Translational applications of hyperpolarized 3He and 129Xe

Monitoring ROS Responsive Fe3O4-based Nanoparticle Mediated Ferroptosis and Immunotherapy via 129Xe MRI

The immune checkpoint blockade strategy has improved the survival rate of late-stage lung cancer patients. However, the low immune response rate limits the immunotherapy efficiency. Here, we report a ROS-responsive Fe3O4-based nanoparticle that undergoes charge reversal and disassembly in the tumor microenvironment, enhancing the uptake of Fe3O4 by tumor cells and triggering a more severe ferroptosis. In the tumor microenvironment, the nanoparticle rapidly disassembles and releases the loaded GOx and the immune-activating peptide Tuftsin under overexpressed H2O2. GOx can consume the glucose of tumor cells and generate more H2O2, promoting the disassembly of the nanoparticle and drug release, thereby enhancing the therapeutic effect of ferroptosis. Combined with Tuftsin, it can more effectively reverse the immune-suppressive microenvironment and promote the recruitment of effector T cells in tumor tissues. Ultimately, in combination with α-PD-L1, there is significant inhibition of the growth of lung metastases. Additionally, the hyperpolarized 129Xe method has been used to evaluate the Fe3O4 nanoparticle-mediated immunotherapy, where the ventilation defects in lung metastases have been significantly improved with complete lung structure and function recovered. The ferroptosis-enhanced immunotherapy combined with non-radiation evaluation methodology paves a new way for designing novel theranostic agents for cancer therapy.

Toward Lung Ventilation Imaging Using Hyperpolarized Diethyl Ether Gas Contrast Agent

Hyperpolarized 129Xe gas was FDA-approved as an inhalable contrast agent for magnetic resonance imaging of a wide range of pulmonary diseases in December 2022. Despite the remarkable success in clinical research settings, the widespread clinical translation of HP 129Xe gas faces two critical challenges: the high cost of the relatively low-throughput hyperpolarization equipment and the lack of 129Xe imaging capability on clinical MRI scanners, which have narrow-bandwidth electronics designed only for proton (1H) imaging. To solve this translational grand challenge of gaseous hyperpolarized MRI contrast agents, here we demonstrate the utility of batch-mode production of proton-hyperpolarized diethyl ether gas via heterogeneous pairwise addition of parahydrogen to ethyl vinyl ether. An approximately 0.1-liter bolus of hyperpolarized diethyl ether gas was produced in 1 second and injected in excised rabbit lungs. Lung ventilation imaging was performed using sub-second 2D MRI with up to 2×2 mm2 in-plane resolution using a clinical 0.35 T MRI scanner without any modifications. This feasibility demonstration paves the way for the use of inhalable diethyl ether as a gaseous contrast agent for pulmonary MRI applications using any clinical MRI scanner.

Carbon-13 Radiofrequency Amplification by Stimulated Emission of Radiation of the Hyperpolarized Ketone and Hemiketal Forms of Allyl [1-13C]Pyruvate

13C hyperpolarized pyruvate is an emerging MRI contrast agent for sensing molecular events in cancer and other diseases with aberrant metabolic pathways. This metabolic contrast agent can be produced via several hyperpolarization techniques. Despite remarkable success in research settings, widespread clinical adoption faces substantial roadblocks because the current sensing technology utilized to sense this contrast agent requires the excitation of 13C nuclear spins that also need to be synchronized with MRI field gradient pulses. Here, we demonstrate sensing of hyperpolarized allyl [1-13C]pyruvate via the stimulated emission of radiation that mitigates the requirements currently blocking broader adoption. Specifically, 13C Radiofrequency Amplification by Stimulated Emission of Radiation (13C RASER) was obtained after pairwise addition of parahydrogen to a pyruvate precursor, detected in a commercial inductive detector with a quality factor (Q) of 32 for sample concentrations as low as 0.125 M with 13C polarization of 4%. Moreover, parahydrogen-induced polarization allowed for the preparation of a mixture of ketone and hemiketal forms of hyperpolarized allyl [1-13C]pyruvate, which are separated by 10 ppm in 13C NMR spectra. This is a good model system to study the simultaneous 13C RASER signals of multiple 13C species. This system models the metabolic production of hyperpolarized [1-13C]lactate from hyperpolarized [1-13C]pyruvate, which has a similar chemical shift difference. Our results show that 13C RASER signals can be obtained from both species simultaneously when the emission threshold is exceeded for both species. On the other hand, when the emission threshold is exceeded only for one of the hyperpolarized species, 13C stimulated emission is confined to this species only, therefore enabling the background-free detection of individual hyperpolarized 13C signals. The reported results pave the way to novel sensing approaches of 13C hyperpolarized pyruvate, potentially unlocking hyperpolarized 13C MRI on virtually any MRI system─an attractive vision for the future molecular imaging and diagnostics.

