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

Ebner, Lukas; Kammerman, Jeff; Driehuys, Bastiaan; Schiebler, Mark L.; Cadman, Robert V.; Fain, Sean B.

doi:10.1016/j.ejrad.2016.09.015

Cited by 54 publications

(39 citation statements)

References 84 publications

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“…Unidirectional valves ensure inhaled gas is only drawn from the HP gas bag, while exhaled gas exits through flexible tubing and is vented outside of the scanner bore. Image adapted from [305]. …”

Section: Figurementioning

confidence: 99%

Magnetic resonance imaging with hyperpolarized agents: methods and applications

et al. 2017

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In the past decade, hyperpolarized (HP) contrast agents have been under active development for MRI applications to address the twin challenges of functional and quantitative imaging. Both HP helium (3He) and xenon (129Xe) gases have reached the stage where they are under study in clinical research. HP 129Xe, in particular, is poised for larger scale clinical research to investigate asthma, chronic obstructive pulmonary disease, and fibrotic lung diseases. With advances in polarizer technology and unique capabilities for imaging of 129Xe gas exchange into lung tissue and blood, HP 129Xe MRI is attracting new attention. In parallel, HP 13C and 15N MRI methods have steadily advanced in a wide range of pre-clinical research applications for imaging metabolism in various cancers and cardiac disease. The HP [1-13C] pyruvate MRI technique, in particular, has undergone phase I trials in prostate cancer and is poised for investigational new drug trials at multiple institutions in cancer and cardiac applications. This review treats the methodology behind both HP gases and HP 13C and 15N liquid state agents. Gas and liquid phase HP agents share similar technologies for achieving non-equilibrium polarization outside the field of the MRI scanner, strategies for image data acquisition, and translational challenges in moving from pre-clinical to clinical research. To cover the wide array of methods and applications, this review is organized by numerical section into 1) a brief introduction, 2) the physical and biological properties of the most common polarized agents with a brief summary of applications and methods of polarization, 3) methods for image acquisition and reconstruction specific to improving data acquisition efficiency for HP MRI, 4) the main physical properties that enable unique measures of physiology or metabolic pathways, followed by a more detailed review of the literature describing the use of HP agents to study 5) metabolic pathways in cancer and cardiac disease and 6) lung function in both pre-clinical and clinical research studies, 7) some future directions and challenges, and 8) an overall summary.

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Section: Figurementioning

confidence: 99%

Magnetic resonance imaging with hyperpolarized agents: methods and applications

et al. 2017

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“…Hyperpolarized 129 Xe ventilation imaging quantifies regional ventilation and is sensitive to airway obstruction in a wide variety of diseases . The technique is safe and well‐tolerated for many populations, including pediatrics .…”

Section: Introductionmentioning

confidence: 99%

“…Hyperpolarized 129 Xe ventilation imaging quantifies regional ventilation and is sensitive to airway obstruction in a wide variety of diseases. [1][2][3][4][5][6][7][8][9][10][11][12] The technique is safe and well-tolerated for many populations, including pediatrics. 1,13,14 Ventilation imaging relies on obtaining reliable, spin density-weighted images to quantify xenon regionally in the lung.…”

Section: Introductionmentioning

confidence: 99%

Improved pulmonary ¹²⁹Xe ventilation imaging via 3D‐spiral UTE MRI

Willmering

Niedbalski

Wang

et al. 2019

Magnetic Resonance in Med

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Purpose Hyperpolarized 129Xe MRI characterizes regional lung ventilation in a variety of disease populations, with high sensitivity to airway obstruction in early disease. However, ventilation images are usually limited to a single breath‐hold and most‐often acquired using gradient‐recalled echo sequences with thick slices (~10‐15 mm), which increases partial‐volume effects, limits ability to observe small defects, and suffers from imperfect slice selection. We demonstrate higher‐resolution ventilation images, in shorter breath‐holds, using FLORET (Fermat Looped ORthogonally Encoded Trajectories), a center‐out 3D‐spiral UTE sequence. Methods In vivo human adult (N = 4; 2 healthy, 2 with cystic fibrosis) 129Xe images were acquired using 2D gradient‐recalled echo, 3D radial, and FLORET. Each sequence was acquired at its highest possible resolution within a 16‐second breath‐hold with a minimum voxel dimension of 3 mm. Images were compared using 129Xe ventilation defect percentage, SNR, similarity coefficients, and vasculature cross‐sections. Results The FLORET sequence obtained relative normalized SNR, 40% greater than 2D gradient‐recalled echo (P = .012) and 26% greater than 3D radial (P = .067). Moreover, the FLORET images were acquired with 3‐fold‐higher nominal resolution in a 15% shorter breath‐hold. Finally, vasculature was less prominent in FLORET, likely due to diminished susceptibility‐induced dephasing at shorter TEs afforded by UTE sequences. Conclusion The FLORET sequence yields higher SNR for a given resolution with a shorter breath‐hold than traditional ventilation imaging techniques. This sequence more accurately measures ventilation abnormalities and enables reduced scan times in patients with poor compliance and severe lung disease.

