POLD; FEV1 < lower limit of normal [LLN] and FEV1/FVC < LLN), prematurity-associated preserved ratio of impaired spirometry (FEV1 < LLN and FEV1/FVC ⩾ LLN), preterm-(FEV1 ⩾ LLN) and term-born control subjects, and those with and without BPD. Ventilation heterogeneity metrics were derived from 129Xe ventilation MRI and SF6 MBW. Alveolar microstructural dimensions were derived from 129Xe diffusion-weighted MRI. Measurements and Main Results: 129Xe ventilation defect percentage and ventilation heterogeneity index were significantly increased in preterm-born children with POLD. In contrast, mean 129Xe apparent diffusion coefficient, 129Xe apparent diffusion coefficient interquartile range, and 129Xe mean alveolar dimension interquartile range were significantly increased in preterm-born children with BPD, suggesting changes of alveolar dimensions. MBW metrics were all significantly increased in the POLD group compared with preterm- and term-born control subjects. Linear regression confirmed the differential effects of obstructive disease on ventilation defects and BPD on lung microstructure. Conclusion: We show that ventilation abnormalities are associated with POLD, and BPD in infancy is associated with abnormal lung microstructure.
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Affiliation(s)
- Ho-Fung Chan
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Laurie J. Smith
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Alberto M. Biancardi
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Jody Bray
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Helen Marshall
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Paul J. C. Hughes
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Guilhem J. Collier
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Madhwesha Rao
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Graham Norquay
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Andrew J. Swift
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Kylie Hart
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Neonatal Unit, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Michael Cousins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Neonatal Unit, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - W. John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Jim M. Wild
- Pulmonary, Lung and Respiratory Imaging Sheffield (POLARIS), Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Neonatal Unit, Cardiff and Vale University Health Board, Cardiff, United Kingdom
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Chow BCK, Lo SSM, Lee JCY, Chiang JB, Chan HF, Ho CB, Szeto LT, Tang KW. Familial Amyloidotic Polyneuropathy with Leptomeningeal and Cardiac Involvement in a Patient with Gly73Glu Transthyretin Gene Mutation — Non-invasive Diagnostic Approach with Multimodality Imaging Findings: a Case Report. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2217296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- BCK Chow
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - SSM Lo
- Scanning Department, St. Teresa’s Hospital, Hong Kong
| | - JCY Lee
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - JB Chiang
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
| | - HF Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - CB Ho
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - LT Szeto
- Department of Nuclear Medicine, Queen Elizabeth Hospital, Hong Kong
| | - KW Tang
- Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong
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Stewart NJ, Smith LJ, Chan HF, Eaden JA, Rajaram S, Swift AJ, Weatherley ND, Biancardi A, Collier GJ, Hughes D, Klafkowski G, Johns CS, West N, Ugonna K, Bianchi SM, Lawson R, Sabroe I, Marshall H, Wild JM. Lung MRI with hyperpolarised gases: current & future clinical perspectives. Br J Radiol 2022; 95:20210207. [PMID: 34106792 PMCID: PMC9153706 DOI: 10.1259/bjr.20210207] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The use of pulmonary MRI in a clinical setting has historically been limited. Whilst CT remains the gold-standard for structural lung imaging in many clinical indications, technical developments in ultrashort and zero echo time MRI techniques are beginning to help realise non-ionising structural imaging in certain lung disorders. In this invited review, we discuss a complementary technique - hyperpolarised (HP) gas MRI with inhaled 3He and 129Xe - a method for functional and microstructural imaging of the lung that has great potential as a clinical tool for early detection and improved understanding of pathophysiology in many lung diseases. HP gas MRI now has the potential to make an impact on clinical management by enabling safe, sensitive monitoring of disease progression and response to therapy. With reference to the significant evidence base gathered over the last two decades, we review HP gas MRI studies in patients with a range of pulmonary disorders, including COPD/emphysema, asthma, cystic fibrosis, and interstitial lung disease. We provide several examples of our experience in Sheffield of using these techniques in a diagnostic clinical setting in challenging adult and paediatric lung diseases.
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Affiliation(s)
- Neil J Stewart
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Laurie J Smith
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - James A Eaden
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Smitha Rajaram
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andrew J Swift
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Nicholas D Weatherley
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Alberto Biancardi
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - David Hughes
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | | | - Christopher S Johns
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Noreen West
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Kelechi Ugonna
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Stephen M Bianchi
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Rod Lawson
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Ian Sabroe
- Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Helen Marshall
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
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Marshall H, Smith L, Biancardi A, Collier G, Chan HF, Hughes P, Astley J, Munro R, Rajaram S, Capener D, Bray J, Smith I, Armstrong L, Hardaker L, Fihn-Wikander T, Hughes R, Wild J. A comparison of 129Xe MRI and advanced lung function testing in patients with asthma and /or COPD: The NOVELTY ADPro substudy. Imaging 2021. [DOI: 10.1183/13993003.congress-2021.pa1872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Niedbalski PJ, Hall CS, Castro M, Eddy RL, Rayment JH, Svenningsen S, Parraga G, Zanette B, Santyr GE, Thomen RP, Stewart NJ, Collier GJ, Chan HF, Wild JM, Fain SB, Miller GW, Mata JF, Mugler JP, Driehuys B, Willmering MM, Cleveland ZI, Woods JC. Protocols for multi-site trials using hyperpolarized 129 Xe MRI for imaging of ventilation, alveolar-airspace size, and gas exchange: A position paper from the 129 Xe MRI clinical trials consortium. Magn Reson Med 2021; 86:2966-2986. [PMID: 34478584 DOI: 10.1002/mrm.28985] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/13/2021] [Accepted: 08/06/2021] [Indexed: 12/12/2022]
Abstract
Hyperpolarized (HP) 129 Xe MRI uniquely images pulmonary ventilation, gas exchange, and terminal airway morphology rapidly and safely, providing novel information not possible using conventional imaging modalities or pulmonary function tests. As such, there is mounting interest in expanding the use of biomarkers derived from HP 129 Xe MRI as outcome measures in multi-site clinical trials across a range of pulmonary disorders. Until recently, HP 129 Xe MRI techniques have been developed largely independently at a limited number of academic centers, without harmonizing acquisition strategies. To promote uniformity and adoption of HP 129 Xe MRI more widely in translational research, multi-site trials, and ultimately clinical practice, this position paper from the 129 Xe MRI Clinical Trials Consortium (https://cpir.cchmc.org/XeMRICTC) recommends standard protocols to harmonize methods for image acquisition in HP 129 Xe MRI. Recommendations are described for the most common HP gas MRI techniques-calibration, ventilation, alveolar-airspace size, and gas exchange-across MRI scanner manufacturers most used for this application. Moreover, recommendations are described for 129 Xe dose volumes and breath-hold standardization to further foster consistency of imaging studies. The intention is that sites with HP 129 Xe MRI capabilities can readily implement these methods to obtain consistent high-quality images that provide regional insight into lung structure and function. While this document represents consensus at a snapshot in time, a roadmap for technical developments is provided that will further increase image quality and efficiency. These standardized dosing and imaging protocols will facilitate the wider adoption of HP 129 Xe MRI for multi-site pulmonary research.
