MRI in lung transplant recipients using hyperpolarized <sup>3</sup>He: Comparison with CT

Gast, Klaus; Viallon, Magalie; Eberle, Balthasar; Lill, Jana; Puderbach, Michael; Hanke, Alexander T.; Schmiedeskamp, Joerg; Kauczor, Hans‐Ulrich

doi:10.1002/jmri.10070

Cited by 60 publications

(32 citation statements)

References 22 publications

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“…2) (26) before and after inhalation of albuterol (67) and in mild asthma after inhaled corticosteroid withdrawal (68). Similar studies directly comparing quantitative CT measures to HP He-3 MRI ventilation in COPD and smokers (69), and bronchiolitis obliterans (BO) in lung transplant (70,71) suggest similar sensitivity and regional specificity for detection of obstructive lung disease using the two imaging techniques.…”

Section: Ventilation Imaging (Spin Density)mentioning

confidence: 68%

Functional lung imaging using hyperpolarized gas MRI

Fain

Korosec

Holmes

et al. 2007

Magnetic Resonance Imaging

177

158

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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.

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Section: Ventilation Imaging (Spin Density)mentioning

confidence: 68%

Functional lung imaging using hyperpolarized gas MRI

Fain

Korosec

Holmes

et al. 2007

Magnetic Resonance Imaging

177

158

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“…A basic limitation of the diffusion-imaging technique is that the ADC can only be measured in ventilated regions of the lung, which is a disadvantage compared with CT. This was not a limitation in our study, since the elastaseinduced emphysema did not result in unventilated regions of the lung, but it is a limitation for the extension of this technique to human patients with COPD, in which regions of poor ventilation are common (8). Furthermore, although the microstructural (Ͻ500 m) detail may be greater than that of CT, the macrostructural (Ͼ1 mm) detail is much lower.…”

Section: Discussionmentioning

confidence: 89%

Evaluation of emphysema severity and progression in a rabbit model: comparison of hyperpolarized ³He and ¹²⁹Xe diffusion MRI with lung morphometry

Mata¹,

Altes²,

Cai³

et al. 2007

Journal of Applied Physiology

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Xe gases were measured in the lungs of rabbits with elastase-induced emphysema and correlated against the mean chord length from lung histology. In vivo measurements were performed at baseline and 2, 4, 6, and 8 wk after instillation of elastase (mild and moderate emphysema groups) or saline (control group). ADCs were determined from acquisitions that used two b values. To investigate the effect of b value on the results, b-value pairs of 0 and 1.6 s/cm 2 and 0 and 4.0 s/cm 2 were used for 3 He, and b-value pairs of 0 and 5.0 s/cm 2 and 0 and 10.0 s/cm 2 were used for 129 Xe. At 8 wk after instillation, the rabbits were euthanized, and the lungs were analyzed histologically and morphometrically. ADCs for the rabbits in the control group did not change significantly from baseline to week 8, whereas ADCs for the rabbits in the emphysema groups increased significantly (P Ͻ 0.05) for all gas and b-value combinations except 129 Xe with the b-value pair of 0 and 5.0 s/cm 2 . The largest percent change in mean ADC from baseline to week 8 (15.3%) occurred with 3 He and the b-value pair of 0 and 1.6 s/cm 2 for rabbits in the moderate emphysema group. ADCs (all b values) were strongly correlated (r ϭ 0.62-0.80, P Ͻ 0.001) with mean chord lengths from histology. These results further support the ability of diffusion-weighted MRI with hyperpolarized gases to detect regional and global structural changes of emphysema within the lung.hyperpolarized gas magnetic resonance imaging; elastase MORE THAN 3,100,000 Americans suffer from emphysema, which is a component of chronic obstructive pulmonary disease (COPD). COPD and other forms of lower respiratory diseases, excluding asthma, represented the fourth-leading cause of death in the United States in 2002, claiming the lives of Ͼ124,000 people (1, 2). Pulmonary function tests are frequently used for the detection and assessment of emphysema. Patients with emphysema have a decreased expiratory flow rate, but 30% of lung capacity can be lost before changes appear in pulmonary function tests (22). Furthermore, the measurements are effort dependent, resulting in a relatively large intraindividual variability. High-resolution CT has been used to assess emphysematous change in the lung. In fact, CT was able to detect a decrease in the rate of decline of lung function in patients with ␣ 1 -antitrypsin deficiency who were treated with ␣ 1 -antitrypsin, whereas no significant change was seen with spirometry (20). Thus CT has been proposed as a potential biomarker for emphysema (3). Because of the tissue destruction that occurs in emphysema, emphysematous regions of the lung have less lung tissue per unit volume than normal lung, so they exhibit lower attenuation on CT. However, other processes in the lung can reduce CT attenuation, including reduced perfusion and air trapping (23). Furthermore, the relatively high radiation dose of a chest CT scan may limit its use for repeated scans in longitudinal studies and clinical trials (4). Hyperpolarized 3 He and 129 Xe are gaseous contrast agent...

