Direct comparison of <sup>129</sup><scp>X</scp>e diffusion measurements with quantitative histology in human lungs

Thomen, Robert P.; Quirk, James D.; Roach, David J.; Egan‐Rojas, Tiffany; Ruppert, K.; Yusen, Roger D.; Altes, Talissa A.; Yablonskiy, Dmitriy A.; Woods, Jason C.

doi:10.1002/mrm.26120

Cited by 40 publications

(45 citation statements)

References 51 publications

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“…A number of preliminary multi‐b diffusion‐weighted 3 He MRI studies in patients with BPD and AATD have provided strong evidence for the feasibility of lung morphometry measurements in patients with extensive disease. Moreover, 129 Xe ADCs were consistent with histologic measurements in chronic obstructive pulmonary disease (COPD) patients . Static ventilation mapping with relatively inexpensive, naturally abundant hyperpolarized 129 Xe is also feasible in patients .…”

Section: Introductionmentioning

confidence: 54%

“…Moreover, 129 Xe ADCs were consistent with histologic measurements in chronic obstructive pulmonary disease (COPD) patients. 10 Static ventilation mapping with relatively inexpensive, naturally abundant hyperpolarized 129 Xe is also feasible in patients. 11 The physical properties of 129 Xe nuclei (e.g., low gyromagnetic ratio) require the use of rapid MRI acquisition strategies [12][13][14] considering that the gradient strengths for clinical scanners is typically around 5 G/cm.…”

Section: Introductionmentioning

confidence: 99%

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Accelerated ¹²⁹Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Ouriadov

Guo

McCormack

et al. 2019

Magnetic Resonance in Med

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Purpose Multi‐b diffusion‐weighted hyperpolarized inhaled‐gas MRI provides imaging biomarkers of terminal airspace enlargement including ADC and mean linear intercept (Lm), but clinical translation has been limited because image acquisition requires relatively long or multiple breath‐holds that are not well‐tolerated by patients. Therefore, we aimed to accelerate single breath‐hold 3D multi‐b diffusion‐weighted 129Xe MRI, using k‐space undersampling in imaging direction using a different undersampling pattern for different b‐values combined with the stretched exponential model to generate maps of ventilation, apparent transverse relaxation time constant (T2∗), ADC, and Lm values in a single, short breath‐hold; accelerated and non‐accelerated measurements were directly compared. Methods We evaluated multi‐b (0, 12, 20, 30, and 45.5 s/cm2) diffusion‐weighted 129Xe T2∗/ADC/morphometry estimates using acceleration factor (AF = 1 and 7) and multi‐breath sampling in 3 volunteers (HV), and 6 participants with alpha‐1 antitrypsin deficiency (AATD). Results For the HV subgroup, mean differences of 5%, 2%, and 8% were observed between fully sampled and undersampled k‐space for ADC, Lm, and T2∗ values, respectively. For the AATD subgroup, mean differences were 9%, 6%, and 12% between fully sampled and undersampled k‐space for ADC, Lm and T2∗ values, respectively. Although mean differences of 1% and 4.5% were observed between accelerated and multi‐breath sampled ADC and Lm values, respectively, mean ADC/Lm estimates were not significantly different from corresponding mean ADCM/LmM or mean ADCA/LmA estimates (all P > 0.60 , A = undersampled and M = multi‐breath sampled). Conclusions Accelerated multi‐b diffusion‐weighted 129Xe MRI is feasible at AF = 7 for generating pulmonary ADC and Lm in AATD and normal lung.

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Section: Introductionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Accelerated ¹²⁹Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Ouriadov

Guo

McCormack

et al. 2019

Magnetic Resonance in Med

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“…Excellent correspondence between MRI‐based L m estimates and the histology mean linear intercept estimates was confirmed . Although there has not been a direct comparison of 129 Xe morphology measurements to histology, recently there have been comparisons of 129 Xe and 3 He‐derived measures, including 129 Xe ADC and histology‐based L m . This recent work lays the groundwork for the next step, which will be to directly compare 129 Xe MRI‐derived L m with histologically derived L m .…”

Section: Hyperpolarized Noble Gas Mrimentioning

confidence: 74%

“…129 Xe MRI morphometry has been piloted and compared in a small group of COPD patients and healthy volunteers with mean MRI‐derived L m values in the range of 220–253 μm and 410 ± 90 μm, respectively . Finally, hyperpolarized gas diffusion‐weighted MRI has been clinically approved for use in the United Kingdom and this will dramatically increase the number of cases that can be used as exemplars of the utility of the method.…”

Section: Applicationsmentioning

confidence: 99%

Advanced pulmonary MRI to quantify alveolar and acinar duct abnormalities: Current status and future clinical applications

Westcott

McCormack

Párraga

et al. 2019

Magnetic Resonance Imaging

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There are serious clinical gaps in our understanding of chronic lung disease that require novel, sensitive, and noninvasive in vivo measurements of the lung parenchyma to measure disease pathogenesis and progressive changes over time as well as response to treatment. Until recently, our knowledge and appreciation of the tissue changes that accompany lung disease has depended on ex vivo biopsy and concomitant histological and stereological measurements. These measurements have revealed the underlying pathologies that drive lung disease and have provided important observations about airway occlusion, obliteration of the terminal bronchioles and airspace enlargement, or fibrosis and their roles in disease initiation and progression. ex vivo tissue stereology and histology are the established gold standards and, more recently, micro‐computed tomography (CT) measurements of ex vivo tissue samples has also been employed to reveal new mechanistic findings about the progression of obstructive lung disease in patients. While these approaches have provided important understandings using ex vivo analysis of excised samples, recently developed hyperpolarized noble gas MRI methods provide an opportunity to noninvasively measure acinar duct and terminal airway dimensions and geometry in vivo, and, without radiation burden. Therefore, in this review we summarize emerging pulmonary MRI morphometry methods that provide noninvasive in vivo measurements of the lung in patients with bronchopulmonary dysplasia and chronic obstructive pulmonary disease, among others. We discuss new findings, future research directions, as well as clinical opportunities to address current gaps in patient care and for testing of new therapies. Level of Evidence: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:28–40.

