Quantification of Pulmonary Blood Flow and Volume in Healthy Volunteers by Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using a Parallel Imaging Technique

Purpose: To present a single-shot perfusion imaging sequence that does not require contrast agents or a subtraction of a tag and a control image to create the perfusionweighted contrast. The proposed method is based on SEEPAGE. Materials and Methods:Experiments with healthy volunteers were performed to qualitatively and quantitatively obtain pulmonary perfusion values in coronal as well as sagittal orientation. In addition, a first experiment with a lung cancer patient was performed to explore the potentials of SEEPAGE in a clinical application. Results:All experiments clearly showed a perfusionweighted contrast, providing clinical quality images with high spatial resolution. The quantified perfusion rates were consistent in the different imaging orientations and covered the interval of 1.00 -4.00 mL/min/mL. In addition, the gravitational dependence of pulmonary perfusion, the influence of adiabatic pulse duration on signal intensity, and the tracer saturation effect were examined. In the patient examination the presented technique provided additional information of the lung deficiency compared to a conventional anatomical image.Conclusion: SEEPAGE has proved to be a robust and reproducible technique for obtaining perfusion-weighted images in a single measurement and for quantifying pulmonary perfusion using an additional reference scan. Furthermore, the proposed method shows promise for future clinical application.

Section: Discussionsupporting

confidence: 89%

Assessment of pulmonary perfusion in a single shot using SEEPAGE

Fischer¹,

Pracht²,

Arnold³

et al. 2007

“…On the other hand, in each subject with body weight equal to or more than 70 kg, 5 mL of the same contrast media with 0.5 mmol/mL was administered via a cubital vein by means of the same automatic infusion system at a rate of 5 mL/sec, followed by 20 mL of saline solution at the same rate. The basic theory and application of contrast-enhanced dynamic perfusion MRI has been documented in previous reports (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). After careful instruction, patients practiced the breath-holding technique to reproduce a consistent degree of inspiration for each scan series before the MR studies.…”

Section: Dynamic Contrast-enhanced Mrimentioning

confidence: 99%

Dynamic perfusion MRI: Capability for evaluation of disease severity and progression of pulmonary arterial hypertension in patients with connective tissue disease

Ohno

Koyama

Nogami

et al. 2008

Purpose:To prospectively evaluate the capability of dynamic perfusion MRI for assessment of disease severity and progression to pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) patients. Materials and Methods:In all, 18 gender-and agematched CTD patients without and with PAH and nine healthy volunteers underwent dynamic perfusion MRI, Doppler echocardiography, and pulmonary function test. Disease severity of CTD was assessed in terms of diffusing capacity for carbon monoxide (%DL CO ) and estimated systolic pulmonary arterial pressure (sPAP), and progression of PAH in terms of pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR). From calculated pulmonary perfusion parameter maps, means of pulmonary blood flow (mPBF), pulmonary blood volume (mPBV), and mean transit time (mMTT) were determined as averages of all region of interest (ROI) measurements. To determine disease severity in CTD, all parameters were statistically correlated with sPAP and %DL CO . To determine progression to PAH, all parameters were statistically correlated with mPAP and PVR.Results: All pulmonary perfusion parameters correlated significantly with sPAP and %DL CO (P Ͻ 0.05). mPBF and mPBV correlated significantly with mPAP and moderately with PVR (P Ͻ 0.05). Conclusion:Dynamic perfusion MRI can be used for assessment of disease severity and progression of PAH in CTD patients.

“…The aspect of determining dose for quantification of pulmonary perfusion has been already investigated by other groups using single-bolus measurements (9,22). The application of higher doses than the ones used in this work was proposed.…”

Section: Discussionmentioning

confidence: 98%

“…In the present study, the GLP was compared to PBF, measured in central slices at the position of the main pulmonary artery. The influence of gravitation on lung perfusion has already been investigated by different groups and showed increasing PBF in gravitational direction (7)(8)(9). Therefore, a systematic difference between GLP and PBF would probably arise if PBF is calculated from ventral or dorsal slices.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Quantitative contrast‐enhanced perfusion measurements of the human lung using the prebolus approach

Oechsner

Mühlhäusler

Ritter

et al. 2009

Purpose: To investigate dynamic contrast-enhanced MRI (DCE-MRI) for quantification of pulmonary blood flow (PBF) and blood volume (PBV) using the prebolus approach and to compare the results to the global lung perfusion (GLP). Materials and Methods:Eleven volunteers were examined by applying different contrast agent doses (0.5, 1.0, 2.0, and 3.0 mL gadolinium diethylene triamine pentaacetic acid [Gd-DTPA]), using a saturation-recovery (SR) true fast imaging with steady precession (TrueFISP) sequence. PBF and PBV were determined for single bolus and prebolus. Region of interest (ROI) evaluation was performed and parameter maps were calculated. Additionally, cardiac output (CO) and lung volume were determined and GLP was calculated as a contrast agent-independent reference value. Results:The prebolus results showed good agreement with low-dose single-bolus and GLP: PBF (mean Ϯ SD in units of mL/minute/100 mL) ϭ single bolus 190 Ϯ 73 (0.5-mL dose) and 193 Ϯ 63 (1.0-mL dose); prebolus 192 Ϯ 70 (1.0 -2.0-mL dose) and 165 Ϯ 52 (1.0 -3.0-mL dose); GLP (mL/minute/100 mL) ϭ 187 Ϯ 34. Higher single-bolus resulted in overestimated values due to arterial input function (AIF) saturation. Conclusion:The prebolus approach enables independent determination of appropriate doses for AIF and tissue signal. Using this technique, the signal-to-noise ratio (SNR) from lung parenchyma can be increased, resulting in improved PBF and PBV quantification, which is especially useful for the generation of parameter maps. THE PERFUSION OF THE HUMAN LUNG, together with ventilation, plays a decisive role for efficient blood oxygenation. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers a radiation-free noninvasive technique for spatial analysis of pulmonary perfusion (1-4). Based on the indicator dilution theory (5), DCE-MRI enables the quantification of pulmonary perfusion (6). Several investigations deal with technical improvements and physiological aspects of lung perfusion measurements (7-10). A major challenge of quantitative DCE-MRI is the choice of appropriate contrast agent doses. Typically, perfusion quantification is performed assuming a linear relationship between the local contrast agent concentration and the MR signal intensity. This assumption is only valid within a limited range. With the application of higher doses, signal saturation occurs, which leads to underestimation of the actual concentration. This problem was investigated by different groups working on contrast-enhanced perfusion quantification with MRI of different tissues, and several techniques have been proposed to overcome this limitation (11)(12)(13)(14)(15). One promising technique is the prebolus (or dual-bolus) approach, which was initially proposed for quantification of myocardial perfusion (14,15). The prebolus approach consists of a low-dose measurement for accurate determination of the arterial input function (AIF), followed by a second, higher dose measurement to evaluate the tissue signal.It has been established from quantification of m...