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Affiliation(s)
- Peter J Niedbalski
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Chase S Hall
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Rachel L Eddy
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan H Rayment
- Division of Respiratory Medicine, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Svenningsen
- Firestone Institute for Respiratory Health, St Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Brandon Zanette
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Giles E Santyr
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Robert P Thomen
- Departments of Radiology and Bioengineering, University of Missouri, Columbia, Missouri, USA
| | - Neil J Stewart
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jim M Wild
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Sean B Fain
- Departments of Medical Physics, Radiology, and Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA
| | - G Wilson Miller
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Jaime F Mata
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - John P Mugler
- Center for In-vivo Hyperpolarized Gas MR Imaging, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Bastiaan Driehuys
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Matthew M Willmering
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Zackary I Cleveland
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics (Pulmonary Medicine) and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Departments of Pediatrics (Pulmonary Medicine) and Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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10
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Whyte S, Bray LJ, Chan HF, Chan RJ, Hunt J, Peltz TS, Dulleck U, Hutmacher DW. Knowledge, consultation time, and choice in breast reconstruction. Br J Surg 2021; 108:e168-e169. [PMID: 33793770 DOI: 10.1093/bjs/znab013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 11/12/2022]
Affiliation(s)
- S Whyte
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Behavioural Economics, Society and Technology, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - L J Bray
- Centre for Behavioural Economics, Society and Technology, Queensland University of Technology, Brisbane, Queensland, Australia.,School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.,ARC Training Centre for Cell and Tissue Engineering Technologies, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - H F Chan
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Behavioural Economics, Society and Technology, Queensland University of Technology, Brisbane, Queensland, Australia
| | - R J Chan
- Princess Alexandra Hospital, Metro South Health, School of Nursing, and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - J Hunt
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - T S Peltz
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - U Dulleck
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Behavioural Economics, Society and Technology, Queensland University of Technology, Brisbane, Queensland, Australia.,ARC Training Centre for Cell and Tissue Engineering Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - D W Hutmacher
- Centre for Behavioural Economics, Society and Technology, Queensland University of Technology, Brisbane, Queensland, Australia.,ARC Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, Queensland, Australia.,ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Queensland University of Technology, Brisbane, Queensland, Australia
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11
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Puddu C, Rao M, Xu X, Deppe MH, Collier G, Maunder A, Chan HF, De Zanche N, Robb F, Wild JM. An asymmetrical whole-body birdcage RF coil without RF shield for hyperpolarized 129 Xe lung MR imaging at 1.5 T. Magn Reson Med 2021; 86:3373-3381. [PMID: 34268802 DOI: 10.1002/mrm.28915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE This study describes the development and testing of an asymmetrical xenon-129 (129 Xe) birdcage radiofrequency (RF) coil for 129 Xe lung ventilation imaging at 1.5 Tesla, which allows proton (1 H) system body coil transmit-receive functionality. METHODS The 129 Xe RF coil is a whole-body asymmetrical elliptical birdcage constructed without an outer RF shield to enable 1 H imaging. B 1 + field homogeneity and flip angle mapping of the 129 Xe birdcage RF coil and 1 H system body RF coil with the 129 Xe RF coil in situ were evaluated in the MR scanner. The functionality of the 129 Xe birdcage RF coil was demonstrated through hyperpolarized 129 Xe lung ventilation imaging with the birdcage in both transceiver configuration and transmit-only configuration when combined with an 8-channel 129 Xe receive-only RF coil array. The functionality of 1 H system body coil with the 129 Xe RF coil in situ was demonstrated by acquiring coregistered 1 H lung anatomical MR images. RESULTS The asymmetrical birdcage produced a homogeneous B 1 + field (±10%) in agreement with electromagnetic simulations. Simulations indicated an optimal detuning configuration with 4 diodes. The obtained g-factor of 1.4 for acceleration factor of R = 2 indicates optimal array configuration. Coregistered 1 H anatomical images from the system body coil along with 129 Xe lung images demonstrated concurrent and compatible arrangement of the RF coils. CONCLUSION A large asymmetrical birdcage for homogenous B 1 + transmission with high sensitivity reception for 129 Xe lung MRI at 1.5 Tesla has been demonstrated. The unshielded asymmetrical birdcage design enables 1 H structural lung MR imaging in the same exam.
