Hyperpolarized 129Xenon MRI Ventilation Defect Quantification via Thresholding and Linear Binning in Multiple Pulmonary Diseases

Roach, David J.; Willmering, Matthew M.; Plummer, J.W.; Walkup, Laura L.; Zhang, Yin; Hossain, Monir; Cleveland, Zackary I.; Woods, Jason C.

doi:10.1016/j.acra.2021.06.017

Cited by 10 publications

(8 citation statements)

References 43 publications

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“…Finally, the GAMLSS‐binning method presented here is not exclusive to gas‐exchange MRI. 129 Xe ventilation MRI, 129 Xe diffusion MRI, and more may benefit from demographic‐corrected healthy‐reference distributions—of which this model can easily be expanded 74,75 …”

Section: Discussionmentioning

confidence: 99%

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Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in ¹²⁹Xe gas‐exchange MRI

Plummer

Willmering

Cleveland

et al. 2022

Magnetic Resonance in Med

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Purpose Xenon‐129 (129Xe) gas‐exchange MRI is a pulmonary‐imaging technique that provides quantitative metrics for lung structure and function and is often compared to pulmonary‐function tests. Unlike such tests, it does not normalize to predictive values based on demographic variables such as age. Many sites have alluded to an age dependence in gas‐exchange metrics; however, a procedure for normalizing metrics has not yet been introduced. Theory We model healthy reference values for 129Xe gas‐exchange MRI against age using generalized additive models for location, scale, and shape (GAMLSS). GAMLSS takes signal data from an aggregated heathy‐reference cohort and fits a distribution with flexible median, variation, skewness, and kurtosis to predict age‐dependent centiles. This approach mirrors methods by the Global Lung Function Initiative for modeling pulmonary‐function test data and applies it to binning methods widely used by the 129Xe MRI community to interpret and quantify gas‐exchange data. Methods Ventilation, membrane‐uptake, red blood cell transfer, and red blood cell:membrane gas‐exchange metrics were collected on 30 healthy subjects over an age range of 5 to 68 years. A GAMLSS model was fit against age and compared against widely used linear and generalized‐linear binning 129Xe MRI analysis schemes. Results All 4 gas‐exchange metrics had significant skewness, and membrane‐uptake had significant kurtosis compared to a normal distribution. Age has significant impact on distribution parameters. GAMLSS‐binning produced narrower bins compared to the linear and generalized‐linear binning schemes and distributed signal data closer to a normal distribution. Conclusion The proposed “proof‐of‐concept” GAMLSS‐binning approach can improve diagnostic accuracy of 129Xe gas‐exchange MRI by providing a means of modeling voxel distribution data against age.

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Section: Discussionmentioning

confidence: 99%

“…129 Xe ventilation MRI, 129 Xe diffusion MRI, and more may benefit from demographic-corrected healthy-reference distributions-of which this model can easily be expanded. 74,75…”

Section: F I G U R Ementioning

confidence: 99%

Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in ¹²⁹Xe gas‐exchange MRI

Plummer

Willmering

Cleveland

et al. 2022

Magnetic Resonance in Med

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“…There are a variety of published methods for analyzing ventilation images to calculate ventilation defect percentage (VDP). 28 As such, our pipeline automatically calculates VDP using several of the most common methods, including mean anchored linear binning, 29,30 linear binning based on a reference population, 31 and Atropos. 32 For the current work, we used the VDP calculated via mean anchored linear binning to compare dedicated and single-breath imaging methods.…”

Section: Image Analysis Pipelinementioning

confidence: 99%

A single‐breath‐hold protocol for hyperpolarized ¹²⁹Xe ventilation and gas exchange imaging

et al. 2023

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Hyperpolarized 129 Xe MRI (Xe-MRI) is increasingly used to image the structure and function of the lungs. Because 129 Xe imaging can provide multiple contrasts (ventilation, alveolar airspace size, and gas exchange), imaging often occurs over several breath-holds, which increases the time, expense, and patient burden of scans. We propose an imaging sequence that can be used to acquire Xe-MRI gas exchange and high-quality ventilation images within a single, approximately 10 s, breath-hold. This method uses a radial one-point Dixon approach to sample dissolved 129 Xe signal, which is interleaved with a 3D spiral ("FLORET") encoding pattern for gaseous 129 Xe.Thus, ventilation images are obtained at higher nominal spatial resolution (4.2 Â 4.2 Â 4.2 mm 3 ) compared with gas-exchange images (6.25 Â 6.25 Â 6.25 mm 3 ), both competitive with current standards within the Xe-MRI field. Moreover, the short 10 s Xe-MRI acquisition time allows for 1 H "anatomic" images used for thoracic cavity masking to be acquired within the same breath-hold for a total scan time of about 14 s. Images were acquired using this single-breath method in 11 volunteers (N = 4 healthy, N = 7 post-acute COVID). For 11 of these participants, a separate breathhold was used to acquire a "dedicated" ventilation scan and five had an additional "dedicated" gas exchange scan. The images acquired using the single-breath protocol were compared with those from dedicated scans using Bland-Altman analysis, intraclass correlation (ICC), structural similarity, peak signal-to-noise ratio, Dice coefficients, and average distance. Imaging markers from the single-breath protocol showed high correlation with dedicated scans (ventilation defect percent, ICC = 0.77, p = 0.01; membrane/gas, ICC = 0.97, p = 0.001; red blood cell/gas, ICC = 0.99, p < 0.001). Images showed good qualitative and quantitative regional agreement. This single-breath protocol enables the collection of essential Xe-MRI information within one breath-hold, simplifying scanning sessions and reducing costs associated with Xe-MRI.