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“…Investigational and potential clinical uses of 3 He MR imaging have included the characterization of lung microstructure (2,3), assessment of agerelated changes in air space size (4)(5)(6), early detection and quantification of emphysema (7)(8)(9)(10)(11), evaluation of ventilation abnormalities in patients with asthma (12,13) and cystic fibrosis (14,15), and noninvasive early detection of chronic rejection in lung transplant recipients (16,17). Although inhalation of hyperpolarized 3 He gas is generally considered to be safe, it is classified as an investigational contrast agent by the U.S. Food and Drug Administration and is not approved for clinical use.…”

mentioning

confidence: 99%

Hyperpolarized³He MR Imaging: Physiologic Monitoring Observations and Safety Considerations in 100 Consecutive Subjects

Lutey¹,

Lefrak²,

Woods³

et al. 2008

Radiology

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Purpose:To evaluate the safety of hyperpolarized helium 3 ( 3 He) magnetic resonance (MR) imaging. Materials and Methods:Local institutional review board approval and informed consent were obtained. Physiologic monitoring data were obtained before, during, and after hyperpolarized 3 He MR imaging in 100 consecutive subjects (57 men, 43 women; mean age, 52 years Ϯ 14 [standard deviation]). The subjects inhaled 1-3 L of a gas mixture containing 300 -500 mL 3 He and 0 -2700 mL N 2 and held their breath for up to 15 seconds during MR imaging. Heart rate and rhythm and oxygen saturation of hemoglobin as measured by pulse oximetry (SpO 2 ) were monitored continuously throughout each study. The effects of 3 He MR imaging on vital signs and SpO 2 and the relationship between pulmonary function, number of doses, and clinical classification (healthy volunteers, patients with asthma, heavy smokers, patients undergoing lung volume reduction surgery for severe emphysema, and patients with lung cancer) and the lowest observed SpO 2 were assessed. Any subjective symptoms were noted. Results:Except for a small postimaging decrease in mean heart rate (from 78 beats per minute Ϯ 13 to 73 beats per minute Ϯ 11, P Ͻ .001), there was no effect on vital signs. A mean transient decrease in SpO 2 of 4% Ϯ 3 was observed during the first minute after gas inhalation (P Ͻ .001) in 77 subjects who inhaled a dose of 1 L for 10 seconds or less, reaching a nadir of less than 90% at least once in 20 subjects and of less than 85% in four subjects. There was no correlation between the lowest SpO 2 and pulmonary function parameters other than baseline SpO 2 (r ϭ 0.36, P ϭ .001). The lowest mean SpO 2 varied by 1% between the first and second and second and third doses (P Ͻ .001) and was unrelated to clinical classification (P ϭ .40). Minor subjective symptoms were noted by 10 subjects. No serious adverse events occurred.

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MRI in lung transplant recipients using hyperpolarized ³He: Comparison with CT

Cited by 60 publications

References 22 publications

Functional lung imaging using hyperpolarized gas MRI

Functional lung imaging using hyperpolarized gas MRI

Evaluation of emphysema severity and progression in a rabbit model: comparison of hyperpolarized ³He and ¹²⁹Xe diffusion MRI with lung morphometry

Hyperpolarized³He MR Imaging: Physiologic Monitoring Observations and Safety Considerations in 100 Consecutive Subjects

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MRI in lung transplant recipients using hyperpolarized 3He: Comparison with CT

Cited by 60 publications

References 22 publications

Functional lung imaging using hyperpolarized gas MRI

Functional lung imaging using hyperpolarized gas MRI

Evaluation of emphysema severity and progression in a rabbit model: comparison of hyperpolarized 3He and 129Xe diffusion MRI with lung morphometry

Hyperpolarized3He MR Imaging: Physiologic Monitoring Observations and Safety Considerations in 100 Consecutive Subjects

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MRI in lung transplant recipients using hyperpolarized ³He: Comparison with CT

Evaluation of emphysema severity and progression in a rabbit model: comparison of hyperpolarized ³He and ¹²⁹Xe diffusion MRI with lung morphometry

Hyperpolarized³He MR Imaging: Physiologic Monitoring Observations and Safety Considerations in 100 Consecutive Subjects