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Voskrebenzev A, Kaireit TF, Klimeš F, Pöhler GH, Behrendt L, Biller H, Berschneider K, Wacker F, Welte T, Hohlfeld JM, Vogel-Claussen J. PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A Retrospective Analysis of a Randomized Controlled Trial. Radiol Cardiothorac Imaging 2022; 4:e210147. [PMID: 35506142 PMCID: PMC9059092 DOI: 10.1148/ryct.210147] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Purpose To assess whether dynamic ventilation and perfusion (Q) biomarkers
derived by phase-resolved functional lung (PREFUL) MRI can measure
treatment response to 14-day therapy with indacaterol-glycopyrronium
(IND-GLY) and correlate to clinical outcomes including lung function,
symptoms, and cardiac function in patients with chronic obstructive
pulmonary disease (COPD), as determined by spirometry, body
plethysmography, cardiac MRI, and dyspnea score measurements. Materials and Methods The cardiac left ventricular function in COPD (CLAIM) study enrolled
patients aged 40 years or older with COPD, stable cardiovascular
function, and hyperinflation (residual volume > 135% predicted).
Dynamic MRI data of these patients were retrospectively analyzed using
the PREFUL technique to assess the effect of 14-day IND-GLY treatment
versus placebo on regional measurements of ventilation dynamics. After
manual segmentation of the lung parenchyma, flow-volume loops of each
voxel were correlated to an individualized reference flow-volume loop,
creating a two-dimensional flow-volume loop correlation map (FVL-CM) as
a measure of ventilation dynamics. Ventilation-perfusion match (VQM) was
evaluated in combination with perfusion and regional ventilation
(VQMRVent) and with perfusion and the FVL-CM measurement
(VQMCM). For image and statistical analysis, the lung
parenchyma was segmented as a region of interest by manually delineating
the lung boundary and excluding the large (central) vessels for each
section. Differences in ventilation, perfusion, and VQM between IND-GLY
and placebo were compared using analysis of variance, with study
treatment, patient, and period included as factors. Results Fifty patients (mean age, 64.3 years ± 7.65 [SD]; 35 men) were
included in this analysis. IND-GLY significantly increased mean
correlation as measured with FVL-CM versus that of placebo (least
squares [LS] means treatment difference: 0.05 [95% CI: 0.03, 0.07];
P < .0001). Compared with placebo, IND-GLY
increased mean Q (LS means treatment difference: 9.27 mL/min/100 mL [95%
CI: 0.05, 18.49]; P = .049) and improved both
VQMCM and VQMRVent (LS means treatment
difference: 0.06 [95% CI: 0.03, 0.08]; P < .0001
and 0.05 [95% CI: 0.02, 0.08]; P = .001,
respectively). Conclusion Regional ventilation dynamics and VQM measured by PREFUL MRI show
treatment response in COPD. Supplemental material is available for this
article. Clinical trial registration no. NTR6831 Keywords: MRI, COPD, Perfusion, Ventilation, Lung,
Pulmonary Published under a CC BY 4.0 license
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Affiliation(s)
- Andreas Voskrebenzev
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Till F Kaireit
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Filip Klimeš
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Gesa H Pöhler
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Lea Behrendt
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Heike Biller
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Korbinian Berschneider
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Tobias Welte
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Jens M Hohlfeld
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
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2
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Bewes J, Doganay O, Chen M, McIntyre A, Gleeson F. Imaging Dynamic Expiration: Feasibility of MRI Spirometry Using Hyperpolarized Xenon Gas. Radiol Cardiothorac Imaging 2021; 3:e200571. [PMID: 34498002 DOI: 10.1148/ryct.2021200571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 06/01/2021] [Accepted: 06/15/2021] [Indexed: 11/11/2022]
Abstract
Purpose To examine the feasibility of imaging-based spirometry using high-temporal-resolution projection MRI and hyperpolarized xenon 129 (129Xe) gas. Materials and Methods In this prospective exploratory study, five healthy participants (age range, 25-45 years; three men) underwent an MRI spirometry technique using inhaled hyperpolarized 129Xe and rapid two-dimensional projection MRI. Participants inhaled 129Xe, then performed a forced expiratory maneuver while in an MR imager. Images of the lungs during expiration were captured in time intervals as short as 250 msec. Volume-corrected images of the lungs at expiration commencement (0 second), 1 second after expiration, and 6 seconds after expiration were extracted to generate forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio pulmonary maps. For comparison, participants performed conventional spirometry in the sitting position using room air, in the supine position using room air, and in the supine position using a room air and 129Xe mixture. Paired t tests with Bonferroni corrections for multiple comparisons were used for statistical analyses. Results The mean MRI-derived FEV1/FVC value was lower in comparison with conventional spirometry (0.52 ± 0.03 vs 0.70 ± 0.05, P < .01), which may reflect selective 129Xe retention. A secondary finding of this study was that 1 L of inhaled 129Xe negatively impacted pulmonary function as measured by conventional spirometry (in supine position), which reduced measured FEV1 (2.70 ± 0.90 vs 3.04 ± 0.85, P < .01) and FEV1/FVC (0.70 ± 0.05 vs 0.79 ± 0.04, P < .01). Conclusion A forced expiratory maneuver was successfully imaged with hyperpolarized 129Xe and high-temporal-resolution MRI. Derivation of regional lung spirometric maps was feasible.Keywords: MR-Imaging, MR-Dynamic Contrast Enhanced, MR-Functional Imaging, Pulmonary, Thorax, Diaphragm, Lung, Pleura, Physics Supplemental material is available for this article. © RSNA, 2021.