Analytical corrections for B1 -inhomogeneity and signal decay in multi-slice 2D spiral hyperpolarized 129 Xe MRI using keyhole reconstruction

PURPOSE

Hyperpolarized xenon MRI suffers from heterogeneous coil bias and magnetization decay that obscure pulmonary abnormalities. Non-physiological signal variability can be mitigated by measuring and mapping the nominal flip angle, and by rescaling the images to correct for signal bias and decay. While flip angle maps can be calculated from sequentially acquired images, scan time and breath-hold duration are doubled. Here, we exploit the low-frequency oversampling of 2D-spiral and keyhole reconstruction to measure flip angle maps from a single acquisition.

METHODS

Flip angle maps were calculated from two images generated from a single dataset using keyhole reconstructions and a Bloch-equation-based model suitable for hyperpolarized substances. Artifacts resulting from acquisition and reconstruction schemes (e.g., keyhole reconstruction radius, slice-selection profile, spiral-ordering, and oversampling) were assessed using point-spread functions. Simulated flip angle maps generated using keyhole reconstruction were compared against the paired-image approach using RMS error (RMSE). Finally, feasibility was demonstrated for in vivo xenon ventilation imaging.

RESULTS

Simulations demonstrated accurate flip angle maps and B1 -inhomogeneity correction can be generated with only 1.25-fold central-oversampling and keyhole reconstruction radius = 5% (RMSE = 0.460°). These settings also generated accurate flip angle maps in a healthy control (RSME = 0.337°) and a person with cystic fibrosis (RMSE = 0.404°) in as little as 3.3 s.

CONCLUSION

Regional lung ventilation images with reduced impact of B1 -inhomogeneity can be acquired rapidly by combining 2D-spiral acquisition, Bloch-equation-based modeling, and keyhole reconstruction. This approach will be especially useful for breath-hold studies where short scan durations are necessary, such as dynamic imaging and applications in children or people with severely compromised respiratory function.

Simultaneous quantification of hyperpolarized xenon-129 ventilation and gas exchange with multi-breath xenon-polarization transfer contrast (XTC) MRI

PURPOSE

To demonstrate the feasibility of a multi-breath xenon-polarization transfer contrast (XTC) MR imaging approach for simultaneously evaluating regional ventilation and gas exchange parameters.

METHODS

Imaging was performed in five healthy volunteers and six chronic obstructive pulmonary disease (COPD) patients. The multi-breath XTC protocol consisted of three repeated schemes of six wash-in breaths of a xenon mixture and four normoxic wash-out breaths, with and without selective saturation of either the tissue membrane or red blood cell (RBC) resonances. Acquisitions were performed at end-exhalation while subjects maintained tidal breathing throughout the session. The no-saturation, membrane-saturation, and RBC-saturation images were fit to a per-breath gas replacement model for extracting voxelwise tidal volume (TV), functional residual capacity (FRC), and fractional ventilation (FV), as well as tissue- and RBC-gas exchange (fMem and fRBC , respectively). The sensitivity of the derived model was also evaluated via simulations.

RESULTS

With the exception of FRC, whole-lung averages for all metrics were decreased in the COPD subjects compared to the healthy cohort, significantly so for FV, fRBC , and fMem . Heterogeneity was higher overall in the COPD subjects, particularly for fRBC , fMem , and fRBC:Mem . The anterior-to-posterior gradient associated with the gravity-dependence of lung function in supine imaging was also evident for FV, fRBC , and fMem values in the healthy subjects, but noticeably absent in the COPD cohort.

CONCLUSION

Multi-breath XTC imaging generated high-resolution, co-registered maps of ventilation and gas exchange parameters acquired during tidal breathing and with low per-breath xenon doses. Clear differences between healthy and COPD subjects were apparent and consistent with spirometry.

