Hyperpolarized 3helium magnetic resonance ventilation imaging of the lung in cystic fibrosis: comparison with high resolution CT and spirometry

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158

The noninvasive assessment of lung function using imaging is increasingly of interest for the study of lung diseases, including chronic obstructive pulmonary disease (COPD) and asthma. Hyperpolarized gas MRI (HP MRI) has demonstrated the ability to detect changes in ventilation, perfusion, and lung microstructure that appear to be associated with both normal lung development and disease progression. The physical characteristics of HP gases and their application to MRI are presented with an emphasis on current applications. Clinical investigations using HP MRI to study asthma, COPD, cystic fibrosis, pediatric chronic lung disease, and lung transplant are reviewed. Recent advances in polarization, pulse sequence development for imaging with Xe-129, and prototype low magnetic field systems dedicated to lung imaging are highlighted as areas of future development for this rapidly evolving technology.

Section: Cfmentioning

confidence: 94%

“…3) (68) and CF (80). Semiquantitative approaches using the regional slope of gas uptake normalized to the uptake in the trachea have also been applied to CF (81).…”

Section: Dynamic Ventilation Imaging (Respiratory Dynamics)mentioning

confidence: 99%

Functional lung imaging using hyperpolarized gas MRI

Fain

Korosec

Holmes

et al. 2007

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158

“…However, the ionizing radiation associated with CT limits its use, particularly for pediatric imaging or multiple imaging sessions to assess treatment efficacy over time (11). Lower dose CT has been developed (12,13), and this reduces the health risks of radiation, but the risks remain significant (14)(15)(16). In addition, CT cannot provide images of functional ventilation within the lung.…”

mentioning

confidence: 99%

Using hyperpolarized ³He MRI to evaluate treatment efficacy in cystic fibrosis patients

Sun

O’Sullivan

Roche

et al. 2011

Purpose: To use hyperpolarized (HP) 3 He MR imaging to assess functional lung ventilation in subjects with cystic fibrosis (CF) before and after treatment. Materials and Methods: We performed HP 3He static ventilation MRI scans on three subjects, using a Philips 3.0 Tesla (T) Achieva MRI scanner, before and after 11 days of in-patient treatment with combined intravenous and inhaled therapies for pulmonary exacerbations of CF. We also collected spirometry data. We quantified pulmonary ventilation volume measured with HP 3 He MRI using an advanced semi-automated analysis technique.Results: Following 11 days of treatment with intravenous antibiotics, hypertonic saline, and rhDNase, HP 3 He MR images in one subject displayed a 25% increase in total ventilation volume. Total ventilation volume in the other two subjects slightly decreased. All three subjects showed increases in FEV 1 and FVC following treatment. Conclusion:In all subjects, the HP 3 He MR images provided detailed information on precisely where in the lungs gas was reaching. These data provide additional support for the conclusion that HP noble gas MRI can be a powerful tool for evaluating lung ventilation in patients with cystic fibrosis, but also raise important questions about the correlation between spirometry and HP gas MRI measurements.

“…3-Helium ( 3 He) MRI of the lungs is a powerful tool for assessing gas distribution and lung function, and ventilation defects in adults and children with CF have been previously reported (14)(15)(16)(17)(18).…”

mentioning

confidence: 99%

Assessment of hyperpolarized ³He lung MRI for regional evaluation of interventional therapy: A pilot study in pediatric cystic fibrosis

Woodhouse

Wild

Beek

et al. 2009

Self Cite

Purpose: To determine whether regional changes in lung ventilation in a group of pediatric cystic fibrosis (CF) patients following a course of chest physiotherapy could be detected with 3 He MRI. Materials and Methods:The reproducibility of lung ventilation volume measurements obtained with 3 He lung magnetic resonance imaging (MRI) was established in a group of five children with CF age 6-15 years. The same methodology was then used to evaluate whether standard chest physiotherapy (percussion and drainage) had any immediate effect on regional ventilated lung volumes in a further group of nine age-matched CF children (5-15 years).Results: Global lung ventilation volumes remained the same within the limits of sensitivity derived from the reproducibility study; however, regional lung ventilation was observed to change in most patients after therapy. Conclusion:3 He MRI can be successfully used in children with CF, and has the sensitivity to detect regional quantitative changes in lung ventilation following chest physiotherapy.