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Affiliation(s)
- James Bewes
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford OX3 7LE, England
| | - Ozkan Doganay
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford OX3 7LE, England
| | - Mitchell Chen
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford OX3 7LE, England
| | - Anthony McIntyre
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford OX3 7LE, England
| | - Fergus Gleeson
- Department of Radiology, The Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford OX3 7LE, England
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3
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Vegter RJK, van den Brink S, Mouton LJ, Sibeijn-Kuiper A, van der Woude LHV, Jeneson JAL. Magnetic Resonance-Compatible Arm-Crank Ergometry: A New Platform Linking Whole-Body Calorimetry to Upper-Extremity Biomechanics and Arm Muscle Metabolism. Front Physiol 2021; 12:599514. [PMID: 33679429 PMCID: PMC7933461 DOI: 10.3389/fphys.2021.599514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Evaluation of the effect of human upper-body training regimens may benefit from knowledge of local energy expenditure in arm muscles. To that end, we developed a novel arm-crank ergometry platform for use in a clinical magnetic resonance (MR) scanner with 31P spectroscopy capability to study arm muscle energetics. Complementary datasets on heart-rate, whole-body oxygen consumption, proximal arm-muscle electrical activity and power output, were obtained in a mock-up scanner. The utility of the platform was tested by a preliminary study over 4 weeks of skill practice on the efficiency of execution of a dynamic arm-cranking task in healthy subjects. RESULTS The new platform successfully recorded the first ever in vivo 31P MR spectra from the human biceps brachii (BB) muscle during dynamic exercise in five healthy subjects. Changes in BB energy- and pH balance varied considerably between individuals. Surface electromyography and mechanical force recordings revealed that individuals employed different arm muscle recruitment strategies, using either predominantly elbow flexor muscles (pull strategy; two subjects), elbow extensor muscles (push strategy; one subject) or a combination of both (two subjects). The magnitude of observed changes in BB energy- and pH balance during ACT execution correlated closely with each strategy. Skill practice improved muscle coordination but did not alter individual strategies. Mechanical efficiency on group level seemed to increase as a result of practice, but the outcomes generated by the new platform showed the additional caution necessary for the interpretation that total energy cost was actually reduced at the same workload. CONCLUSION The presented platform integrates dynamic in vivo 31P MRS recordings from proximal arm muscles with whole-body calorimetry, surface electromyography and biomechanical measurements. This new methodology enables evaluation of cyclic motor performance and outcomes of upper-body training regimens in healthy novices. It may be equally useful for investigations of exercise physiology in lower-limb impaired athletes and wheelchair users as well as frail patients including patients with debilitating muscle disease and the elderly.
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Affiliation(s)
- Riemer J. K. Vegter
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sebastiaan van den Brink
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Leonora J. Mouton
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anita Sibeijn-Kuiper
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University Medical Center Groningen, Groningen, Netherlands
| | - Lucas H. V. van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Center for Rehabilitation, University Medical Center Groningen, Groningen, Netherlands
| | - Jeroen A. L. Jeneson
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University Medical Center Groningen, Groningen, Netherlands
- Center for Child Development and Exercise, Wilhelmina’s Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
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4
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Klimeš F, Voskrebenzev A, Gutberlet M, Kern AL, Behrendt L, Grimm R, Suhling H, Crisosto CG, Kaireit TF, Pöhler GH, Glandorf J, Wacker F, Vogel-Claussen J. 3D phase-resolved functional lung ventilation MR imaging in healthy volunteers and patients with chronic pulmonary disease. Magn Reson Med 2020; 85:912-925. [PMID: 32926451 DOI: 10.1002/mrm.28482] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/04/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To test the feasibility of 3D phase-resolved functional lung (PREFUL) MRI in healthy volunteers and patients with chronic pulmonary disease, to compare 3D to 2D PREFUL, and to investigate the required temporal resolution to obtain stable 3D PREFUL measurement. METHODS Sixteen participants underwent MRI using 2D and 3D PREFUL. Retrospectively, the spatial resolution of 3D PREFUL (4 × 4 × 4 mm3 ) was decreased to match the spatial resolution of 2D PREFUL (4 × 4 × 15 mm3 ), abbreviated as 3Dlowres . In addition to regional ventilation (RVent), flow-volume loops were computed and rated by a cross-correlation (CC). Ventilation defect percentage (VDP) maps were obtained. RVent, CC, VDPRVent , and VDPCC were compared for systematic differences between 2D, 3Dlowres , and 3D PREFUL. Dividing the 3D PREFUL data into 4- (≈ 20 phases), 8- (≈ 40 phases), and 12-min (≈ 60 phases) acquisition pieces, the ventilation parameter maps, including the heterogeneity of ventilation time to peak, were tested regarding the required temporal resolution. RESULTS RVent, CC, VDPRVent , and VDPCC presented significant correlations between 2D and 3D PREFUL (r = 0.64-0.94). CC and VDPCC of 2D and 3Dlowres PREFUL were significantly different (P < .0113). Comparing 3Dlowres and 3D PREFUL, all parameters were found to be statistically different (P < .0045). CONCLUSION 3D PREFUL MRI depicts the whole lung volume and breathing cycle with superior image resolution and with likely more precision compared to 2D PREFUL. Furthermore, 3D PREFUL is more sensitive to detect regions of hypoventilation and ventilation heterogeneity compared to 3Dlowres PREFUL, which is important for early detection and improved monitoring of patients with chronic lung disease.