Facile hyperpolarization chemistry for molecular imaging and metabolic tracking of [1-13C]pyruvate in vivo

Hyperpolarization chemistry based on reversible exchange of parahydrogen, also known as Signal Amplification By Reversible Exchange (SABRE), is a particularly simple approach to attain high levels of nuclear spin hyperpolarization, which can enhance NMR and MRI signals by many orders of magnitude. SABRE has received significant attention in the scientific community since its inception because of its relative experimental simplicity and its broad applicability to a wide range of molecules, however in vivo detection of molecular probes hyperpolarized by SABRE has remained elusive. Here we describe a first demonstration of SABRE-hyperpolarized contrast detected in vivo, specifically using hyperpolarized [1-13C]pyruvate. Biocompatible formulations of hyperpolarized [1-13C]pyruvate in, both, methanol-water mixtures, and ethanol-water mixtures followed by dilution with saline and catalyst filtration were prepared and injected into healthy Sprague Dawley and Wistar rats. Effective hyperpolarization-catalyst removal was performed with silica filters without major losses in hyperpolarization. Metabolic conversion of pyruvate to lactate, alanine, and bicarbonate was detected in vivo. Pyruvate-hydrate was also observed as minor byproduct. Measurements were performed on the liver and kidney at 4.7 T via time-resolved spectroscopy and chemical-shift-resolved MRI. In addition, whole-body metabolic measurements were obtained using a cryogen-free 1.5 T MRI system, illustrating the utility of combining lower-cost MRI systems with simple, low-cost hyperpolarization chemistry to develop safe, and scalable molecular imaging.

Ultra-Low-Cost Disposable Hand-Held Clinical-Scale Propane Gas Hyperpolarizer for Pulmonary Magnetic Resonance Imaging Sensing

Hyperpolarized magnetic resonance imaging (MRI) contrast agents are revolutionizing the field of biomedical imaging. Hyperpolarized Xe-129 was recently FDA approved as an inhalable MRI contrast agent for functional lung imaging sensing. Despite success in research settings, modern Xe-129 hyperpolarizers are expensive (up to $1M), large, and complex to site and operate. Moreover, Xe-129 sensing requires specialized MRI hardware that is not commonly available on clinical MRI scanners. Here, we demonstrate that proton-hyperpolarized propane gas can be produced on demand using a disposable, hand-held, clinical-scale hyperpolarizer via parahydrogen-induced polarization, which relies on parahydrogen as a source of hyperpolarization. The device consists of a heterogeneous catalytic reactor connected to a gas mixture storage can containing pressurized hyperpolarization precursors: propylene and parahydrogen (10 bar total pressure). Once the built-in flow valve of the storage can is actuated, the precursors are ejected from the can into a reactor, and a stream of hyperpolarized propane gas is ejected from the reactor. Robust operation of the device is demonstrated for producing proton sensing polarization of 1.2% in a wide range of operational pressures and gas flow rates. We demonstrate that the propylene/parahydrogen gas mixture can retain potency for days in the storage can with a monoexponential decay time constant of 6.0 ± 0.5 days, which is limited by the lifetime of the parahydrogen singlet spin state in the storage container. The utility of the produced sensing agent is demonstrated for phantom imaging on a 3 T clinical MRI scanner located 100 miles from the agent/device preparation site and also for ventilation imaging of excised pig lungs using a 0.35 T clinical MRI scanner. The cost of the device components is less than $35, which we envision can be reduced to less than $5 for mass-scale production. The hyperpolarizer device can be reused, recycled, or disposed.

Functional lung imaging using novel and emerging MRI techniques

Respiratory diseases are leading causes of death and disability in the world. While early diagnosis is key, this has proven difficult due to the lack of sensitive and non-invasive tools. Computed tomography is regarded as the gold standard for structural lung imaging but lacks functional information and involves significant radiation exposure. Lung magnetic resonance imaging (MRI) has historically been challenging due to its short T2 and low proton density. Hyperpolarised gas MRI is an emerging technique that is able to overcome these difficulties, permitting the functional and microstructural evaluation of the lung. Other novel imaging techniques such as fluorinated gas MRI, oxygen-enhanced MRI, Fourier decomposition MRI and phase-resolved functional lung imaging can also be used to interrogate lung function though they are currently at varying stages of development. This article provides a clinically focused review of these contrast and non-contrast MR imaging techniques and their current applications in lung disease.

Diffusion weighted hyperpolarized 129 Xe MRI of the lung with 2D and 3D (FLORET) spiral

PURPOSE

To enable efficient hyperpolarized ¹²⁹ Xe diffusion imaging using 2D and 3D (Fermat Looped, ORthogonally Encoded Trajectories, FLORET) spiral sequences and demonstrate that ¹²⁹ Xe ADCs obtained using these sequences are comparable to those obtained using a conventional, 2D gradient-recalled echo (GRE) sequence.