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Affiliation(s)
- Claudio Puddu
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Madhwesha Rao
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Xiaojun Xu
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Martin H Deppe
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Guilhem Collier
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Adam Maunder
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Ho-Fung Chan
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Nicola De Zanche
- Department of Medical Physics, Cross Cancer Institute and University of Alberta, Alberta, Canada
| | - Fraser Robb
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.,GE Healthcare, Aurora, Ohio, USA
| | - Jim M Wild
- POLARIS, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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12
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Kwok HM, Luk WH, Cheng LF, Pan NY, Chan HF, Ma JKF. Gallium-67 Scan with Single Photon Emission Computed Tomography for the Evaluation and Monitoring of Infected Abdominal Aortic Aneurysms: A 10-Year Case Series. Vasc Specialist Int 2021; 37:17. [PMID: 34183473 PMCID: PMC8239215 DOI: 10.5758/vsi.210020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/19/2021] [Accepted: 06/14/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose This study aimed to evaluate the role of gallium-67 single photon emission computed tomography (SPECT) with contrast computed tomography (CT) in the evaluation and monitoring of infected abdominal aortic aneurysms (IAAA). Methods Materials and A retrospective cohort analysis was performed using prospectively collected data of consecutive patients with IAAA in Princess Margaret Hospital in Hong Kong between January 2010 and December 2020. The patients were identified using the Radiology Information System. Results All five patients had proven IAAA on CT and/or metabolic imaging. Among them, three were further supported by positive blood culture results. Gallium-67 SPECT with contrast CT was useful in the detection of residual disease, monitoring, and detection of recurrence. Conclusion Gallium-67 SPECT with contrast CT is helpful for evaluating IAAA. It serves an important role in guiding management, especially during long-term follow-up.
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Affiliation(s)
- Hoi-Ming Kwok
- Department of Diagnostic and Interventional Radiology, Princess Margaret Hospital, Hong Kong, China
| | - Wing-Hang Luk
- Department of Diagnostic and Interventional Radiology, Princess Margaret Hospital, Hong Kong, China
| | - Lik-Fai Cheng
- Department of Diagnostic and Interventional Radiology, Princess Margaret Hospital, Hong Kong, China
| | - Nin-Yuan Pan
- Department of Diagnostic and Interventional Radiology, Princess Margaret Hospital, Hong Kong, China
| | - Ho-Fung Chan
- Department of Diagnostic and Interventional Radiology, Princess Margaret Hospital, Hong Kong, China
| | - Johnny Ka-Fai Ma
- Department of Diagnostic and Interventional Radiology, Princess Margaret Hospital, Hong Kong, China
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13
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Lam KCK, Fung EML, Chan HF, Louie FTM, Chan F. Metacognitive-Focused Occupational Therapy for Substance Abuse in Medical-Social Service Collaboration: a Case Report. East Asian Arch Psychiatry 2021; 31:19-20. [PMID: 33753573 DOI: 10.12809/eaap2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We describe a 26-year-old man who underwent Metacognitive-Focused Occupational Therapy for his substance abuse problems.
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Affiliation(s)
- K C K Lam
- Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - E M L Fung
- Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - H F Chan
- Cheer Lutheran Centre (Counselling Centre for Psychotropic Substance Abusers)
| | - F T M Louie
- Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
| | - F Chan
- Department of Psychiatry, North District Hospital, Hong Kong
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14
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Chan HF, Collier GJ, Parra-Robles J, Wild JM. Finite element simulations of hyperpolarized gas DWI in micro-CT meshes of acinar airways: validating the cylinder and stretched exponential models of lung microstructural length scales. Magn Reson Med 2021; 86:514-525. [PMID: 33624325 DOI: 10.1002/mrm.28703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/07/2020] [Accepted: 01/07/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This work assesses the accuracy of the stretched exponential (SEM) and cylinder models of lung microstructural length scales that can be derived from hyperpolarized gas DWI. This was achieved by simulating 3 He and 129 Xe DWI signals within two micro-CT-derived realistic acinar airspace meshes that represent healthy and idiopathic pulmonary fibrosis lungs. METHODS The healthy and idiopathic pulmonary fibrosis acinar airway meshes were derived from segmentations of 3D micro-CT images of excised human lungs and meshed for finite element simulations of the Bloch-Torrey equations. 3 He and 129 Xe multiple b value DWI experiments across a range of diffusion times (3 He Δ = 1.6 ms; 129 Xe Δ = 5 to 20 ms) were simulated in each mesh. Global SEM mean diffusive length scale and cylinder model mean chord length value was derived from each finite element simulation and compared against each mesh's mean linear intercept length, calculated from intercept length measurements within micro-CT segmentation masks. RESULTS The SEM-derived mean diffusive length scale was within ±10% of the mean linear intercept length for simulations with both 3 He (Δ = 1.6 ms) and 129 Xe (Δ = 7 to 13 ms) in the healthy mesh, and with 129 Xe (Δ = 13 to 20 ms) for the idiopathic pulmonary fibrosis mesh, whereas for the cylinder model-derived mean chord length the closest agreement with mean linear intercept length (11.7% and 22.6% difference) was at 129 Xe Δ = 20 ms for both healthy and IPF meshes, respectively. CONCLUSION This work validates the use of the SEM for accurate estimation of acinar dimensions and indicates that the SEM is relatively robust across a range of experimental conditions and acinar length scales.
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Affiliation(s)
- Ho-Fung Chan
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Guilhem J Collier
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Juan Parra-Robles
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.,Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain
| | - Jim M Wild
- POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.,Insigneo, Institute for in Silico Medicine, University of Sheffield, Sheffield, United Kingdom
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15
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Marshall H, Stewart NJ, Chan HF, Rao M, Norquay G, Wild JM. In vivo methods and applications of xenon-129 magnetic resonance. Prog Nucl Magn Reson Spectrosc 2021; 122:42-62. [PMID: 33632417 PMCID: PMC7933823 DOI: 10.1016/j.pnmrs.2020.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 05/28/2023]
Abstract
Hyperpolarised gas lung MRI using xenon-129 can provide detailed 3D images of the ventilated lung airspaces, and can be applied to quantify lung microstructure and detailed aspects of lung function such as gas exchange. It is sensitive to functional and structural changes in early lung disease and can be used in longitudinal studies of disease progression and therapy response. The ability of 129Xe to dissolve into the blood stream and its chemical shift sensitivity to its local environment allow monitoring of gas exchange in the lungs, perfusion of the brain and kidneys, and blood oxygenation. This article reviews the methods and applications of in vivo129Xe MR in humans, with a focus on the physics of polarisation by optical pumping, radiofrequency coil and pulse sequence design, and the in vivo applications of 129Xe MRI and MRS to examine lung ventilation, microstructure and gas exchange, blood oxygenation, and perfusion of the brain and kidneys.