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Affiliation(s)
- Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Marcel Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Agilo Luitger Kern
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Lea Behrendt
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | | | - Hendrik Suhling
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany.,Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Cristian Gonzales Crisosto
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Till Frederick Kaireit
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Gesa Helen Pöhler
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Julian Glandorf
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research (DZL), Hannover, Germany
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5
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Boucneau T, Fernandez B, Larson P, Darrasse L, Maître X. 3D Magnetic Resonance Spirometry. Sci Rep 2020; 10:9649. [PMID: 32541799 PMCID: PMC7295793 DOI: 10.1038/s41598-020-66202-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 04/21/2020] [Indexed: 01/23/2023] Open
Abstract
Spirometry is today the gold standard technique for assessing pulmonary ventilatory function in humans. From the shape of a flow-volume loop measured while the patient is performing forced respiratory cycles, the Forced Vital Capacity (FVC) and the Forced Expiratory Volume in one second (FEV1) can be inferred, and the pulmonologist is able to detect and characterize common respiratory afflictions. This technique is non-invasive, simple, widely available, robust, repeatable and reproducible. Yet, its outcomes rely on the patient's cooperation and provide only global information over the lung. With 3D Magnetic Resonance (MR) Spirometry, local ventilation can be assessed by MRI anywhere in the lung while the patient is freely breathing. The larger dimensionality of 3D MR Spirometry advantageously allows the extraction of original metrics that characterize the anisotropic and hysteretic regional mechanical behavior of the lung. Here, we demonstrated the potential of this technique on a healthy human volunteer breathing along different respiratory patterns during the MR acquisition. These new results are discussed with lung physiology and recent pulmonary CT data. As respiratory mechanics inherently support lung ventilation, 3D MR Spirometry may open a new way to non-invasively explore lung function while providing improved diagnosis of localized pulmonary diseases.
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Affiliation(s)
- Tanguy Boucneau
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | | | - Peder Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Luc Darrasse
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Xavier Maître
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France.
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6
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Ong F, Zhu X, Cheng JY, Johnson KM, Larson PEZ, Vasanawala SS, Lustig M. Extreme MRI: Large-scale volumetric dynamic imaging from continuous non-gated acquisitions. Magn Reson Med 2020; 84:1763-1780. [PMID: 32270547 DOI: 10.1002/mrm.28235] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE To develop a framework to reconstruct large-scale volumetric dynamic MRI from rapid continuous and non-gated acquisitions, with applications to pulmonary and dynamic contrast-enhanced (DCE) imaging. THEORY AND METHODS The problem considered here requires recovering 100 gigabytes of dynamic volumetric image data from a few gigabytes of k-space data, acquired continuously over several minutes. This reconstruction is vastly under-determined, heavily stressing computing resources as well as memory management and storage. To overcome these challenges, we leverage intrinsic three-dimensional (3D) trajectories, such as 3D radial and 3D cones, with ordering that incoherently cover time and k-space over the entire acquisition. We then propose two innovations: (a) A compressed representation using multiscale low-rank matrix factorization that constrains the reconstruction problem, and reduces its memory footprint. (b) Stochastic optimization to reduce computation, improve memory locality, and minimize communications between threads and processors. We demonstrate the feasibility of the proposed method on DCE imaging acquired with a golden-angle ordered 3D cones trajectory and pulmonary imaging acquired with a bit-reversed ordered 3D radial trajectory. We compare it with "soft-gated" dynamic reconstruction for DCE and respiratory-resolved reconstruction for pulmonary imaging. RESULTS The proposed technique shows transient dynamics that are not seen in gating-based methods. When applied to datasets with irregular, or non-repetitive motions, the proposed method displays sharper image features. CONCLUSIONS We demonstrated a method that can reconstruct massive 3D dynamic image series in the extreme undersampling and extreme computation setting.
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Affiliation(s)
- Frank Ong
- Electrical Engineering, Stanford University, Stanford, CA, USA.,Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Xucheng Zhu
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, San Francisco, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Joseph Y Cheng
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Kevin M Johnson
- Medical Physics, University of Wisconsin, Madison, WI, USA.,Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Peder E Z Larson
- Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Michael Lustig
- Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
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7
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Jahani N, Choi S, Choi J, Iyer K, Hoffman EA, Lin CL. Assessment of regional ventilation and deformation using 4D-CT imaging for healthy human lungs during tidal breathing. J Appl Physiol (1985) 2015; 119:1064-74. [PMID: 26316512 DOI: 10.1152/japplphysiol.00339.2015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/20/2015] [Indexed: 11/22/2022] Open
Abstract
This study aims to assess regional ventilation, nonlinearity, and hysteresis of human lungs during dynamic breathing via image registration of four-dimensional computed tomography (4D-CT) scans. Six healthy adult humans were studied by spiral multidetector-row CT during controlled tidal breathing as well as during total lung capacity and functional residual capacity breath holds. Static images were utilized to contrast static vs. dynamic (deep vs. tidal) breathing. A rolling-seal piston system was employed to maintain consistent tidal breathing during 4D-CT spiral image acquisition, providing required between-breath consistency for physiologically meaningful reconstructed respiratory motion. Registration-derived variables including local air volume and anisotropic deformation index (ADI, an indicator of preferential deformation in response to local force) were employed to assess regional ventilation and lung deformation. Lobar distributions of air volume change during tidal breathing were correlated with those of deep breathing (R(2) ≈ 0.84). Small discrepancies between tidal and deep breathing were shown to be likely due to different distributions of air volume change in the left and the right lungs. We also demonstrated an asymmetric characteristic of flow rate between inhalation and exhalation. With ADI, we were able to quantify nonlinearity and hysteresis of lung deformation that can only be captured in dynamic images. Nonlinearity quantified by ADI is greater during inhalation, and it is stronger in the lower lobes (P < 0.05). Lung hysteresis estimated by the difference of ADI between inhalation and exhalation is more significant in the right lungs than that in the left lungs.