THEORY AND METHODS

Diffusion-weighted ¹²⁹ Xe MRI (b-values = 0, 7.5, 15 s/cm² ) was performed in four healthy volunteers and one subject with lymphangioleiomyomatosis using slice-selective 2D-GRE (scan time = 15 s), slice-selective 2D-Spiral (4 s), and 3D-FLORET (16 s) sequences. Experimental SNRs from b-value = 0 images ( SNR 0 EX $$ SNR{0}_{EX} $$ ) and mean ADC values were compared across sequences. In two healthy subjects, a second b = 0 image was acquired using the 2D-Spiral sequence to map flip angle and correct RF-induced, hyperpolarized signal decay at the voxel level, thus improving regional ADC estimates.

RESULTS

Diffusion-weighted images from spiral sequences displayed image quality comparable to 2D-GRE and produced sufficient SNR 0 EX $$ SNR{0}_{EX} $$ (16.8 ± 3.8 for 2D-GRE, 21.2 ± 3.5 for 2D-Spiral, 20.4 ± 3.5 for FLORET) to accurately calculate ADC. Whole-lung means and SDs of ADC obtained via spiral were not significantly different (P > 0.54) from those obtained via 2D-GRE. Finally, 2D-Spiral images were corrected for signal decay, which resulted in a whole-lung mean ADC decrease of ˜15%, relative to uncorrected images.

CONCLUSIONS

Relative to GRE, efficient spiral sequences allow ¹²⁹ Xe diffusion images to be acquired with isotropic lung coverage (3D), higher SNR $$ SNR $$ (2D and 3D), and three-fold faster (2D) within a single breath-hold. In turn, shortened breath-holds enable flip-angle mapping, and thus, allow RF-induced signal decay to be corrected, increasing ADC accuracy.

Spin Hyperpolarization in Modern Magnetic Resonance

Magnetic resonance techniques are successfully utilized in a broad range of scientific disciplines and in various practical applications, with medical magnetic resonance imaging being the most widely known example. Currently, both fundamental and applied magnetic resonance are enjoying a major boost owing to the rapidly developing field of spin hyperpolarization. Hyperpolarization techniques are able to enhance signal intensities in magnetic resonance by several orders of magnitude, and thus to largely overcome its major disadvantage of relatively low sensitivity. This provides new impetus for existing applications of magnetic resonance and opens the gates to exciting new possibilities. In this review, we provide a unified picture of the many methods and techniques that fall under the umbrella term "hyperpolarization" but are currently seldom perceived as integral parts of the same field. Specifically, before delving into the individual techniques, we provide a detailed analysis of the underlying principles of spin hyperpolarization. We attempt to uncover and classify the origins of hyperpolarization, to establish its sources and the specific mechanisms that enable the flow of polarization from a source to the target spins. We then give a more detailed analysis of individual hyperpolarization techniques: the mechanisms by which they work, fundamental and technical requirements, characteristic applications, unresolved issues, and possible future directions. We are seeing a continuous growth of activity in the field of spin hyperpolarization, and we expect the field to flourish as new and improved hyperpolarization techniques are implemented. Some key areas for development are in prolonging polarization lifetimes, making hyperpolarization techniques more generally applicable to chemical/biological systems, reducing the technical and equipment requirements, and creating more efficient excitation and detection schemes. We hope this review will facilitate the sharing of knowledge between subfields within the broad topic of hyperpolarization, to help overcome existing challenges in magnetic resonance and enable novel applications.

Nichtinvasive funktionelle Lungenbildgebung mit hyperpolarisiertem Xenon

Hintergrund

Die Magnetresonanztomographie (MRT) ist ein nichtinvasives Verfahren mit hervorragendem Weichteilkontrast. Aufgrund der geringen Protonendichte und vielen Luft-Gewebe-Übergängen ist die Anwendung in der Lunge jedoch eingeschränkt, so dass hier häufig röntgenbasierte Methoden eingesetzt werden (mit den bekannten Nachteilen ionisierender Strahlung).

Fragestellung

In dieser Übersichtsarbeit wird die Lungen-MRT mit hyperpolarisiertem Xenon-129 (Xe-MRT) dargestellt. Die Xe-MRT erlaubt einzigartige wertvolle Einblicke in die Mikrostruktur und Funktion der Lunge, einschließlich des Gasaustauschs mit roten Blutkörperchen – Parameter, die mit klinischen Standardmethoden nicht zugänglich sind.

