Gadofosveset-enhanced lung magnetic resonance imaging to detect ongoing vascular leak in pulmonary fibrosis

Abstract

Summary Sentence: Vascular leak is increased diffusely in the lungs in pulmonary fibrosis and is not limited to radiographic areas of disease involvement.

Surfactant dysfunction and alveolar collapse are linked with fibrotic septal wall remodeling in the TGF-β1-induced mouse model of pulmonary fibrosis

“…Recent imaging studies provided further evidence that instability of distal airspaces is present in non-remodeled lung parenchyma and might precede the development of pulmonary fibrosis in IPF, so that authors discussed the role of alveolar collapse as a trigger for fibrosis [3]. In line with this suggestion are observations of increased vascular leakage in IPF lungs in areas that are not yet remodeled, indicating that the disease shows activity outside the fibrotic areas detectable by HRCT [26].…”

“…Recent imaging studies provided evidence that the disease is active not only in areas of manifest fibrosis. Gadofosveset-enhanced magnetic resonance imaging suggests the existence of vascular leakage and therefore ongoing lung injury in areas of the IPF lung, which did not have visible fibrosis in HRCT [26].…”

Improving the reactivity of hydrazine-bearing MRI probes for in vivo imaging of lung fibrogenesis

“…We previously reported MR probes and methods to quantify the burden of brosis in the lung, 31 inammation in the lung, 32 as well as vascular permeability in the context of IPF. 33,34 Our data indicate that improving the aldehyde reactivity and affinity of hydrazine-bearing gadolinium contrast agents translates to enhanced and prolonged accumulation in brosing lung tissue and improved specicity. We are currently expanding our library of allysine-reactive probes to determine the relationship of modifying the rate of reactivity on in vivo efficacy.…”

Molecular imaging of fibrosis: recent advances and future directions

“…Using apolipoprotein E-deficient mice fed HFD, MR signal intensity of the brachiocephalic artery vessel wall correlated with degree of EBD uptake and increased with atherosclerotic progression (59). We performed gadofosveset-enhanced lung MRI to detect vascular leak in patients with pulmonary fibrosis (60). Using an albumin extravasation index (the change in lung parenchyma signal intensity with contrast administration normalized to the change in aorta signal intensity), we found that the lungs of patients with pulmonary fibrosis had increased albumin extravasation in all measured lung regions compared with the lungs of healthy volunteers.…”