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“…27,28 Distinguishing RILI from recurrent cancer and infection is also problematic. 8 Magnetic resonance imaging (MRI) with hyperpolarized (HP) 129 Xe has been shown to be useful for structural and functional imaging of a variety of lung diseases [29][30][31] (e.g., cystic fibrosis, CF; asthma; chronic obstructive pulmonary disorder, COPD; and idiopathic pulmonary fibrosis, IPF), including RILI. [32][33][34][35] The solubility of xenon in tissues (e.g., lung parenchyma, blood plasma, red blood cells; RBCs) and the associated compartmental chemical shifts allow for discrimination of 129 Xe signals inside these environments.…”

Section: Introductionmentioning

confidence: 99%

Physiological gas exchange mapping of hyperpolarized ¹²⁹Xe using spiral‐IDEAL and MOXE in a model of regional radiation‐induced lung injury

et al. 2018

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Purpose: To map physiological gas exchange parameters using dissolved hyperpolarized (HP) 129 Xe in a rat model of regional radiation-induced lung injury (RILI) with spiral-IDEAL and the model of xenon exchange (MOXE). Results are compared to quantitative histology of pulmonary tissue and red blood cell (RBC) distribution. Methods: Two cohorts (n = 6 each) of age-matched rats were used. One was irradiated in the rightmedial lung, producing regional injury. Gas exchange was mapped 4 weeks postirradiation by imaging dissolved-phase HP 129 Xe using spiral-IDEAL at five gas exchange timepoints using a clinical 1.5 T scanner. Physiological lung parameters were extracted regionally on a voxel-wise basis using MOXE. Mean gas exchange parameters, specifically air-capillary barrier thickness (d) and hematocrit (HCT) in the right-medial lung were compared to the contralateral lung as well as nonirradiated control animals. Whole-lung spectroscopic analysis of gas exchange was also performed. Results: d was significantly increased (1.43 AE 0.12 lm from 1.07 AE 0.09 lm) and HCT was significantly decreased (17.2 AE 1.2% from 23.6 AE 1.9%) in the right-medial lung (i.e., irradiated region) compared to the contralateral lung of the irradiated rats. These changes were not observed in healthy controls. d and HCT correlated with histologically measured increases in pulmonary tissue heterogeneity (r = 0.77) and decreases in RBC distribution (r = 0.91), respectively. No changes were observed using whole-lung analysis. Conclusion: This work demonstrates the feasibility of mapping gas exchange using HP 129 Xe in an animal model of RILI 4 weeks postirradiation. Spatially resolved gas exchange mapping is sensitive to regional injury between cohorts that was undetected with whole-lung gas exchange analysis, in agreement with histology. Gas exchange mapping holds promise for assessing regional lung function in RILI and other pulmonary diseases.

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

Cited by 54 publications

References 84 publications

Magnetic resonance imaging with hyperpolarized agents: methods and applications

Magnetic resonance imaging with hyperpolarized agents: methods and applications

Improved pulmonary ¹²⁹Xe ventilation imaging via 3D‐spiral UTE MRI

Physiological gas exchange mapping of hyperpolarized ¹²⁹Xe using spiral‐IDEAL and MOXE in a model of regional radiation‐induced lung injury

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

Cited by 54 publications

References 84 publications

Magnetic resonance imaging with hyperpolarized agents: methods and applications

Magnetic resonance imaging with hyperpolarized agents: methods and applications

Improved pulmonary 129Xe ventilation imaging via 3D‐spiral UTE MRI

Physiological gas exchange mapping of hyperpolarized 129Xe using spiral‐IDEAL and MOXE in a model of regional radiation‐induced lung injury

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Improved pulmonary ¹²⁹Xe ventilation imaging via 3D‐spiral UTE MRI

Physiological gas exchange mapping of hyperpolarized ¹²⁹Xe using spiral‐IDEAL and MOXE in a model of regional radiation‐induced lung injury