Material und Methoden

Durch die magnetische Markierung, die Hyperpolarisierung, wird das Signal von Xenon-129 um bis zu 100.000-fach verstärkt. Hierbei werden die Elektronen von Rubidium mittels Laserlicht zunächst auf 100 % polarisiert und dann durch Stöße auf Xenon übertragen. Danach wird das hyperpolarisierte Gas in einem Beutel zum Patienten gebracht und eingeatmet, kurz bevor die MRT-Aufnahmen beginnen.

Ergebnisse

Durch spezielle Programmierungen (Sequenzen) in der MRT kann die Ventilation, Mikrostruktur oder der Gasaustausch der Lunge in 3‑D dargestellt werden. Dies ermöglicht z. B. die quantitative Darstellung von Belüftungsdefekten, der Größe der Alveolen, der Gasaufnahme im Gewebe und des Gastransfers ins Blut.

Schlussfolgerung

Die Xe-MRT liefert einzigartige Informationen über den Zustand der Lunge – nichtinvasiv, in vivo und in weniger als einer Minute.

Improving hyperpolarized 129 Xe ADC mapping in pediatric and adult lungs with uncertainty propagation

RATIONALE

Hyperpolarized (HP) ¹²⁹ Xe-MRI provides non-invasive methods to quantify lung function and structure, with the ¹²⁹ Xe apparent diffusion coefficient (ADC) being a well validated measure of alveolar airspace size. However, the experimental factors that impact the precision and accuracy of HP ¹²⁹ Xe ADC measurements have not been rigorously investigated. Here, we introduce an analytical model to predict the experimental uncertainty of ¹²⁹ Xe ADC estimates. Additionally, we report ADC dependence on age in healthy pediatric volunteers.

METHODS

An analytical expression for ADC uncertainty was derived from the Stejskal-Tanner equation and simplified Bloch equations appropriate for HP media. Parameters in the model were maximum b-value (b_max ), number of b-values (N_b ), number of phase encoding lines (N_ph ), flip angle and the ADC itself. This model was validated by simulations and phantom experiments, and five fitting methods for calculating ADC were investigated. To examine the lower range for ¹²⁹ Xe ADC, 32 healthy subjects (age 6-40 years) underwent diffusion-weighted ¹²⁹ Xe MRI.

RESULTS

The analytical model provides a lower bound on ADC uncertainty and predicts that decreased signal-to-noise ratio yields increases in relative uncertainty (ϵADC) . As such, experimental parameters that impact non-equilibrium ¹²⁹ Xe magnetization necessarily impact the resulting ϵADC . The values of diffusion encoding parameters (N_b and b_max ) that minimize ϵADC strongly depend on the underlying ADC value, resulting in a global minimum for ϵADC . Bayesian fitting outperformed other methods (error < 5%) for estimating ADC. The whole-lung mean ¹²⁹ Xe ADC of healthy subjects increased with age at a rate of 1.75 × 10^-4  cm² /s/yr (p = 0.001).

CONCLUSIONS

HP ¹²⁹ Xe diffusion MRI can be improved by minimizing the uncertainty of ADC measurements via uncertainty propagation. Doing so will improve experimental accuracy when measuring lung microstructure in vivo and should allow improved monitoring of regional disease progression and assessment of therapy response in a range of lung diseases.

Pilot Quality-Assurance Study of a Third-Generation Batch-Mode Clinical-Scale Automated Xenon-129 Hyperpolarizer

We present a pilot quality assurance (QA) study of a clinical-scale, automated, third-generation (GEN-3) ¹²⁹Xe hyperpolarizer employing batch-mode spin-exchange optical pumping (SEOP) with high-Xe densities (50% natural abundance Xe and 50% N₂ in ~2.6 atm total pressure sourced from Nova Gas Technologies) and rapid temperature ramping enabled by an aluminum heating jacket surrounding the 0.5 L SEOP cell. ¹²⁹Xe hyperpolarization was performed over the course of 700 gas loading cycles of the SEOP cell, simulating long-term hyperpolarized contrast agent production in a clinical lung imaging setting. High levels of ¹²⁹Xe polarization (avg. %P_Xe = 51.0% with standard deviation σ_PXe = 3.0%) were recorded with fast ¹²⁹Xe polarization build-up time constants (avg. T_b = 25.1 min with standard deviation σ_Tb = 3.1 min) across the first 500 SEOP cell refills, using moderate temperatures of 75 °C. These results demonstrate a more than 2-fold increase in build-up rate relative to previously demonstrated results in a comparable QA study on a second-generation (GEN-2) ¹²⁹Xe hyperpolarizer device, with only a minor reduction in maximum achievable %P_Xe and with greater consistency over a larger number of SEOP cell refill processes at a similar polarization lifetime duration (avg. T₁ = 82.4 min, standard deviation σ_T1 = 10.8 min). Additionally, the effects of varying SEOP jacket temperatures, distribution of Rb metal, and preparation and operation of the fluid path are quantified in the context of device installation, performance optimization and maintenance to consistently produce high ¹²⁹Xe polarization values, build-up rates (T_b as low as 6 min) and lifetimes over the course of a typical high-throughput ¹²⁹Xe polarization SEOP cell life cycle. The results presented further demonstrate the significant potential for hyperpolarized ¹²⁹Xe contrast agent in imaging and bio-sensing applications on a clinical scale.