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Affiliation(s)
- Helen Marshall
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Neil J Stewart
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Ho-Fung Chan
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Madhwesha Rao
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Graham Norquay
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | - Jim M Wild
- POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
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16
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Maunder A, Chan HF, Hughes PJC, Collier G, Norquay G, Rodgers O, Thelwall P, Robb F, Rao M, Wild JM. MR properties of 19 F C 3 F 8 gas in the lungs of healthy volunteers: T 2 ∗ and apparent diffusion coefficient at 1.5T and T 2 ∗ at 3T. Magn Reson Med 2020; 85:1561-1570. [PMID: 32926448 DOI: 10.1002/mrm.28511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/08/2020] [Accepted: 08/17/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE To measure the transverse relaxation time ( T 2 ∗ ) and apparent diffusion coefficient (ADC) of 19 F-C3 F8 gas in vivo in human lungs at 1.5T and 3T, and to determine the representative distribution of values of these parameters in a cohort of healthy volunteers. METHODS Mapping of ADC at lung inflation levels of functional residual capacity (FRC) and total lung capacity (TLC) was performed with inhaled 19 F-C3 F8 (eight subjects) and 129 Xe (six subjects) at 1.5T. T 2 ∗ mapping with 19 F-C3 F8 was performed at 1.5T (at FRC and TLC) for 8 subjects and at 3T (at TLC for seven subjects). RESULTS At both FRC and TLC, the 19 F-C3 F8 ADC was smaller than the free diffusion coefficient demonstrating airway microstructural diffusion restriction. From FRC to TLC, the mean ADC significantly increased from 1.56 mm2 /s to 1.83 mm2 /s (P = .0017) for 19 F-C3 F8, and from 2.49 mm2 /s to 3.38 mm2 /s (P = .0015) for 129 Xe. The posterior-to-anterior gradient in ADC for FRC versus TLC in the superior half of the lungs was measured as 0.0308 mm2 /s per cm versus 0.0168 mm2 /s per cm for 19 F-C3 F8 and 0.0871 mm2 /s per cm versus 0.0326 mm2 /s per cm for 129 Xe. A consistent distribution of 19 F-C3 F8 T 2 ∗ values was observed in the lungs, with low values observed near the diaphragm and large pulmonary vessels. The mean T 2 ∗ across volunteers was 4.48 ms at FRC and 5.33 ms at TLC for 1.5T, and 3.78 ms at TLC for 3T. CONCLUSION In this feasibility study, values of physiologically relevant parameters of lung microstructure measurable by MRI ( T 2 ∗ , and ADC) were established for C3 F8 in vivo lung imaging in healthy volunteers.
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Affiliation(s)
- Adam Maunder
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Ho-Fung Chan
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Paul J C Hughes
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Guillhem Collier
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Graham Norquay
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Oliver Rodgers
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Peter Thelwall
- Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Fraser Robb
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom.,GE Healthcare, Aurora, Ohio, USA
| | - Madhwesha Rao
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
| | - Jim M Wild
- POLARIS, Imaging Group, Department of IICD, University of Sheffield, Sheffield, United Kingdom
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17
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Chan HF, Petersson Sjögren M, Hughes P, Rodgers O, Collier G, Norquay G, Olsson L, Wollmer P, Wild J, Löndahl J. Benchmarking inhaled nanoparticle measurements of airspace dimension with hyperpolarised 129Xe diffusion-weighted MRI. Imaging 2020. [DOI: 10.1183/13993003.congress-2020.2091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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18
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19
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Ng KTF, Chau CM, Chan HF, Cheng LF, Ma KF, Chan KM. Percutaneous Repair of Inadvertent Brachiocephalic Arterial Puncture by Closure Device: A Case Report. Hong Kong Journal of Radiology 2020. [DOI: 10.12809/hkjr2017125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- KTF Ng
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - CM Chau
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - HF Chan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - LF Cheng
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - KF Ma
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - KM Chan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
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Woo SC, Yung KS, Wong T, Yu ELM, Li SK, Chan HF, Chan CH, Lee YC, Chan JMC, Leung WS. Imaging findings of critically ill patients with COVID-19 pneumonia: a case series. Hong Kong Med J 2020; 26:236-239. [PMID: 32362589 DOI: 10.12809/hkmj208441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- S C Woo
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - K S Yung
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - T Wong
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - E L M Yu
- Clinical Research Centre, Princess Margaret Hospital, Hong Kong
| | - S K Li
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - H F Chan
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - C H Chan
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - Y C Lee
- Department of Radiology, Princess Margaret Hospital, Hong Kong
| | - J M C Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - W S Leung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
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Affiliation(s)
- YC Lee
- Diagnostic Radiology Department, Princess Margaret Hospital, Laichikok, Hong Kong
| | - NY Pan
- Diagnostic Radiology Department, Princess Margaret Hospital, Laichikok, Hong Kong
| | - HF Chan
- Diagnostic Radiology Department, Princess Margaret Hospital, Laichikok, Hong Kong
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Chan TS, Pan NY, Chan HF. Magnetic Resonance Imaging of Anterior Cruciate Ligament Repair and Complications: a Pictorial Essay. Hong Kong Journal of Radiology 2019. [DOI: 10.12809/hkjr1916930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- TS Chan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - NY Pan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - HF Chan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