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Affiliation(s)
- Nariman Jahani
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, Iowa; IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
| | - Sanghun Choi
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, Iowa; IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
| | - Jiwoong Choi
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, Iowa; IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa
| | - Krishna Iyer
- Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa
| | - Eric A Hoffman
- Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa; Department of Internal Medicine, The University of Iowa, Iowa City, Iowa; Department of Radiology, The University of Iowa, Iowa City, Iowa
| | - Ching-Long Lin
- Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, Iowa; IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa;
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Berman BP, Pandey A, Li Z, Jeffries L, Trouard TP, Oliva I, Cortopassi F, Martin DR, Altbach MI, Bilgin A. Volumetric MRI of the lungs during forced expiration. Magn Reson Med 2015; 75:2295-302. [DOI: 10.1002/mrm.25798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Benjamin P. Berman
- Program in Applied Mathematics; University of Arizona; Tucson Arizona USA
| | - Abhishek Pandey
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona USA
| | - Zhitao Li
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona USA
| | - Lindsie Jeffries
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona USA
| | - Theodore P. Trouard
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona USA
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Isabel Oliva
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Felipe Cortopassi
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Diego R. Martin
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Maria I. Altbach
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Ali Bilgin
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona USA
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona USA
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
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9
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Güldner M, Becker S, Wolf U, Düber C, Friesenecker A, Gast KK, Heil W, Hoffmann C, Karpuk S, Otten EW, Rivoire J, Salhi Z, Scholz A, Schreiber LM, Terekhov M. Application unit for the administration of contrast gases for pulmonary magnetic resonance imaging: optimization of ventilation distribution for (3) He-MRI. Magn Reson Med 2014; 74:884-93. [PMID: 25213218 DOI: 10.1002/mrm.25433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 08/05/2014] [Accepted: 08/06/2014] [Indexed: 11/05/2022]
Abstract
PURPOSE MRI of lung airspaces using gases with MR-active nuclei ((3) He, (129) Xe, and (19) F) is an important area of research in pulmonary imaging. The volume-controlled administration of gas mixtures is important for obtaining quantitative information from MR images. State-of-the-art gas administration using plastic bags (PBs) does not allow for a precise determination of both the volume and timing of a (3) He bolus. METHODS A novel application unit (AU) was built according to the requirements of the German medical devices law. Integrated spirometers enable the monitoring of the inhaled gas flow. The device is particularly suited for hyperpolarized (HP) gases (e.g., storage and administration with minimal HP losses). The setup was tested in a clinical trial (n = 10 healthy volunteers) according to the German medicinal products law using static and dynamic ventilation HP-(3) He MRI. RESULTS The required specifications for the AU were successfully realized. Compared to PB-administration, better reproducibility of gas intrapulmonary distribution was observed when using the AU for both static and dynamic ventilation imaging. CONCLUSION The new AU meets the special requirements for HP gases, which are storage and administration with minimal losses. Our data suggest that gas AU-administration is superior to manual modes for determining the key parameters of dynamic ventilation measurements.
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Affiliation(s)
- M Güldner
- Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - U Wolf
- Department of Radiology, University Medical Center Mainz, Mainz, Germany
| | - C Düber
- Department of Radiology, University Medical Center Mainz, Mainz, Germany
| | | | - K K Gast
- Department of Radiology, University Medical Center Mainz, Mainz, Germany
| | - W Heil
- Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany
| | - C Hoffmann
- Department of Radiology, University Medical Center Mainz, Mainz, Germany
| | - S Karpuk
- Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany
| | - E W Otten
- Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany
| | - J Rivoire
- Department of Radiology, Section of Medical Physics, University Medical Center Mainz, Mainz, Germany
| | - Z Salhi
- Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany
| | - A Scholz
- Department of Radiology, Section of Medical Physics, University Medical Center Mainz, Mainz, Germany
| | - L M Schreiber
- Department of Radiology, Section of Medical Physics, University Medical Center Mainz, Mainz, Germany
| | - M Terekhov
- Department of Radiology, Section of Medical Physics, University Medical Center Mainz, Mainz, Germany
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Murrie RP, Stevenson AW, Morgan KS, Fouras A, Paganin DM, Siu KKW. Feasibility study of propagation-based phase-contrast X-ray lung imaging on the Imaging and Medical beamline at the Australian Synchrotron. JOURNAL OF SYNCHROTRON RADIATION 2014; 21:430-445. [PMID: 24562566 DOI: 10.1107/s1600577513034681] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 12/27/2013] [Indexed: 06/03/2023]
Abstract
Propagation-based phase-contrast X-ray imaging (PB-PCXI) using synchrotron radiation has achieved high-resolution imaging of the lungs of small animals both in real time and in vivo. Current studies are applying such imaging techniques to lung disease models to aid in diagnosis and treatment development. At the Australian Synchrotron, the Imaging and Medical beamline (IMBL) is well equipped for PB-PCXI, combining high flux and coherence with a beam size sufficient to image large animals, such as sheep, due to a wiggler source and source-to-sample distances of over 137 m. This study aimed to measure the capabilities of PB-PCXI on IMBL for imaging small animal lungs to study lung disease. The feasibility of combining this technique with computed tomography for three-dimensional imaging and X-ray velocimetry for studies of airflow and non-invasive lung function testing was also investigated. Detailed analysis of the role of the effective source size and sample-to-detector distance on lung image contrast was undertaken as well as phase retrieval for sample volume analysis. Results showed that PB-PCXI of lung phantoms and mouse lungs produced high-contrast images, with successful computed tomography and velocimetry also being carried out, suggesting that live animal lung imaging will also be feasible at the IMBL.
