Regional Heterogeneity of Lobar Ventilation in Asthma Using Hyperpolarized Helium-3 MRI

Zha, Wei; Kruger, Stanley J.; Cadman, Robert V.; Mummy, David; Evans, Michael D.; Nagle, Scott K.; Denlinger, Loren C.; Jarjour, Nizar N.; Sorkness, Ronald L.; Fain, Sean B.

doi:10.1016/j.acra.2017.09.014

Cited by 31 publications

(26 citation statements)

References 33 publications

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“…[7172] However, it is not well known yet of where chronic airway obstruction in asthmatic patient, recurrent infections, or poorly controlled forms of the disease are the culprit for permanent ventilation defects, and a predisposition for acute exacerbations. [3] Zha et al [71] investigated lobar ventilation patterns within asthmatic lungs using 3 He magnetic resonance imaging (HP 3 He MRI). The study included 82 subjects with different asthma severity scores (20 severe, 48 mild to moderate, and 14 non-asthmatics).…”

Section: Ventilation Patterns In Asthmatic Lungsmentioning

confidence: 99%

Asthma exacerbation related to viral infections: An up to date summary

Adeli

El-Shareif

Hendaus

2019

J Family Med Prim Care

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Asthma exacerbation can be a major life threatening event. Viruses have been pinned as the cause behind the vast majority of these exacerbations. The purpose of this short review is to explore the mechanisms behind these exacerbations, focusing mostly on viral infections as triggers. We will also be discussing the phenotypes prone to asthma exacerbation, the pathophysiology of viral induced asthma and ventilation patterns of asthmatic lungs. This manuscript will assist primary care physicians in delineating the proper pathophysiology of the disease as well as the management.

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Section: Ventilation Patterns In Asthmatic Lungsmentioning

confidence: 99%

Asthma exacerbation related to viral infections: An up to date summary

Adeli

El-Shareif

Hendaus

2019

J Family Med Prim Care

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“…Spirometry was performed according to American Thoracic Society guidelines (23). The spirometric measurements include asthma (28) was used in this cohort of participants with CF. Proton images were first registered to the hyperpolarized 3 He MRI images and were then segmented jointly for a lung mask.…”

Section: Pulmonary Function Testingmentioning

confidence: 99%

Three-dimensional Isotropic Functional Imaging of Cystic Fibrosis Using Oxygen-enhanced MRI: Comparison with Hyperpolarized ³He MRI

et al. 2019

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To compare the performance of three-dimensional radial ultrashort echo time (UTE) oxygen-enhanced (OE) MRI with that of hyperpolarized helium 3 (3 He) MRI with respect to quantitative ventilation measurements in patients with cystic fibrosis (CF). Materials and Methods: In this prospective study conducted from June 2013 to May 2015, 25 participants with CF aged 10-55 years (14 male; age range, 13-55 years; 11 female; age range, 10-37 years) successfully underwent pulmonary function tests, hyperpolarized 3 He MRI, and OE MRI. OE MRI used two sequential 3.5-minute normoxic and hyperoxic steady-state free-breathing UTE acquisitions. Seven participants underwent imaging at two separate examinations 1-2 weeks apart to assess repeatability. Regional ventilation was quantified as ventilation defect percentage (VDP) individually from OE MRI and hyperpolarized 3 He MRI by using the same automated quantification tool. Bland-Altman analysis, intraclass correlation coefficient (ICC), Spearman correlation coefficient, and Wilcoxon signed-rank test were used to evaluate repeatability. Results: In all 24 participants, the global VDP measurements from either OE MRI (r = 20.66, P , .001) or hyperpolarized 3 He MRI (r = 20.75, P , .001) were significantly correlated with the percentage predicted forced expiratory volume in 1 second. VDP reported at OE MRI was 5.0% smaller than (P = .014) but highly correlated with (r = 0.78, P , .001) VDP reported at hyperpolarized 3 He MRI. Both OE MRI-based VDP and hyperpolarized 3 He MRI-based VDP demonstrated good repeatability (ICC = 0.91 and 0.95, respectively; P  .001). Conclusion: In lungs with cystic fibrosis, ultrashort echo time oxygen-enhanced MRI showed similar performance compared with hyperpolarized 3 He MRI for quantitative measures of ventilation defects and their repeatability.

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“…While modalities such as MDCT and MR have been used on a research basis to image changes in the lungs and airways specific to severe asthma, their usefulness to direct treatment is unclear. MR imaging using hyperpolarized noble gases such as 3He and 129Xe can be used to image ventilation inhomogeneity [37]. One can see areas of low and no ventilation in individuals with asthma at baseline and during acute exacerbations.…”

Section: Imagingmentioning

confidence: 99%

The Hidden Burden of Severe Asthma: From Patient Perspective to New Opportunities for Clinicians

Scichilone

Barnes

Battaglia

et al. 2020

JCM

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Severe asthma is an important topic in respiratory diseases, due to its high impact on morbidity and mortality as well as on health-care resources. The many challenges that still exist in the management of the most difficult-to-treat forms of the disease, and the acknowledgement of the existence of unexplored areas in the pathophysiological mechanisms and the therapeutic targets represent an opportunity to gather experts in the field with the immediate goals to summarize current understanding about the natural history of severe asthma and to identify gaps in knowledge and research opportunities, with the aim to contribute to improved medical care and health outcomes. This article is a consensus document from the “International Course on Severe Asthma” that took place in Palermo, Italy, on May 10–11, 2019. Emerging topics in severe asthma were addressed and discussed among experts, with special focus on patient’s needs and research opportunities, with the aim to highlight the unanswered questions in the diagnostic process and therapeutic approach.

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Regional Heterogeneity of Lobar Ventilation in Asthma Using Hyperpolarized Helium-3 MRI

Abstract: In asthma, the RML and RUL showed greater ventilation abnormalities, and the RLL and LLL were more highly ventilated with greater local heterogeneity. These findings may facilitate guided bronchoscopic sampling and localized airway treatment in future studies.

Cited by 31 publications

References 33 publications

Asthma exacerbation related to viral infections: An up to date summary

Asthma exacerbation related to viral infections: An up to date summary

Three-dimensional Isotropic Functional Imaging of Cystic Fibrosis Using Oxygen-enhanced MRI: Comparison with Hyperpolarized ³He MRI

The Hidden Burden of Severe Asthma: From Patient Perspective to New Opportunities for Clinicians

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Regional Heterogeneity of Lobar Ventilation in Asthma Using Hyperpolarized Helium-3 MRI

Abstract: In asthma, the RML and RUL showed greater ventilation abnormalities, and the RLL and LLL were more highly ventilated with greater local heterogeneity. These findings may facilitate guided bronchoscopic sampling and localized airway treatment in future studies.

Cited by 31 publications

References 33 publications

Asthma exacerbation related to viral infections: An up to date summary

Asthma exacerbation related to viral infections: An up to date summary

Three-dimensional Isotropic Functional Imaging of Cystic Fibrosis Using Oxygen-enhanced MRI: Comparison with Hyperpolarized 3He MRI

The Hidden Burden of Severe Asthma: From Patient Perspective to New Opportunities for Clinicians

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Three-dimensional Isotropic Functional Imaging of Cystic Fibrosis Using Oxygen-enhanced MRI: Comparison with Hyperpolarized ³He MRI