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Wild JM, Biancardi A, Chan HF, Smith L, Bray J, Marshall H, Collier G, Norquay G, Hughes P, Swift A, Cousins M, Hart K, Kotecha S. Imaging functional and microstructural changes in the lungs of children born prematurely. IMAGING 2019. [DOI: 10.1183/13993003.congress-2019.pa3171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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24
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Eaden J, Chan HF, Hughes P, Weatherly N, Austin M, Smith L, Lithgow J, Swift A, Renshaw S, Buch M, Leonard C, Skeoch S, Chaudhuri N, Parker G, Bianchi S, Wild J. Hyperpolarised 129-xenon diffusion-weighted MRI in interstitial lung disease. Imaging 2019. [DOI: 10.1183/13993003.congress-2019.pa3157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Chan Y, Luk W, Cheng L, Chan H, Pan NY, Ma K. Tc-99m sulfur colloid SPECT-CT and assessment of functional liver reserve after Y90 radioembolization: A case report. Int J Surg Case Rep 2019; 62:89-93. [PMID: 31479839 PMCID: PMC6726919 DOI: 10.1016/j.ijscr.2019.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/06/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Quantitative assessment is an essential tool in determining the proportion of liver to be reserved before lobectomy. Technetium-99 m sulfur colloid single-photon emission computed tomography (Tc-99 m SC SPECT-CT) can help in the quantitative assessment of functioning liver tissues and percentage of liver reserve before segmentectomy and lobectomy Matesan et al. (2017), Bowen et al. (2016) and Lam et al. (2013). PRESENTATION OF CASE A 64-year-old man with alcoholic cirrhosis was admitted to our hospital with a 15 × 10 x 13 cm bilobar HCC. Y90 radioembolization was utilized to downstage the liver tumor. On follow-up CT scan of the liver after radiotherapy, the HCC was much reduced to 6.5 cm in size but still viable with elevated alpha fetoprotein ([AFP] from 225 to 381 to 959 ng/mL). Resection was considered. Constitutional indocyanine green retention at 15 min (ICG-R-15) was 22%. We introduced the Tc-99 m SC SPECT-CT scan in order to assess the percentage liver function of each lobe. It showed minimal uptake in the remaining functioning right lobe with a hypertrophic left lobe to whole liver uptake ratio of 87.1%. This finding gave us confidence to perform right hepatectomy. DISCUSSION We used Tc-99 m SC SPECT-CT to estimate the normal functional liver reserve after Y90 radioembolization of a hepatocellular carcinoma (HCC). To our understanding, it is the first case report using Tc-99 m SC to predict the percentage of functional liver reserve after yttrium-90 (Y90) radioembolization. CONCLUSION Tc-99 m SC SPECT-CT is a novel helper used to assess the differential liver function after Y90 radioembolization of HCC and before segmentectomy and lobectomy of the liver.
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Affiliation(s)
- YeeMei Chan
- Department of Diagnostic Radiology, LG1, Princess Margaret Hospital, Lai King Hill Road, Hong Kong.
| | - WingHang Luk
- Department of Diagnostic Radiology, LG1, Princess Margaret Hospital, Lai King Hill Road, Hong Kong.
| | - LikFai Cheng
- Department of Diagnostic Radiology, LG1, Princess Margaret Hospital, Lai King Hill Road, Hong Kong
| | - HoFung Chan
- Department of Diagnostic Radiology, LG1, Princess Margaret Hospital, Lai King Hill Road, Hong Kong
| | - N Y Pan
- Department of Diagnostic Radiology, LG1, Princess Margaret Hospital, Lai King Hill Road, Hong Kong
| | - KaFai Ma
- Department of Diagnostic Radiology, LG1, Princess Margaret Hospital, Lai King Hill Road, Hong Kong
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Chan RLS, Chan CH, Chan HF, Pan NY. The many facets of neuropathic arthropathy. BJR Open 2019; 1:20180039. [PMID: 33178926 PMCID: PMC7592473 DOI: 10.1259/bjro.20180039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 11/05/2022] Open
Abstract
Neuropathic arthropathy, also known as Charcot arthropathy, refers to progressive and occasionally rapid joint destruction that results from underlying disorders of the nervous system. This pictorial essay aims to illustrate various radiologic findings in neuropathic arthropathy using various examples in the upper and lower limbs and in the spine. Pearls for radiologic diagnosis, clinical differential considerations and possible complications are discussed individually for each joint. MR imaging techniques for differentiating infection and neuropathic arthropathy are explained with examples. Management issues are outlined.
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Affiliation(s)
- R L S Chan
- Princess Margaret Hospital, Department of Radiology, Hong Kong,
| | - C H Chan
- Princess Margaret Hospital, Department of Radiology, Hong Kong,
| | - H F Chan
- Princess Margaret Hospital, Department of Radiology, Hong Kong,
| | - N Y Pan
- Princess Margaret Hospital, Department of Radiology, Hong Kong,
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Weatherley ND, Stewart NJ, Chan HF, Austin M, Smith LJ, Collier G, Rao M, Marshall H, Norquay G, Renshaw SA, Bianchi SM, Wild JM. Hyperpolarised xenon magnetic resonance spectroscopy for the longitudinal assessment of changes in gas diffusion in IPF. Thorax 2019; 74:500-502. [PMID: 30389827 PMCID: PMC6475110 DOI: 10.1136/thoraxjnl-2018-211851] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 09/30/2018] [Accepted: 10/08/2018] [Indexed: 11/03/2022]
Abstract
Prognosticating idiopathic pulmonary fibrosis (IPF) is challenging, in part due to a lack of sensitive biomarkers. A recent article in Thorax described how hyperpolarised xenon magnetic resonance spectroscopy may quantify regional gas exchange in IPF lungs. In a population of patients with IPF, we find that the xenon signal from red blood cells diminishes relative to the tissue/plasma signal over a 12-month time period, even when the diffusion factor for carbon monoxide is static over the same time period. We conclude that hyperpolarised 129Xe MR spectroscopy may be sensitive to short-term changes in interstitial gas diffusion in IPF.
