Using Hyperpolarized 129Xe MRI to Quantify the Pulmonary Ventilation Distribution

He, Mu; Driehuys, Bastiaan; Que, Loretta G.; Huang, Yuh‐Chin T.

doi:10.1016/j.acra.2016.07.014

Cited by 71 publications

(93 citation statements)

References 55 publications

(73 reference statements)

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“…These clusters each span an intensity range equal to one standard deviation of the ventilation reference distribution derived from a healthy cohort 31 . The barrier and RBC images were divided on a voxel-by-voxel basis by the gas-phase intensities to create maps of barrier uptake and RBC transfer.…”

Section: Methodsmentioning

confidence: 99%

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Wang

Robertson

Wang³

et al. 2017

Thorax

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Background Assessing functional impairment, therapeutic response, and disease progression in patients with idiopathic pulmonary fibrosis (IPF) continues to be challenging. Hyperpolarized 129Xe MRI can address this gap through its unique capability to image gas transfer three-dimensionally from airspaces to interstitial barrier tissues to RBCs. This must be validated by testing the degree to which it correlates with pulmonary function tests (PFTs) and CT scores and its spatial distribution reflects known physiology and patterns of disease. Methods 13 healthy individuals (33.6±15.7 years) and 12 IPF patients (66.0±6.4 years) underwent 129Xe MRI to generate 3D quantitative maps depicting the 129Xe ventilation distribution, its uptake in interstitial barrier tissues, and its transfer to RBCs. For each map, mean values were correlated with PFTs and CT fibrosis scores and their patterns were tested for the ability to depict functional gravitational gradients in healthy lung, and to detect the known basal and peripheral predominance of disease in IPF. Results 129Xe MRI depicted functional impairment in IPF patients, whose mean barrier uptake increased by 188% compared to the healthy reference population. 129Xe MRI metrics correlated poorly and insignificantly with CT fibrosis scores, but strongly with pulmonary function tests. Barrier uptake and RBC transfer both correlated significantly with DLCO (r=−0.75, p<0.01 and r=0.72, p<0.01), while their ratio (RBC/barrier) correlated strongly (r=0.94, p<0.01). RBC transfer exhibited significant anterior-posterior gravitational gradients in healthy volunteers, but not in IPF, where it was significantly impaired in the basal (p=0.02) and sub-pleural (p<0.01) lung. Conclusions Hyperpolarized 129Xe MRI is a rapid and well-tolerated exam that provides region-specific quantification of interstitial barrier thickness and RBC transfer efficiency. With further development, it could become a robust tool for measuring disease progression and therapeutic response in IPF patients, sensitively and non-invasively.

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Section: Methodsmentioning

confidence: 99%

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Wang

Robertson

Wang³

et al. 2017

Thorax

Self Cite

122

136

View full text Add to dashboard Cite

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“…The bin widths and locations were derived based on a reference population consisting of 12 normal subjects. 23 In these maps, green represents normal ventilation, yellow/orange depicts low ventilation, and red indicates minimal or no ventilation. Blue color depicts regions with high ventilation.…”

Section: Methodsmentioning

confidence: 99%

“…These maps enable quantitative and unbiased reporting of the percentage of lung volume falling into each category of ventilation, as shown and validated in our previous study. 23 Similarly, color coded binning maps were generated to characterize regional 129 Xe uptake by red blood cells. 24 …”

Section: Methodsmentioning

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 helium 3 ( 3 He) MR imaging has been shown to be a sensitive measure of ventilation heterogeneity in asthma (7,8). Although numerous metrics have been derived to describe ventilation heterogeneity from both hyperpolarized xenon 129 ( 129 Xe) and 3 He images by using texture-based methods like feature analysis or clustering methods such as k-means clustering (9)(10)(11)(12), efforts have been focused on cross-sectional assessment of cohorts. Longitudinal studies and therapy assessment have focused on global outcome measures from hyperpolarized 3 He imaging, in particular percentage ventilated volume (%VV) or its counterpart, percentage defect volume (7,13).…”

Section: Study Population and Designmentioning

confidence: 99%

Regional Ventilation Changes in the Lung: Treatment Response Mapping by Using Hyperpolarized Gas MR Imaging as a Quantitative Biomarker

et al. 2017

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Using Hyperpolarized 129Xe MRI to Quantify the Pulmonary Ventilation Distribution

Cited by 71 publications

References 55 publications

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

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

Regional Ventilation Changes in the Lung: Treatment Response Mapping by Using Hyperpolarized Gas MR Imaging as a Quantitative Biomarker

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Using Hyperpolarized 129Xe MRI to Quantify the Pulmonary Ventilation Distribution

Cited by 71 publications

References 55 publications

Using hyperpolarized 129Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Using hyperpolarized 129Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

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

Regional Ventilation Changes in the Lung: Treatment Response Mapping by Using Hyperpolarized Gas MR Imaging as a Quantitative Biomarker

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Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis