Dynamic perfluorinated gas MRI reveals abnormal ventilation despite normal FEV1 in cystic fibrosis

Goralski, Jennifer L.; Chung, Sang Hun; Glass, Tyler M.; Ceppe, Agathe; Akinnagbe-Zusterzeel, Esther; Trimble, Aaron; Boucher, Richard C.; Soher, Brian J.; Charles, H. Cecil; Donaldson, Scott H.; Lee, Yueh Z.

doi:10.1172/jci.insight.133400

Cited by 18 publications

(104 citation statements)

References 23 publications

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“…Figure 2 provides examples of the variability of gas filling between methods. In Subject 1, the ventilation defect location and volume from the early-breath 19 F was similar to that of the high-resolution 129 Xe. In contrast, the max-vent 19 F showed eventual filling of a majority of these ventilation defects.…”

Section: Signal To Noisementioning

confidence: 64%

“…However, these ventilation abnormalities are not entirely congruent. 19 F and HP 129 Xe imaging provide complementary information that enable differentiation of normally ventilated, slowly ventilated, and non-ventilated regions in the lungs.…”

Section: Discussionmentioning

confidence: 99%

“…The Bland-Altman plot shows a significant mean difference in VDP between max-vent 19 F and high-res 129 Xe (−10.6%, P = .007; Figure 3E). There was no significant difference in mean VDP values between early-breath 19 F and high-res 129 Xe (−0.5%, P = .87; Figure 3D). In contrast, low-res vs. highres 129 Xe VDP display a significant correlation (r = 0.68, P = .03; Figure 3C), although a significant mean difference in VDP (−10.5%, P = .001; Figure 3F) indicated consistent underestimation of VDP values by low-res 129 Xe images.…”

Section: Signal To Noisementioning

confidence: 96%

“…Subjects ranged in age from 21 to 44 years, and had a mean FEV 1 of 81.7 ± 15.0% predicted. Each subject completed a single imaging session during which both 19 F and 129 Xe ventilation images were acquired in a random order. Prior to the imaging session, all subjects completed spirometry according to American Thoracic Society standards.…”

Section: Study Participants and Study Designmentioning

confidence: 99%

“…In contrast, low-res vs. highres 129 Xe VDP display a significant correlation (r = 0.68, P = .03; Figure 3C), although a significant mean difference in VDP (−10.5%, P = .001; Figure 3F) indicated consistent underestimation of VDP values by low-res 129 Xe images. Figure 4 shows the comparison between max-vent 19 F VDP and early-breath 19 F VDP. There was significant correlation (r = 0.75, P = .012) and a significant mean difference (10.0%, P = 4.9e-5) indicating overestimation of VDP by early breath 19 F.…”

Section: Signal To Noisementioning

confidence: 99%

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Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

McCallister

Chung

Antonacci

et al. 2020

Magnetic Resonance in Med

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Purpose To quantitatively compare dynamic 19F and single breath hyperpolarized 129Xe MRI for the detection of ventilation abnormalities in subjects with mild cystic fibrosis (CF) lung disease. Methods Ten participants with stable CF and a baseline FEV1 > 70% completed a single imaging session where dynamic 19F and single breath 129Xe lung ventilation images were acquired on a 3T MRI scanner. Ventilation defect percentages (VDP) values between 19F early‐breath, 19F maximum‐ventilation, 129Xe low‐resolution, and 129Xe high‐resolution images were compared. Dynamic 19F images were used to determine gas wash‐in/out rates in regions of ventilation congruency and mismatch between 129Xe and 19F. Results VDP values from high‐resolution 129Xe images were greater than from low‐resolution images (P = .001), although these values were significantly correlated (r = 0.68, P = .03). Early‐breath 19F VDP and max‐vent 19F VDP also showed significant correlation (r = 0.75, P = .012), with early‐breath 19F VDP values being significantly greater (P < .001). No correlation in VDP values were detected between either 19F method or high‐res 129Xe images. In addition, the location and volume of ventilation defects were often different when comparing 129Xe and 19F images from the same subject. Areas of ventilation congruence displayed the expected ventilation kinetics, while areas of ventilation mismatch displayed abnormally slow gas wash‐in and wash‐out. Conclusion In CF subjects, ventilation abnormalities are identified by both 19F and HP 129Xe imaging. However, these ventilation abnormalities are not entirely congruent. 19F and HP 129Xe imaging provide complementary information that enable differentiation of normally ventilated, slowly ventilated, and non‐ventilated regions in the lungs.