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Affiliation(s)
| | - Neil J Stewart
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Ho-Fung Chan
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Matthew Austin
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Laurie J Smith
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Guilhem Collier
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Madhwesha Rao
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Helen Marshall
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Stephen A Renshaw
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Stephen Mark Bianchi
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Jim M Wild
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
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28
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Chan HF, Lai KW, Yung AWT, Luk WH, Cheng LF, Ma JKF. Transcatheter arterial embolisation can be the standard treatment for non-variceal upper gastrointestinal bleeding refractory to endoscopy. Hong Kong Med J 2019; 25:164-166. [PMID: 30971510 DOI: 10.12809/hkmj187486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- H F Chan
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - K W Lai
- Department of Surgery, Princess Margaret Hospital, Laichikok, Hong Kong
| | - A W T Yung
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - W H Luk
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - L F Cheng
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
| | - J K F Ma
- Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong
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Marshall H, Collier GJ, Johns CS, Chan HF, Norquay G, Lawson RA, Wild JM. Imaging Collateral Ventilation in Patients With Advanced Chronic Obstructive Pulmonary Disease: Relative Sensitivity of 3 He and 129 Xe MRI. J Magn Reson Imaging 2019; 49:1195-1197. [PMID: 30267553 PMCID: PMC6749943 DOI: 10.1002/jmri.26273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Helen Marshall
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | | | | | - Ho-Fung Chan
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Rod A Lawson
- Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Jim M Wild
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
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Chan HF, Weatherley ND, Johns CS, Stewart NJ, Collier GJ, Bianchi SM, Wild JM. Airway Microstructure in Idiopathic Pulmonary Fibrosis: Assessment at Hyperpolarized 3He Diffusion-weighted MRI. Radiology 2019; 291:223-229. [DOI: 10.1148/radiol.2019181714] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chan HF, Collier GJ, Weatherley ND, Wild JM. Comparison of in vivo lung morphometry models from 3D multiple b-value3He and129Xe diffusion-weighted MRI. Magn Reson Med 2018; 81:2959-2971. [DOI: 10.1002/mrm.27608] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Ho-Fung Chan
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
| | - Guilhem J. Collier
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
| | - Nicholas D. Weatherley
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
- Academic Directorate of Respiratory Medicine; Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield United Kingdom
| | - Jim M. Wild
- POLARIS, Academic Unit of Radiology, Infection, Immunity & Cardiovascular Disease; University of Sheffield; Sheffield United Kingdom
- Insigneo, Institute for in Silico Medicine; University of Sheffield; Sheffield United Kingdom
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Hughes PJC, Smith L, Chan HF, Tahir BA, Norquay G, Collier GJ, Biancardi A, Marshall H, Wild JM. Assessment of the influence of lung inflation state on the quantitative parameters derived from hyperpolarized gas lung ventilation MRI in healthy volunteers. J Appl Physiol (1985) 2018; 126:183-192. [PMID: 30412033 DOI: 10.1152/japplphysiol.00464.2018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In this study, the effect of lung volume on quantitative measures of lung ventilation was investigated using MRI with hyperpolarized 3He and 129Xe. Six volunteers were imaged with hyperpolarized 3He at five different lung volumes [residual volume (RV), RV + 1 liter (1L), functional residual capacity (FRC), FRC + 1L, and total lung capacity (TLC)], and three were also imaged with hyperpolarized 129Xe. Imaging at each of the lung volumes was repeated twice on the same day with corresponding 1H lung anatomical images. Percent lung ventilated volume (%VV) and variation of signal intensity [heterogeneity score (Hscore)] were evaluated. Increased ventilation heterogeneity, quantified by reduced %VV and increased Hscore, was observed at lower lung volumes with the least ventilation heterogeneity observed at TLC. For 3He MRI data, the coefficient of variation of %VV was <1.5% and <5.5% for Hscore at all lung volumes, while for 129Xe data the values were 4 and 10%, respectively. Generally, %VV generated from 129Xe images was lower than that seen from 3He images. The good repeatability of 3He %VV found here supports prior publications showing that percent lung-ventilated volume is a robust method for assessing global lung ventilation. The greater ventilation heterogeneity observed at lower lung volumes indicates that there may be partial airway closure in healthy lungs and that lung volume should be carefully considered for reliable longitudinal measurements of %VV and Hscore. The results suggest that imaging patients at different lung volumes may help to elucidate obstructive disease pathophysiology and progression. NEW & NOTEWORTHY We present repeatability data of quantitative metrics of lung function derived from hyperpolarized helium-3, xenon-129, and proton anatomical images acquired at five lung volumes in volunteers. Increased regional ventilation heterogeneity at lower lung inflation levels was observed in the lungs of healthy volunteers.