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Affiliation(s)
| | - Andrew W Stevenson
- CSIRO Materials Science and Engineering, Private Bag 33, Clayton South, Victoria 3169, Australia
| | - Kaye S Morgan
- School of Physics, Monash University, Victoria 3800, Australia
| | - Andreas Fouras
- Department of Mechanical and Aerospace Engineering, Monash University, Victoria 3800, Australia
| | - David M Paganin
- School of Physics, Monash University, Victoria 3800, Australia
| | - Karen K W Siu
- School of Physics, Monash University, Victoria 3800, Australia
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11
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Automatic tracking of the respiratory motion of lung parenchyma on dynamic magnetic resonance imaging: comparison with pulmonary function tests in patients with chronic obstructive pulmonary disease. J Thorac Imaging 2013; 27:387-92. [PMID: 21795993 DOI: 10.1097/rti.0b013e3182242b11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study evaluated the respiratory motion of the lung parenchyma using dynamic magnetic resonance imaging and clarified differences between healthy individuals and patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS The study comprised 6 healthy volunteers and 42 patients diagnosed with smoking-related COPD. We captured 80 sequential frames from the mid-sagittal portion of the right lung while repeating forced deep breathing using a balanced fast-field echo sequence (repetition time, 2.2 ms; echo time, 1.1 ms; slice thickness, 10 mm; field of view, 450 mm; matrix size, 128 × 256; and acquisition time, 0.28 s/frame). We traced 15 points on pulmonary vessels using a computer-aided system and measured the maximal motion distance of each tracked point. Movement of these points was then compared with spirometric data using the Pearson correlation coefficient. RESULTS Patients with COPD showed reduced respiratory motion compared with healthy volunteers. Respiratory motion and spirometric data such as forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity showed highly significant positive correlations (correlation between normalized motion distance for the whole lung and FEV1, r = 0.75; P < 0.01). CONCLUSIONS The respiratory motion of the pulmonary vessels reflects expansion and deflation of the lung parenchyma, and such motion is restricted in patients with COPD due to airflow limitation.
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Dubsky S, Hooper SB, Siu KKW, Fouras A. Synchrotron-based dynamic computed tomography of tissue motion for regional lung function measurement. J R Soc Interface 2012; 9:2213-24. [PMID: 22491972 DOI: 10.1098/rsif.2012.0116] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
During breathing, lung inflation is a dynamic process involving a balance of mechanical factors, including trans-pulmonary pressure gradients, tissue compliance and airway resistance. Current techniques lack the capacity for dynamic measurement of ventilation in vivo at sufficient spatial and temporal resolution to allow the spatio-temporal patterns of ventilation to be precisely defined. As a result, little is known of the regional dynamics of lung inflation, in either health or disease. Using fast synchrotron-based imaging (up to 60 frames s(-1)), we have combined dynamic computed tomography (CT) with cross-correlation velocimetry to measure regional time constants and expansion within the mammalian lung in vivo. Additionally, our new technique provides estimation of the airflow distribution throughout the bronchial tree during the ventilation cycle. Measurements of lung expansion and airflow in mice and rabbit pups are shown to agree with independent measures. The ability to measure lung function at a regional level will provide invaluable information for studies into normal and pathological lung dynamics, and may provide new pathways for diagnosis of regional lung diseases. Although proof-of-concept data were acquired on a synchrotron, the methodology developed potentially lends itself to clinical CT scanning and therefore offers translational research opportunities.
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Affiliation(s)
- Stephen Dubsky
- Division of Biological Engineering, Monash University, Victoria, Australia.
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13
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Tustison NJ, Cook TS, Song G, Gee JC. Pulmonary kinematics from image data: a review. Acad Radiol 2011; 18:402-17. [PMID: 21377592 DOI: 10.1016/j.acra.2010.10.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 09/02/2010] [Accepted: 10/25/2010] [Indexed: 10/18/2022]
Abstract
The effects of certain lung pathologies include alterations in lung physiology negatively affecting pulmonary compliance. Current approaches to diagnosis and treatment assessment of lung disease commonly rely on pulmonary function testing. Such testing is limited to global measures of lung function, neglecting regional measurements, which are critical for early diagnosis and localization of disease. Increased accessibility to medical image acquisition strategies with high spatiotemporal resolution coupled with the development of sophisticated intensity-based and geometric registration techniques has resulted in the recent exploration of modeling pulmonary motion for calculating local measures of deformation. In this review, the authors provide a broad overview of such research efforts for the estimation of pulmonary deformation. This includes discussion of various techniques, current trends in validation approaches, and the public availability of software and data resources.
