Hyperpolarized Gas MR Imaging

Roos, Justus E.; McAdams, H. Page; Kaushik, S. Sivaram; Driehuys, Bastiaan

doi:10.1016/j.mric.2015.01.003

Cited by 97 publications

(43 citation statements)

References 47 publications

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“…In the past 20 years, hyperpolarized (HP) gas MRI (using either 3 He or 129 Xe) of lung has been shown to be a sensitive imaging tool for investigation of lung function (10–12). Several groups have performed HP 3 He MRI in CF patients (mostly adults) in order to investigate regional defects in ventilation (13–16), HP gas repeatability (17,18), longitudinal ventilation changes (19), and treatment efficacy (20–23).…”

Section: Introductionmentioning

confidence: 99%

Hyperpolarized 129Xe for investigation of mild cystic fibrosis lung disease in pediatric patients

Thomen

Walkup

Roach

et al. 2017

Journal of Cystic Fibrosis

115

129

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Background Cystic fibrosis (CF) is a genetic disease which carries high morbidity and mortality from lung-function decline. Monitoring disease progression and treatment response in young patients is desirable, but serial imaging via CT is often considered prohibitive, and detailed functional information cannot be obtained using conventional imaging techniques. Hyperpolarized 129Xe magnetic resonance imaging (MRI) can depict and quantify regional ventilation, but has not been investigated in pediatrics. We hypothesized that 129Xe MRI is feasible and would demonstrate ventilation defects in mild CF lung disease with greater sensitivity than FEV1. Methods 11 healthy controls (age 6–16 years) and 11 patients with mild CF (age 8–16 years, Forced Expiratory Volume (FEV1) percent predicted >70%) were recruited for this study. Nine CF patients had an FEV1>85%. Each subject was imaged via hyperpolarized 129Xe MRI, and the ventilation defect percentage (VDP) was measured. Recent FEV1 and VDP were compared between the groups. Results FEV1 for controls was 100.3%±8.5% (mean ± sd) and for CF patients was 97.9%±16.0% (p=0.67). VDP was 6.4%±2.8% for controls and 18.3%±8.6% for CF (p<0.001). When considering the 9 CF patients with normal FEV1 (>85%), the mean FEV1 was 103.1%±12.3% (p=0.57 compared to controls) and VDP was 15.4% ± 6.3% (p=0.002). Conclusions Hyperpolarized 129Xe MRI demonstrated ventilation defects in CF patients with normal FEV1 and more effectively discriminated CF from controls than FEV1. Thus 129Xe may be a useful outcome measure to detect mild CF lung disease and to investigate regional lung function in pediatric lung diseases and to follow disease progression.

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Section: Introductionmentioning

confidence: 99%

Hyperpolarized 129Xe for investigation of mild cystic fibrosis lung disease in pediatric patients

Thomen

Walkup

Roach

et al. 2017

Journal of Cystic Fibrosis

115

129

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“…The cell is irradiated with circularly polarized laser light tuned to a spectral line of Rb to produce spin polarization in the valence electron of the Rb atoms. The Rb electronic polarization is transferred to the noble gas nuclei by collisional spin exchange [24,37]. In practice, polarization fractions of gas nuclei from 20 to 50% can be achieved depending on experimental conditions, vastly improving the achievable signal over conventional thermal polarization from the main magnetic field, i.e.…”

Section: Hardware and Gas Deliverymentioning

confidence: 99%

“…The isotope is produced as a by-product of the decay of tritium that was used in the production of nuclear warheads in the 1960s and ‘70s. Moreover, because 3 He is an efficient neutron detector, much of its supply has been directed towards this application since 2001 [16,24]. As supply is scarce, 3 He faces sharply rising costs.…”

Section: Introductionmentioning

confidence: 99%

The role of hyperpolarized 129xenon in MR imaging of pulmonary function

Ebner

Kammerman

Driehuys

et al. 2017

European Journal of Radiology

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In the last two decades, functional imaging of the lungs using hyperpolarized noble gases has entered the clinical stage. Both helium (3 He) and xenon (129Xe) gas have been thoroughly investigated for their ability to assess both the global and regional patterns of lung ventilation. With advances in polarizer technology and the current transition towards the widely available 129Xe gas, this method is ready for translation to the clinic. Currently, hyperpolarized (HP) noble gas lung MRI is limited to selected academic institutions; yet, the promising results from initial clinical trials have drawn the attention of the pulmonary medicine community. HP 129Xe MRI provides not only 3-dimensional ventilation imaging, but also unique capabilities for probing regional lung physiology. In this review article, we aim to (1) provide a brief overview of current ventilation MR imaging techniques, (2) emphasize the role of HP 129Xe MRI within the array of different imaging strategies, (3) discuss the unique imaging possibilities with HP 129Xe MRI, and (4) propose clinical applications.

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“…16,17 It is now possible to combine this with novel approaches to assess lung physiology, in particular the use of hyperpolarized xenon (HP 129 Xe) gas MRI to image ventilation. 18–20 It enables the distribution of a single inhalation of xenon gas to be visualized in the airspaces, providing a map of quantitative regional ventilation. 18,21 Moreover, Xe diffuses into the red blood cells (RBCs) where it can be imaged separately from Xe in the airspaces because of its distinct resonant signal frequency.…”

Section: Introductionmentioning

confidence: 99%

“…18–20 It enables the distribution of a single inhalation of xenon gas to be visualized in the airspaces, providing a map of quantitative regional ventilation. 18,21 Moreover, Xe diffuses into the red blood cells (RBCs) where it can be imaged separately from Xe in the airspaces because of its distinct resonant signal frequency. This can provide unique regional gas transfer information.…”

Section: Introductionmentioning

confidence: 99%

Novel Magnetic Resonance Imaging for Assessment of Bronchial Stenosis in Lung Transplant Recipients

Mahmood

Ebner

et al. 2017

American Journal of Transplantation

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Bronchial stenosis in lung transplant recipients is a common disorder that adversely affects clinical outcomes. It is evaluated by spirometry, CT scan and bronchoscopy with significant limitations. We hypothesize that magnetic resonance imaging (MRI) employing both ultrashort echo time (UTE) scans and hyperpolarized (HP) 129Xe gas can offer structural and functional assessment of bronchial stenosis seen after lung transplantation. Six patients with lung transplantation-related bronchial stenosis underwent HP 129Xe MRI and UTE MRI. Three patients subsequently underwent airway stent placement and had repeated MRI at 4 week follow up. HP 129Xe MRI depicted decreased ventilation distal to the stenotic airway. After airway stent placement, MRI showed that low-ventilation regions had decreased (35% vs. 27.6%, P =0.006) and normal-ventilation regions increased (17.9% vs 27.6%, P = 0.04) in the stented lung. Improved gas transfer was also seen on 129Xe MRI. There was a good correlation between UTE MRI and independent bronchoscopic airway diameter assessment (Pearson correlation coefficient = 0.92). This pilot study shows that UTE and HP 129Xe MRI are feasible in patients with bronchial stenosis related to lung transplantation, and may provide structural and functional airway assessment to guide treatment. These conclusions need to be confirmed by larger studies.

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Hyperpolarized Gas MR Imaging

Cited by 97 publications

References 47 publications

Hyperpolarized 129Xe for investigation of mild cystic fibrosis lung disease in pediatric patients

Hyperpolarized 129Xe for investigation of mild cystic fibrosis lung disease in pediatric patients

The role of hyperpolarized 129xenon in MR imaging of pulmonary function

Novel Magnetic Resonance Imaging for Assessment of Bronchial Stenosis in Lung Transplant Recipients

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