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Affiliation(s)
- Paul J C Hughes
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom
| | - Laurie Smith
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom.,Sheffield Children's Hospital , Sheffield , United Kingdom
| | - Ho-Fung Chan
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom
| | - Bilal A Tahir
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom.,Academic Unit of Clinical Oncology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom
| | - Graham Norquay
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom
| | - Guilhem J Collier
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom
| | - Alberto Biancardi
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom.,Insigneo Institute for In Silico Medicine, University of Sheffield , Sheffield , United Kingdom
| | - Helen Marshall
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom
| | - Jim M Wild
- POLARIS, Academic Unit of Radiology, University of Sheffield , Sheffield, South Yorkshire , United Kingdom.,Insigneo Institute for In Silico Medicine, University of Sheffield , Sheffield , United Kingdom
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Tahir BA, Hughes PJ, Robinson SD, Marshall H, Stewart NJ, Norquay G, Biancardi A, Chan HF, Collier GJ, Hart KA, Swinscoe JA, Hatton MQ, Wild JM, Ireland RH. Spatial Comparison of CT-Based Surrogates of Lung Ventilation With Hyperpolarized Helium-3 and Xenon-129 Gas MRI in Patients Undergoing Radiation Therapy. Int J Radiat Oncol Biol Phys 2018; 102:1276-1286. [DOI: 10.1016/j.ijrobp.2018.04.077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/21/2018] [Accepted: 04/26/2018] [Indexed: 11/30/2022]
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Chan HF, Stewart NJ, Norquay G, Collier GJ, Wild JM. 3D diffusion-weighted 129 Xe MRI for whole lung morphometry. Magn Reson Med 2017; 79:2986-2995. [PMID: 29034509 PMCID: PMC5888195 DOI: 10.1002/mrm.26960] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/14/2017] [Accepted: 09/19/2017] [Indexed: 12/27/2022]
Abstract
Purpose To obtain whole lung morphometry measurements from 129Xe in a single breath‐hold with 3D multiple b‐value 129Xe diffusion‐weighted MRI (DW‐MRI) with an empirically optimized diffusion time and compressed sensing for scan acceleration. Methods Prospective three‐fold undersampled 3D multiple b‐value hyperpolarized 129Xe DW‐MRI datasets were acquired, and the diffusion time (Δ) was iterated so as to provide diffusive length scale (LmD) estimates from the stretched exponential model (SEM) that are comparable to those from 3He. The empirically optimized 129Xe diffusion time was then implemented with a four‐fold undersampling scheme and was prospectively benchmarked against 3He measurements in a cohort of five healthy volunteers, six ex‐smokers, and two chronic obstructive pulmonary disease patients using both SEM‐derived LmD and cylinder model (CM)‐derived mean chord length (Lm). Results Good agreement between the mean 129Xe and 3He LmD (mean difference, 2.2%) and Lm (mean difference, 1.1%) values was obtained in all subjects at an empirically optimized 129Xe Δ = 8.5 ms. Conclusion Compressed sensing has facilitated single‐breath 3D multiple b‐value 129Xe DW‐MRI acquisitions, and results at 129Xe Δ = 8.5 ms indicate that 129Xe provides a viable alternative to 3He for whole lung morphometry mapping with either the SEM or CM. Magn Reson Med 79:2986–2995, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Ho-Fung Chan
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Neil J Stewart
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Graham Norquay
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Guilhem J Collier
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Jim M Wild
- POLARIS, Academic Unit of Radiology, University of Sheffield, Sheffield, UK
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Chan HF, Parra-Robles J, Collier G, Wild J. Comparison of in-vivo lung morphometry models from multiple b-value diffusion-weighted MRI in healthy controls, IPF and COPD patients. Imaging 2017. [DOI: 10.1183/1393003.congress-2017.oa4644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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36
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Weatherley N, Chan HF, Stewart N, Norquay G, Rao M, Collier G, Austin M, Smith L, Marshall H, Renshaw SA, Bianchi S, Wild JM. Late Breaking Abstract - Hyperpolarised gas MRI demonstrates sub-clinical progression in IPF over 6 months. Imaging 2017. [DOI: 10.1183/1393003.congress-2017.oa4642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
The rapid advances in synthetic biology and biotechnology are increasingly demanding high-throughput screening technology, such as screening of the functionalities of synthetic genes for optimization of protein expression. Compartmentalization of single cells in water-in-oil (W/O) emulsion droplets allows screening of a vast number of individualized assays, and recent advances in automated microfluidic devices further help realize the potential of droplet technology for high-throughput screening. However these single-emulsion droplets are incompatible with aqueous phase analysis and the inner droplet environment cannot easily communicate with the external phase. We present a high-throughput, miniaturized screening platform for microchip-synthesized genes using microfluidics-generated water-in-oil-in-water (W/O/W) double emulsion (DE) droplets that overcome these limitations. Synthetic gene variants of fluorescent proteins are synthesized with a custom-built microarray inkjet synthesizer, which are then screened for expression in Escherichia coli (E. coli) cells. Bacteria bearing individual fluorescent gene variants are encapsulated as single cells into DE droplets where fluorescence signals are enhanced by 100 times within 24 h of proliferation. Enrichment of functionally-correct genes by employing an error correction method is demonstrated by screening DE droplets containing fluorescent clones of bacteria with the red fluorescent protein (rfp) gene. Permeation of isopropyl β-d-1-thiogalactopyranoside (IPTG) through the thin oil layer from the external solution initiates target gene expression. The induced expression of the synthetic fluorescent proteins from at least ∼100 bacteria per droplet generates detectable fluorescence signals to enable fluorescence-activated cell sorting (FACS) of the intact droplets. This technology obviates time- and labor-intensive cell culture typically required in conventional bulk experiment.
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Affiliation(s)
- H F Chan
- Department of Biomedical Engineering, Duke University, Durham, 27705, USA. and Department of Biomedical Engineering, Columbia University, New York, 10027, USA
| | - S Ma
- Department of Biomedical Engineering, Duke University, Durham, 27705, USA. and General Biosystems, Inc. Morrisville, 27560 USA
| | - J Tian
- Department of Biomedical Engineering, Duke University, Durham, 27705, USA. and General Biosystems, Inc. Morrisville, 27560 USA and Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin, 300308, China
| | - K W Leong
- Department of Biomedical Engineering, Duke University, Durham, 27705, USA. and Department of Biomedical Engineering, Columbia University, New York, 10027, USA and Department of Systems Biology, Columbia University, New York, 10027, USA
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Law CY, Yeung WL, Cheung YF, Chan HF, Fung E, Hui J, Yung IO, Yuen YP, Chan AO, Lam CW. A common PRRT2 mutation in familial paroxysmal kinesigenic dyskinesia in Hong Kong: a case series of 16 patients. Hong Kong Med J 2016; 22:619-22. [PMID: 27920401 DOI: 10.12809/hkmj154579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- C Y Law
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
| | - W L Yeung
- Department of Paediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
| | - Y F Cheung
- Division of Neurology, Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - H F Chan
- Division of Neurology, Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - E Fung
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - J Hui
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | - I Ok Yung
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y P Yuen
- Department of Chemical Pathology, Prince of Wales Hospital, Shatin, Hong Kong
| | - A Ok Chan
- Division of Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - C W Lam
- Department of Pathology, The University of Hong Kong, Pokfulam, Hong Kong
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Chan HF, Tawhai MH, Levin DL, Bartholmai BB, Clark AR. Supine to upright lung mechanics: do changes in lung shape influence lung tissue deformation? Annu Int Conf IEEE Eng Med Biol Soc 2016; 2014:832-5. [PMID: 25570088 DOI: 10.1109/embc.2014.6943720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In this study we analyze lung shape change between the upright and supine postures and the effect of this shape change on the deformation of lung tissue under gravity. We use supine computed tomography images along with upright tomosynthesis images obtained on the same day to show that there is significant diaphragmatic movement between postures. Using a continuum model of lung tissue deformation under gravity we show that the shape changes due to this diaphragmatic movement could result in different lung tissue expansion patterns between supine and upright lungs. This is an essential consideration when interpreting imaging data acquired in different postures or translating data acquired in supine imaging to upright function.