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“…Novel new hyperpolarized gas methods for magnetic resonance imaging provide the tools to longitudinally follow indices associated with the terminal bronchioles (10)(11)(12). Dual-energy CT has allowed for the assessment of peripheral distributions of perfused blood volume, a surrogate for parenchymal perfusion, leading to the exploration of vascular dysfunction and its role in smoking-associated emphysema (13).…”

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confidence: 99%

Multiscale Lung Imaging Provides New Insights into Disease Progression in the Chronic Obstructive Pulmonary Disease Lung

Hoffman¹,

Weibel

2017

Am J Respir Crit Care Med

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The early disappearance of terminal bronchioles in the sequelae of events associated with chronic obstructive pulmonary disease (COPD) was observed in what is now considered to be a landmark publication of McDonough and colleagues using both multi-detector row computed tomography (MDCT) and micro-computed tomography (microCT) to study the lungs of subjects with panlobular (PLE) and centrilobular (CLE) emphysema (1). In comparison with control subjects, McDonough and colleagues found a reduction of airway segments detected at the limits of resolution of MDCT in both PLE and CLE (1). These reductions in the 2-to 2.5-mm inner diameter airways observed on MDCT were accompanied by a reduction in the number of terminal bronchioles in PLE and more so in subjects with CLE studied by microCT. In this issue of the Journal, Tanabe and colleagues (pp. 630-638) extend the observations of McDonough and colleagues by assessing, in an expanded set of lung samples, the anatomic characteristics of the preterminal airways of PLE, CLE, and control subjects (2). The observations include a demonstration of an increased wall thickness and wall area percentage in CLE compared with subjects with PLE and control subjects.One of the most interesting features of this study is that it allowed airways to be integrally studied, from branch point to branch point, cross-section, and length. This resulted in the paradoxical finding that, compared with control subjects, the length of preterminal bronchioles is reduced by 28 and 48% in CLE and PLE, respectively, whereas the lung volumes are increased by 33 and 46%, an observation that needs some explanation. However, it is only paradoxical if one assumes that the emphysema pathology affects both the acinar structures and the airways homogeneously, but this is hardly the case. Integrity of lung structure is essentially ensured by the complex fiber continuum that extends from the pleura through the septal fiber nets of the acini and along the airway tree to the hilum (3). This system has the characteristics of a tensegrity structure (4, 5): when one fiber of the tensed network is snapped, the entire structure becomes deformed. In the case of emphysema, the acinar fiber networks are partly disrupted, which reduces the tensile forces they exert on the proximal structures, mainly on the (pre)terminal airways that will retract toward the larger more central airways; at the same time they will withdraw from the acinar structures, thus increasing the acinar space, the hallmark of emphysema.The observation that total wall volume of preterminal bronchioles was not maintained but reduced, despite the

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Direct comparison of ¹²⁹Xe diffusion measurements with quantitative histology in human lungs

Abstract: Diffusion MRI of HP Xe quantifies regional airspace enlargement in COPD. Xe ADC showed much less overlap between groups than quantitative histology, consistent with our past experience with He diffusion MRI in COPD. Magn Reson Med 77:265-272, 2017. © 2016 Wiley Periodicals, Inc.

Cited by 40 publications

References 51 publications

Accelerated ¹²⁹Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Accelerated ¹²⁹Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Advanced pulmonary MRI to quantify alveolar and acinar duct abnormalities: Current status and future clinical applications

Multiscale Lung Imaging Provides New Insights into Disease Progression in the Chronic Obstructive Pulmonary Disease Lung

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Direct comparison of 129Xe diffusion measurements with quantitative histology in human lungs

Abstract: Diffusion MRI of HP Xe quantifies regional airspace enlargement in COPD. Xe ADC showed much less overlap between groups than quantitative histology, consistent with our past experience with He diffusion MRI in COPD. Magn Reson Med 77:265-272, 2017. © 2016 Wiley Periodicals, Inc.

Cited by 40 publications

References 51 publications

Accelerated 129Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Accelerated 129Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Advanced pulmonary MRI to quantify alveolar and acinar duct abnormalities: Current status and future clinical applications

Multiscale Lung Imaging Provides New Insights into Disease Progression in the Chronic Obstructive Pulmonary Disease Lung

Contact Info

Product

Resources

About

Direct comparison of ¹²⁹Xe diffusion measurements with quantitative histology in human lungs

Accelerated ¹²⁹Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency

Accelerated ¹²⁹Xe MRI morphometry of terminal airspace enlargement: Feasibility in volunteers and those with alpha‐1 antitrypsin deficiency