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Section: Signal To Noisementioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Signal To Noisementioning

confidence: 96%

Section: Study Participants and Study Designmentioning

confidence: 99%

Section: Signal To Noisementioning

confidence: 99%

See 3 more Smart Citations

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

McCallister

Chung

Antonacci

et al. 2020

Magnetic Resonance in Med

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Editorial for “Intra‐ and Inter‐visit Repeatability of ¹²⁹Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease”

Kern

2022

Magnetic Resonance Imaging

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Intra‐ and Inter‐visit Repeatability of ¹²⁹Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease

Alam

Zanette

Munidasa

et al. 2023

Magnetic Resonance Imaging

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Background Multiple‐breath washout (MBW) 129Xe MRI (MBW Xe‐MRI) is a promising technique for following pediatric cystic fibrosis (CF) lung disease progression. However, its repeatability in stable CF needs to be established to use it as an outcome measure for novel therapies. Purpose To assess intravisit and intervisit repeatability of MBW Xe‐MRI in healthy and CF children. Study Type Prospective, longitudinal cohort study. Subjects A total of 18 pediatric subjects (7 healthy, 11 CF). Field Strength/Sequence A 3 T/2D coronal hyperpolarized (HP) 129Xe images using GRE sequence. Assessment All subjects completed MBW Xe‐MRI, pulmonary function tests (PFTs) (spirometry, nitrogen [N2] MBW for lung clearance index [LCI]) and ventilation defect percent (VDP) at baseline (visit 1) and 1‐month after. Fractional ventilation (FV), coefficient of variation (CoVFV) maps were calculated from MBW Xe‐MRI data acquired between intervening air washout breaths performed after an initial xenon breath‐hold. Skewness of FV and CoVFV map distributions was also assessed. Statistical Tests Repeatability: intraclass correlation coefficients (ICC), within‐subject coefficient of variation (CV%), repeatability coefficient (CR). Agreement: Bland–Altman. For correlations between MBW Xe‐MRI, VDP and PFTs: Spearman's correlation. Significance threshold: P < 0.05. Results For FV, intravisit median [IQR] ICC was high in both healthy (0.94 [0.48, 0.99]) and CF (0.83 [0.04, 0.97]) subjects. CoVFV also had good intravisit ICC in healthy (0.92 [0.42, 0.99]) and CF (0.79 [0.02, 0.96]) subjects. Similarly, for FV, intervisit ICC was high in health (0.94 [0.68, 0.99]) and CF (0.89 [0.61, 0.97]). CoVFV also had good intervisit ICC in health (0.92 [0.42, 0.99]) and CF (0.78 [0.26, 0.94]). FV had better intervisit repeatability than VDP. CoVFV correlated significantly with LCI (R = 0.56). Skewness of FV distributions significantly distinguished between cohorts at baseline. Data Conclusion MBW Xe‐MRI had high intravisit and intervisit repeatability in healthy and stable CF subjects. CoVFV correlated with LCI, suggesting the importance of ventilation heterogeneity to early CF. Evidence Level 1. Technical Efficacy Stage 2.

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Dynamic perfluorinated gas MRI reveals abnormal ventilation despite normal FEV1 in cystic fibrosis

Cited by 18 publications

References 23 publications

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

Editorial for “Intra‐ and Inter‐visit Repeatability of ¹²⁹Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease”

Intra‐ and Inter‐visit Repeatability of ¹²⁹Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease

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Dynamic perfluorinated gas MRI reveals abnormal ventilation despite normal FEV1 in cystic fibrosis

Cited by 18 publications

References 23 publications

Comparison of single breath hyperpolarized 129Xe MRI with dynamic 19F MRI in cystic fibrosis lung disease

Comparison of single breath hyperpolarized 129Xe MRI with dynamic 19F MRI in cystic fibrosis lung disease

Editorial for “Intra‐ and Inter‐visit Repeatability of 129Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease”

Intra‐ and Inter‐visit Repeatability of 129Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease

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Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

Editorial for “Intra‐ and Inter‐visit Repeatability of ¹²⁹Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease”

Intra‐ and Inter‐visit Repeatability of ¹²⁹Xenon Multiple‐Breath Washout MRI in Children With Stable Cystic Fibrosis Lung Disease