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Chan HF, Stewart NJ, Parra-Robles J, Collier GJ, Wild JM. Whole lung morphometry with 3D multiple b-value hyperpolarized gas MRI and compressed sensing. Magn Reson Med 2016; 77:1916-1925. [PMID: 27283321 PMCID: PMC5412864 DOI: 10.1002/mrm.26279] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 01/05/2023]
Abstract
Purpose To demonstrate three‐dimensional (3D) multiple b‐value diffusion‐weighted (DW) MRI of hyperpolarized 3He gas for whole lung morphometry with compressed sensing (CS). Methods A fully‐sampled, two b‐value, 3D hyperpolarized 3He DW‐MRI dataset was acquired from the lungs of a healthy volunteer and retrospectively undersampled in the ky and kz phase‐encoding directions for CS simulations. Optimal k‐space undersampling patterns were determined by minimizing the mean absolute error between reconstructed and fully‐sampled 3He apparent diffusion coefficient (ADC) maps. Prospective three‐fold, undersampled, 3D multiple b‐value 3He DW‐MRI datasets were acquired from five healthy volunteers and one chronic obstructive pulmonary disease (COPD) patient, and the mean values of maps of ADC and mean alveolar dimension (LmD) were validated against two‐dimensional (2D) and 3D fully‐sampled 3He DW‐MRI experiments. Results Reconstructed undersampled datasets showed no visual artifacts and good preservation of the main image features and quantitative information. A good agreement between fully‐sampled and prospective undersampled datasets was found, with a mean difference of +3.4% and +5.1% observed in mean global ADC and LmD values, respectively. These differences were within the standard deviation range and consistent with values reported from healthy and COPD lungs. Conclusions Accelerated CS acquisition has facilitated 3D multiple b‐value 3He DW‐MRI scans in a single breath‐hold, enabling whole lung morphometry mapping. Magn Reson Med 77:1916–1925, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Ho-Fung Chan
- POLARIS, Academic Unit of Radiology, University of Sheffield, United Kingdom
| | - Neil J Stewart
- POLARIS, Academic Unit of Radiology, University of Sheffield, United Kingdom
| | - Juan Parra-Robles
- POLARIS, Academic Unit of Radiology, University of Sheffield, United Kingdom
| | - Guilhem J Collier
- POLARIS, Academic Unit of Radiology, University of Sheffield, United Kingdom
| | - Jim M Wild
- POLARIS, Academic Unit of Radiology, University of Sheffield, United Kingdom.,Insigneo, Institute for in silico medicine, Sheffield, United Kingdom
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Chan CH, Cheng KK, Pan NY, Wong KC, Lai HY, Chan HF, Chow HL. Mueller-Weiss Syndrome: an Important but Under-recognised Cause of Foot Pain and Deformity. Hong Kong J Radiol 2016. [DOI: 10.12809/hkjr1615337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Chan HF, Clark AR, Hoffman EA, Malcolm DTK, Tawhai MH. Quantifying normal geometric variation in human pulmonary lobar geometry from high resolution computed tomography. J Biomech Eng 2015; 137:051010. [PMID: 25727935 DOI: 10.1115/1.4029919] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Indexed: 11/08/2022]
Abstract
Previous studies of the ex vivo lung have suggested significant intersubject variability in lung lobe geometry. A quantitative description of normal lung lobe shape would therefore have value in improving the discrimination between normal population variability in shape and pathology. To quantify normal human lobe shape variability, a principal component analysis (PCA) was performed on high resolution computed tomography (HRCT) imaging of the lung at full inspiration. Volumetric imaging from 22 never-smoking subjects (10 female and 12 male) with normal lung function was included in the analysis. For each subject, an initial finite element mesh geometry was generated from a group of manually selected nodes that were placed at distinct anatomical locations on the lung surface. Each mesh used cubic shape functions to describe the surface curvilinearity, and the mesh was fitted to surface data for each lobe. A PCA was performed on the surface meshes for each lobe. Nine principal components (PCs) were sufficient to capture >90% of the normal variation in each of the five lobes. The analysis shows that lobe size can explain between 20% and 50% of intersubject variability, depending on the lobe considered. Diaphragm shape was the next most significant intersubject difference. When the influence of lung size difference is removed, the angle of the fissures becomes the most significant shape difference, and the variability in relative lobe size becomes important. We also show how a lobe from an independent subject can be projected onto the study population's PCs, demonstrating potential for abnormalities in lobar geometry to be defined in a quantitative manner.
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43
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Chan HF, Cheng LF. Use of NP-59 (131I-iodocholesterol) Scan as a Potential Alternative to Adrenal Venous Sampling in the Investigation of Primary Aldosteronism: a 5-Year Retrospective Study. Hong Kong J Radiol 2014. [DOI: 10.12809/hkjr1414230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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