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“…Although HXe MRI's diagnostic capabilities have been demonstrated in many lung disorders, [1][2][3][4][5][6][7][8][9][10] the hallmark imaging markers-ventilation defect percent (VDP) and ratios of the dissolved-and gas-phase compartments-are typically assessed during a long breath-hold following inhalation of a high concentration bolus of HXe gas. [11][12][13][14] However, static images of gas distribution after a single breath may overestimate VDP as poorly ventilated lung regions, which require multiple breaths of xenon to fill, are prematurely characterized as defects preventing further analysis. 15 Additionally, gas redistribution throughout breath-holds is a particularly heterogeneous process in diseased lungs, as some regions are initially under-ventilated and slowly fill with gas compared to other regions, leading to intervoxel flow artifacts that can accumulate over the course of a breath-hold.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous quantification of hyperpolarized xenon‐129 ventilation and gas exchange with multi‐breath xenon‐polarization transfer contrast (XTC) MRI

Amzajerdian

Hamedani

Baron

et al. 2023

Magnetic Resonance in Med

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PurposeTo demonstrate the feasibility of a multi‐breath xenon‐polarization transfer contrast (XTC) MR imaging approach for simultaneously evaluating regional ventilation and gas exchange parameters.MethodsImaging was performed in five healthy volunteers and six chronic obstructive pulmonary disease (COPD) patients. The multi‐breath XTC protocol consisted of three repeated schemes of six wash‐in breaths of a xenon mixture and four normoxic wash‐out breaths, with and without selective saturation of either the tissue membrane or red blood cell (RBC) resonances. Acquisitions were performed at end‐exhalation while subjects maintained tidal breathing throughout the session. The no‐saturation, membrane‐saturation, and RBC‐saturation images were fit to a per‐breath gas replacement model for extracting voxelwise tidal volume (TV), functional residual capacity (FRC), and fractional ventilation (FV), as well as tissue‐ and RBC‐gas exchange (fMem and fRBC, respectively). The sensitivity of the derived model was also evaluated via simulations.ResultsWith the exception of FRC, whole‐lung averages for all metrics were decreased in the COPD subjects compared to the healthy cohort, significantly so for FV, fRBC, and fMem. Heterogeneity was higher overall in the COPD subjects, particularly for fRBC, fMem, and fRBC:Mem. The anterior‐to‐posterior gradient associated with the gravity‐dependence of lung function in supine imaging was also evident for FV, fRBC, and fMem values in the healthy subjects, but noticeably absent in the COPD cohort.ConclusionMulti‐breath XTC imaging generated high‐resolution, co‐registered maps of ventilation and gas exchange parameters acquired during tidal breathing and with low per‐breath xenon doses. Clear differences between healthy and COPD subjects were apparent and consistent with spirometry.

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Hyperpolarized 129Xenon MRI Ventilation Defect Quantification via Thresholding and Linear Binning in Multiple Pulmonary Diseases

Cited by 10 publications

References 43 publications

Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in ¹²⁹Xe gas‐exchange MRI

Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in ¹²⁹Xe gas‐exchange MRI

A single‐breath‐hold protocol for hyperpolarized ¹²⁹Xe ventilation and gas exchange imaging

Simultaneous quantification of hyperpolarized xenon‐129 ventilation and gas exchange with multi‐breath xenon‐polarization transfer contrast (XTC) MRI

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Hyperpolarized 129Xenon MRI Ventilation Defect Quantification via Thresholding and Linear Binning in Multiple Pulmonary Diseases

Cited by 10 publications

References 43 publications

Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in 129Xe gas‐exchange MRI

Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in 129Xe gas‐exchange MRI

A single‐breath‐hold protocol for hyperpolarized 129Xe ventilation and gas exchange imaging

Simultaneous quantification of hyperpolarized xenon‐129 ventilation and gas exchange with multi‐breath xenon‐polarization transfer contrast (XTC) MRI

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Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in ¹²⁹Xe gas‐exchange MRI

Childhood to adulthood: Accounting for age dependence in healthy‐reference distributions in ¹²⁹Xe gas‐exchange MRI

A single‐breath‐hold protocol for hyperpolarized ¹²⁹Xe ventilation and gas exchange imaging