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Fain S, Schiebler ML, McCormack DG, Parraga G. Imaging of lung function using hyperpolarized helium-3 magnetic resonance imaging: Review of current and emerging translational methods and applications. J Magn Reson Imaging 2011; 32:1398-408. [PMID: 21105144 DOI: 10.1002/jmri.22375] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
During the past several years there has been extensive development and application of hyperpolarized helium-3 (HP (3)He) magnetic resonance imaging (MRI) in clinical respiratory indications such as asthma, chronic obstructive pulmonary disease, cystic fibrosis, radiation-induced lung injury, and transplantation. This review focuses on the state-of-the-art of HP (3)He MRI and its application to clinical pulmonary research. This is not an overview of the physics of the method, as this topic has been covered previously. We focus here on the potential of this imaging method and its challenges in demonstrating new types of information that has the potential to influence clinical research and decision making in pulmonary medicine. Particular attention is given to functional imaging approaches related to ventilation and diffusion-weighted imaging with applications in chronic obstructive pulmonary disease, cystic fibrosis, asthma, and radiation-induced lung injury. The strengths and challenges of the application of (3)He MRI in these indications are discussed along with a comparison to established and emerging imaging techniques.
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Affiliation(s)
- Sean Fain
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
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15
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Biederer J, Hintze C, Fabel M, Dinkel J. Magnetic resonance imaging and computed tomography of respiratory mechanics. J Magn Reson Imaging 2011; 32:1388-97. [PMID: 21105143 DOI: 10.1002/jmri.22386] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Radiotherapy for organs with respiratory motion has motivated the development of dynamic volume lung imaging with computed tomography (4D-CT) or magnetic resonance imaging (4D-MRI). 4D-CT can be realized in helical (continuous couch translation during image acquisition) or cine mode (translation step-by-step), either acquired prospectively or reconstructed retrospectively with temporal resolutions of up to 250 msec. Long exposure times result in high radiation dose and restrict 4D-CT to specific indications (ie, radiotherapy planning). Dynamic MRI accelerated by parallel imaging and echo sharing reaches temporal resolutions of up to 10 images/sec (2D+t) or 1 volume/s (3D+t) that allow analyzing respiratory motion of the lung and its tumors. Near isotropic 4D-MRI can be used to assess tumor displacement, chest wall invasion, and segmental respiratory mechanics. Limited temporal resolution of dynamic volume acquisitions (in their current implementation) may lead to an overestimation of tumor size, as the mass is volume averaged into many voxels during motion. Nevertheless, 4D-MRI allows for repeated and prolonged measurements without radiation exposure and therefore appears to be appropriate for patient selection in motion-adapted radiotherapy as well as for a broad spectrum of scientific applications.
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Affiliation(s)
- Jürgen Biederer
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
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16
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Tustison NJ, Awate SP, Cai J, Altes TA, Miller GW, de Lange EE, Mugler JP, Gee JC. Pulmonary kinematics from tagged hyperpolarized helium-3 MRI. J Magn Reson Imaging 2010; 31:1236-41. [PMID: 20432362 DOI: 10.1002/jmri.22137] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To propose and test the feasibility of a novel method for quantifying 3D regional pulmonary kinematics from hyperpolarized helium-3 tagged MRI in human subjects using a tailored image processing pipeline and a recently developed nonrigid registration framework. MATERIALS AND METHODS Following image acquisition, inspiratory and expiratory tagged (3)He magnetic resonance (MR) images were preprocessed using various image filtering techniques to enhance the tag surfaces. Segmentation of the three orthogonal sets of tag planes in each lung produced distinct point-set representations of the tag surfaces. Using these labeled point-sets, deformation fields and corresponding strain maps were obtained via nonrigid point-set registration. Kinematic analysis was performed on three volunteers. RESULTS Tag lines in inspiratory and expiratory images were coregistered producing a continuous 3D correspondence mapping. Average displacement and directional strains were calculated in three subjects in the inferior, mid, and superior portions of the right and left lungs. As expected, the predominant direction of displacements with expiration is from inferior to superior. CONCLUSION Kinematic quantitation of pulmonary motion using tagged (3)He MRI is feasible using the applied image preprocessing filtering techniques and nonrigid point-set registration. Potential benefits from regional pulmonary kinematic quantitation include the facilitation of diagnosis and local assessment of disease progression.
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Affiliation(s)
- Nicholas J Tustison
- Penn Image Computing and Science Laboratory, University of Pennsylvania, Philadelphia, PA 19104, USA.