Hyperpolarized 129Xenon MRI Ventilation Defect Quantification via Thresholding and Linear Binning in Multiple Pulmonary Diseases

RATIONALE

There is no agreed upon method for quantifying ventilation defect percentage (VDP) with high sensitivity and specificity from hyperpolarized (HP) gas ventilation MR images in multiple pulmonary diseases for both pediatrics and adults, yet identifying such methods will be necessary for future multi-site trials. Most HP gas MRI ventilation research focuses on a specific pulmonary disease and utilizes one quantification scheme for determining VDP. Here we sought to determine the potential of different methods for quantifying VDP from HP 129Xe images in multiple pulmonary diseases through comparison of the most utilized quantification schemes: linear binning and thresholding.

MATERIALS AND METHODS

HP 129Xe MRI was performed in a total of 176 subjects (125 pediatrics and 51 adults, age 20.98±16.48 years) who were either healthy controls (n = 23) or clinically diagnosed with cystic fibrosis (CF) (n = 37), lymphangioleiomyomatosis (LAM) (n = 29), asthma (n = 22), systemic juvenile idiopathic arthritis (sJIA) (n = 11), interstitial lung disease (ILD) (n = 7), or were bone marrow transplant (BMT) recipients (n = 47). HP 129Xe ventilation images were acquired during a ≤16 second breath-hold using a 2D multi-slice gradient echo sequence on a 3T Philips scanner (TR/TE 8.0/4.0ms, FA 10-12°, FOV 300 × 300mm, voxel size≈3 × 3 × 15mm). Images were analyzed using 5 different methods to quantify VDPs: linear binning (histogram normalization with binning into 6 clusters) following either linear or a variant of a nonparametric nonuniform intensity normalization algorithm (N4ITK) bias-field correction, thresholding ≤60% of the mean signal intensity with linear bias-field correction, and thresholding ≤60% and ≤75% of the mean signal intensity following N4ITK bias-field correction. Spirometry was successfully obtained in 84% of subjects.

RESULTS

All quantification schemes were able to label visually identifiable ventilation defects in similar regions within all subjects. The VDPs of control subjects were significantly lower (p<0.05) compared to BMT, CF, LAM, and ILD subjects for most of the quantification methods. No one quantification scheme was better able to differentiate individual disease groups from the control group. Advanced statistical modeling of the VDP quantification schemes revealed that in comparing controls to the combined disease group, N4ITK bias-field corrected 60% thresholding had the highest predictive efficacy, sensitivity, and specificity at the VDP cut-point of 2.3%. However, compared to the thresholding quantification schemes, linear binning was able to capture and label subtle low-ventilation regions in subjects with milder obstruction, such as subjects with asthma.

CONCLUSION

The difference in VDP between healthy controls and patients varied between the different disease states for all quantification methods. Although N4ITK bias-field corrected 60% thresholding was superior in separating the combined diseased group from controls, linear binning is able to better label low-ventilation regions unlike the current, 60% thresholding scheme. For future clinical trials, a consensus will need to be reached on which VDP scheme to utilize, as there are subtle advantages for each for specific disease.

Hyperpolarized 129Xe magnetic resonance spectroscopy in a rat model of bronchopulmonary dysplasia