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17
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Wellman TJ, Winkler T, Costa ELV, Musch G, Harris RS, Venegas JG, Melo MFV. Measurement of regional specific lung volume change using respiratory-gated PET of inhaled 13N-nitrogen. J Nucl Med 2010; 51:646-53. [PMID: 20237036 DOI: 10.2967/jnumed.109.067926] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Regional specific lung volume change (sVol), defined as the regional tidal volume divided by the regional end-expiratory gas volume, is a key variable in lung mechanics and in the pathogenesis of ventilator-induced lung injury. Despite the usefulness of PET to study regional lung function, there is no established method to assess sVol with PET. We present a method to measure sVol from respiratory-gated PET images of inhaled (13)N-nitrogen ((13)NN), validate the method against regional specific ventilation (sV), and study the effect of region-of-interest (ROI) volume and orientation on the sVol-sV relationship. METHODS Four supine sheep were mechanically ventilated (tidal volume V(T) = 8 mL/kg, respiratory rate adjusted to normocapnia) at low (n = 2, positive end-expiratory pressure = 0) and high (n = 2, positive end-expiratory pressure adjusted to achieve a plateau pressure of 30 cm H(2)O) lung volumes. Respiratory-gated PET scans were obtained after inhaled (13)NN equilibration both at baseline and after a period of mechanical ventilation. We calculated sVol from (13)NN-derived regional fractional gas content at end-inspiration (F(EI)) and end-expiration (F(EE)) using the formula sVol = (F(EI) - F(EE))/(F(EE)[1 - F(EI)]). sV was computed as the inverse of the subsequent (13)NN washout curve time constant. ROIs were defined by dividing the lung field with equally spaced coronal, sagittal, and transverse planes, perpendicular to the ventrodorsal, laterolateral, and cephalocaudal axes, respectively. RESULTS sVol-sV linear regressions for ROIs based on the ventrodorsal axis yielded the highest R(2) (range, 0.71-0.92 for mean ROI volumes from 7 to 162 mL), the cephalocaudal axis the next highest (R(2) = 0.77-0.88 for mean ROI volumes from 38 to 162 mL), and the laterolateral axis the lowest (R(2) = 0.65-0.83 for mean ROI volumes from 8 to 162 mL). ROIs based on the ventrodorsal axis yielded lower standard errors of estimates of sVol from sV than those based on the laterolateral axis or the cephalocaudal axis. CONCLUSION sVol can be computed with PET using the proposed method and is highly correlated with sV. Errors in sVol are smaller for larger ROIs and for orientations based on the ventrodorsal axis.
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Affiliation(s)
- Tyler J Wellman
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
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18
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Tetzlaff R, Eichinger M. [Magnetic resonance imaging of respiratory movement and lung function]. Radiologe 2009; 49:712-9. [PMID: 19693620 DOI: 10.1007/s00117-009-1881-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Lung function measurements are the domain of spirometry or plethysmography. These methods have proven their value in clinical practice, nevertheless, being global measurements the functional indices only describe the sum of all functional units of the lung. Impairment of only a single component of the respiratory pump or of a small part of lung parenchyma can be compensated by unaffected lung tissue. Dynamic imaging can help to detect such local changes and lead to earlier adapted therapy. Magnetic resonance imaging (MRI) seems to be perfect for this application as it is not hampered by image distortion as is projection radiography and it does not expose the patient to potentially harmful radiation like computed tomography. Unfortunately, lung parenchyma is not easy to image using MRI due to its low signal intensity. For this reason first applications of MRI in lung function measurements concentrated on the movement of the thoracic wall and the diaphragm. Recent technical advances in MRI however might allow measurements of regional dynamics of the lungs.
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Affiliation(s)
- R Tetzlaff
- Abteilung Radiologie (E010), Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg.
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Abstract
STUDY DESIGN Review. OBJECTIVE To review and outline the preoperative evaluation and approach in assessing children with congenital vertebral malformation. SUMMARY OF BACKGROUND DATA Congenital vertebral malformations encompass a broad spectrum of conditions. A high association of renal, cardiac, and intraspinal anomalies with congenital vertebral malformation has been well documented in the literature. Vertebral malformation with involvement of the thoracic cage may lead to the development of thoracic insufficiency. The natural history, the character, and location of the deformity ultimately influence the propensity for progression and the necessity for treatment. Multiple factors should be considered before treatment with the goal of treatment aimed at providing the best possible care to be able to optimize the child's overall function and potential for growth. METHODS Narrative and review of literature. CONCLUSION Congenital scoliosis is a multifaceted condition. The presentation of the condition can be quite varied from those presenting with an isolated hemivertebrae to those with severe malformations, complicated by multiple medical conditions. A thorough preoperative evaluation is necessary before the institution of any treatment protocol. The presence of any medical condition must be addressed; the treatment should be tailor-made for each patient putting into consideration the patients' age and the effects of treatment on pulmonary function at maturity.
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VAN BEEK EJR, TCHATALBACHEV V, WILD JM. Lung magnetic resonance imaging – an update. IMAGING 2008. [DOI: 10.1259/imaging/63202218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Iwasawa T, Takahashi H, Ogura T, Asakura A, Gotoh T, Kagei S, Nishimura JI, Obara M, Inoue T. Correlation of lung parenchymal MR signal intensity with pulmonary function tests and quantitative computed tomography (CT) evaluation: a pilot study. J Magn Reson Imaging 2008; 26:1530-6. [PMID: 17968893 DOI: 10.1002/jmri.21183] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE To evaluate the effect of ventilatory impairment on MR signal intensity of the lung parenchyma. MATERIALS AND METHODS Subjects were five normal volunteers (age = 30 +/- 7.9 years, mean +/- SD) and 19 male patients with chronic obstructive lung disease (COPD) (mean age = 70.4 +/- 6.5 years). Coronal MR images were obtained over entire lung fields at full inspiration and full expiration with cardiac triggering on a 1.5T system. Changes in the mean lung intensity between the two respiratory states were normalized by each intercept of the linear regression lines of the signal changes, and the slope of the relationship was calculated. Computed tomography (CT) images were also obtained in COPD patients at full inspiration using a multidetector row CT scanner. Attenuation values less than -950 Hounsfield units (HU) (RA-950) represented the percentage of relative lung area on the CT. RESULTS The mean slope of COPD patients (0.365 +/- 0.074) was less steep than that of the normal subjects (0.570 +/- 0.124, P < 0.001). In COPD patients, the slope correlated significantly with forced expiratory volume in one second (FEV1, r = 0.508, P = 0.026), but not with RA-950. CONCLUSION In COPD patients, lung signal change measured by MRI correlates with airflow obstruction, but not with volume of the emphysema measured by lung CT.
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Affiliation(s)
- Tae Iwasawa
- Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
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Takahashi M, Kubo S, Kiryu S, Gee J, Hatabu H. MR microscopy of the lung in small rodents. Eur J Radiol 2007; 64:367-74. [PMID: 17904321 DOI: 10.1016/j.ejrad.2007.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 07/31/2007] [Accepted: 08/01/2007] [Indexed: 01/08/2023]
Abstract
Understanding how the mammalian respiratory system works and how it changes in disease states and under the influence of drugs is frequently pursued in model systems such as small rodents. These have many advantages, including being easily obtained in large numbers as purebred strains. Studies in small rodents are valuable for proof of concept studies and for increasing our knowledge about disease mechanisms. Since the recent developments in the generation of genetically designed animal models of disease, one needs the ability to assess morphology and function in in vivo systems. In this article, we first review previous reports regarding thoracic imaging. We then discuss approaches to take in making use of small rodents to increase MR microscopic sensitivity for these studies and to establish MR methods for clinically relevant lung imaging.
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Affiliation(s)
- Masaya Takahashi
- Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
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Cai J, Miller GW, Altes TA, Read PW, Benedict SH, de Lange EE, Cates GD, Brookeman JR, Mugler JP, Sheng K. Direct measurement of lung motion using hyperpolarized helium-3 MR tagging. Int J Radiat Oncol Biol Phys 2007; 68:650-3. [PMID: 17445997 PMCID: PMC3658834 DOI: 10.1016/j.ijrobp.2007.02.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 02/08/2007] [Accepted: 02/08/2007] [Indexed: 11/19/2022]
Abstract
PURPOSE To measure lung motion between end-inhalation and end-exhalation using a hyperpolarized helium-3 (HP (3)He) magnetic resonance (MR) tagging technique. METHODS AND MATERIALS Three healthy volunteers underwent MR tagging studies after inhalation of 1 L HP (3)He gas diluted with nitrogen. Multiple-slice two-dimensional and volumetric three-dimensional MR tagged images of the lungs were obtained at end-inhalation and end-exhalation, and displacement vector maps were computed. RESULTS The grids of tag lines in the HP (3)He MR images were well defined at end-inhalation and remained evident at end-exhalation. Displacement vector maps clearly demonstrated the regional lung motion and deformation that occurred during exhalation. Discontinuity and differences in motion pattern between two adjacent lung lobes were readily resolved. CONCLUSIONS Hyperpolarized helium-3 MR tagging technique can be used for direct in vivo measurement of respiratory lung motion on a regional basis. This technique may lend new insights into the regional pulmonary biomechanics and thus provide valuable information for the deformable registration of lung.
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Affiliation(s)
- Jing Cai
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA
| | - G. Wilson Miller
- Department of Radiology, University of Virginia, Charlottesville, VA, USA
| | - Talissa A. Altes
- Department of Radiology, University of Virginia, Charlottesville, VA, USA
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Paul W. Read
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA
| | - Stanley H. Benedict
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA
| | - Eduard E. de Lange
- Department of Radiology, University of Virginia, Charlottesville, VA, USA
| | - Gordon D. Cates
- Department of Physics, University of Virginia, Charlottesville, VA, USA
| | - James R. Brookeman
- Department of Radiology, University of Virginia, Charlottesville, VA, USA
| | - John P. Mugler
- Department of Radiology, University of Virginia, Charlottesville, VA, USA
| | - Ke Sheng
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA
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Swift AJ, Woodhouse N, Fichele S, Siedel J, Mills GH, van Beek EJR, Wild JM. Rapid Lung Volumetry Using Ultrafast Dynamic Magnetic Resonance Imaging During Forced Vital Capacity Maneuver. Invest Radiol 2007; 42:37-41. [PMID: 17213747 DOI: 10.1097/01.rli.0000250735.92266.6b] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Dynamic magnetic resonance imaging (MRI) has the potential for rapid noninvasive evaluation of changes in lung volume. The aim of this study was to perform rapid lung volumetry using ultrafast dynamic MRI to capture a forced vital capacity (FVC) maneuver. MATERIALS AND METHODS Nine healthy volunteers underwent 2-dimensional spoiled gradient echo imaging in coronal and sagittal planes during FVC maneuvers. An elliptical model of the axial cross section of the lungs was used to generate rapid volume-time curves. Spirometric indices were correlated with MR volumetry findings. RESULTS Total lung volume calculated from static MRI correlated well with the dynamic MR scans (r = 0.83; P < 0.01). Spirometric indices (first second of forced expiration and FVC) calculated from our MR volumetry technique correlated well with conventional spirometry (P < 0.01). CONCLUSION The technique provides a means of sampling lung volume change during the rapid subsecond movements that take place during a FVC maneuver.
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Affiliation(s)
- Andy J Swift
- Unit of Academic Radiology, University of Sheffield, Sheffield, United Kingdom.
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