Premature infants often require mechanical ventilation and oxygen therapy, which can result in bronchopulmonary dysplasia (BPD), characterized by developmental arrest and impaired lung function. Conventional clinical methods for assessing the prenatal lung are not adequate for the detection and assessment of long-term health risks in infants with BPD, highlighting the need for a noninvasive tool for the characterization of lung microstructure and function. Theoretical diffusion models, like the model of xenon exchange (MOXE), interrogate alveolar gas exchange by predicting the uptake of inert hyperpolarized (HP) ¹²⁹Xe gas measured with HP ¹²⁹Xe magnetic resonance spectroscopy (MRS). To investigate HP ¹²⁹Xe MRS as a tool for noninvasive characterization of pulmonary microstructural and functional changes in vivo, HP ¹²⁹Xe gas exchange data were acquired in an oxygen exposure rat model of BPD that recapitulates the fewer and larger distal airways and pulmonary vascular stunting characteristics of BPD. Gas exchange parameters from MOXE, including airspace mean chord length (L_m), apparent hematocrit in the pulmonary capillaries (HCT), and pulmonary capillary transit time (t_x), were compared with airspace mean axis length and area density (MAL and ρ_A) and percentage area of tissue and air (PTA and PAA) from histology. L_m was significantly larger in the exposed rats (P = 0.003) and correlated with MAL, ρ_A, PTA, and PAA (0.59<|ρ|<0.66 and P < 0.05). Observed increase in HCT (P = 0.012) and changes in t_x are also discussed. These findings support the use of HP ¹²⁹Xe MRS for detecting fewer, enlarged distal airways in this rat model of BPD, and potentially in humans.

Evaluating post-bronchodilator response in well-controlled paediatric severe asthma using hyperpolarised 129Xe-MRI: A pilot study

INTRODUCTION

Pulmonary function tests (PFTs) are the main objective measures used to assess asthma in children. However, PFTs provide a global measure of lung function. Hyperpolarised xenon-129 magnetic resonance imaging (129Xe-MRI) can assess lung function spatially. This cross-sectional cohort study aimed to evaluate the use of 129Xe-MRI in detecting ventilation abnormalities in children with well-controlled severe asthma pre- and post-bronchodilator (BD).

METHOD

Six healthy children (aged 11 ± 3) and six with well-controlled severe asthma (14 ± 1) underwent spirometry, multiple breath washout (MBW), and 129Xe-MRI. These tests were repeated post-BD in the asthma cohort. Image analysis was performed in MATLAB. Wilcoxon signed-rank test, repeated measures analysis of variance (ANOVA), and Spearman's rank correlation coefficient were used for statistical analysis.

RESULTS

A significantly higher number of ventilation defects were found in the asthma cohort pre-BD compared to the healthy participants and post-BD within the asthma cohort (p = 0.02 and 0.01). A greater number of wedge-shaped defects were detected in the asthma cohort pre-BD compared to healthy participants and post-BD within the asthma cohort (p = 0.01 and 0.008, respectively). 129Xe ventilation defect percentage (VDP) and coefficient of variation (CoV) were significantly higher in the asthma cohort pre-BD compared to the healthy cohort (p = 0.006 for both). VDP and CoV were reduced significantly post-BD in the asthma cohort, to a level where there was no longer a significant difference between the two cohorts.

CONCLUSION

129Xe-MRI is a sensitive marker of ventilation inhomogeneity in paediatric severe asthma and may potentially be used as a biomarker to assess disease progression and therapeutic response.

Automated Low-Cost In Situ IR and NMR Spectroscopy Characterization of Clinical-Scale 129Xe Spin-Exchange Optical Pumping

We present on the utility of in situ nuclear magnetic resonance (NMR) and near-infrared (NIR) spectroscopic techniques for automated advanced analysis of the ¹²⁹Xe hyperpolarization process during spin-exchange optical pumping (SEOP). The developed software protocol, written in the MATLAB programming language, facilitates detailed characterization of hyperpolarized contrast agent production efficiency based on determination of key performance indicators, including the maximum achievable ¹²⁹Xe polarization, steady-state Rb-¹²⁹Xe spin-exchange and ¹²⁹Xe polarization build-up rates, ¹²⁹Xe spin-relaxation rates, and estimates of steady-state Rb electron polarization. Mapping the dynamics of ¹²⁹Xe polarization and relaxation as a function of SEOP temperature enables systematic optimization of the batch-mode SEOP process. The automated analysis of a typical experimental data set, encompassing ∼300 raw NMR and NIR spectra combined across six different SEOP temperatures, can be performed in under 5 min on a laptop computer. The protocol is designed to be robust in operation on any batch-mode SEOP hyperpolarizer device. In particular, we demonstrate the implementation of a combination of low-cost NIR and low-frequency NMR spectrometers (∼$1,100 and ∼$300 respectively, ca. 2020) for use in the described protocols. The demonstrated methodology will aid in the characterization of NMR hyperpolarization hardware in the context of SEOP and other hyperpolarization techniques for more robust and less expensive clinical production of HP ¹²⁹Xe and other contrast agents.

Low-Flammable Parahydrogen-Polarized MRI Contrast Agents

Many MRI contrast agents formed with the parahydrogen-induced polarization (PHIP) technique exhibit biocompatible profiles. In the context of respiratory imaging with inhalable molecular contrast agents, the development of nonflammable contrast agents would nonetheless be highly beneficial for the biomedical translation of this sensitive, high-throughput and affordable hyperpolarization technique. To this end, we assess the hydrogenation kinetics, the polarization levels and the lifetimes of PHIP hyperpolarized products (acids, ethers and esters) at various degrees of fluorine substitution. The results highlight important trends as a function of molecular structure that are instrumental for the design of new, safe contrast agents for in vivo imaging applications of the PHIP technique, with an emphasis on the highly volatile group of ethers used as inhalable anesthetics.

A semi-empirical model to optimize continuous-flow hyperpolarized 129Xe production under practical cryogenic-accumulation conditions

Continuous-flow spin exchange optical pumping (SEOP) with cryogenic accumulation is a powerful technique to generate multiple, large volumes of hyperpolarized (HP) 129Xe in rapid succession. It enables a range of studies, from dark matter tracking to preclinical and clinical MRI. Multiple analytical models based on first principles atomic physics and device-specific design features have been proposed for individual processes within HP 129Xe production. However, the modeling efforts have not yet integrated all the steps involved in practical, large volume HP 129Xe production process (e.g., alkali vapor generation, continuous-flow SEOP, and cryogenic accumulation). Here, we use a simplified analytical model that couples both SEOP and cryogenic accumulation, incorporating only two system-specific empirical parameters: the longitudinal relaxation time of the polycrystalline 129Xe "snow', T1snow, generated during cryogenic accumulation, and 2) the average Rb density during active, continuous-flow polarization. By fitting the model to polarization data collected from >140 L of 129Xe polarized across a range of flow and volume conditions, the estimates for Rb density and T1snow were 1.6 ± 0.1 × 1013 cm-3 and 84 ± 5 min, respectively - each notably less than expected based on previous literature. Together, these findings indicate that 1) earlier polarization predictions were hindered by miscalculated Rb densities, and 2) polarization is not optimized by maximizing SEOP efficiency with a low concentration 129Xe, but rather by using richer 129Xe-buffer gas blends that enable faster accumulation. Accordingly, modeling and experimentation revealed the optimal fraction of 129Xe, f, in the 129Xe-buffer gas blend was ~2%. Further, if coupled with modest increases in laser power, the model predicts liter volumes of HP 129Xe with polarizations exceeding 60% could be generated routinely in only tens of minutes.

Parahydrogen-Induced Polarization of Diethyl Ether Anesthetic

The growing interest in magnetic resonance imaging (MRI) for assessing regional lung function relies on the use of nuclear spin hyperpolarized gas as a contrast agent. The long gas-phase lifetimes of hyperpolarized 129 Xe make this inhalable contrast agent acceptable for clinical research today despite limitations such as high cost, low throughput of production and challenges of 129 Xe imaging on clinical MRI scanners, which are normally equipped with proton detection only. We report on low-cost and high-throughput preparation of proton-hyperpolarized diethyl ether, which can be potentially employed for pulmonary imaging with a nontoxic, simple, and sensitive overall strategy using proton detection commonly available on all clinical MRI scanners. Diethyl ether is hyperpolarized by pairwise parahydrogen addition to vinyl ethyl ether and characterized by 1 H NMR spectroscopy. Proton polarization levels exceeding 8 % are achieved at near complete chemical conversion within seconds, causing the activation of radio amplification by stimulated emission radiation (RASER) throughout detection. Although gas-phase T1 relaxation of hyperpolarized diethyl ether (at partial pressure of 0.5 bar) is very efficient, with T1 of ca. 1.2 second, we demonstrate that, at low magnetic fields, the use of long-lived singlet states created via pairwise parahydrogen addition extends the relaxation decay by approximately threefold, paving the way to bioimaging applications and beyond.

Molecular Sensing with Host Systems for Hyperpolarized 129Xe

Hyperpolarized noble gases have been used early on in applications for sensitivity enhanced NMR. 129Xe has been explored for various applications because it can be used beyond the gas-driven examination of void spaces. Its solubility in aqueous solutions and its affinity for hydrophobic binding pockets allows "functionalization" through combination with host structures that bind one or multiple gas atoms. Moreover, the transient nature of gas binding in such hosts allows the combination with another signal enhancement technique, namely chemical exchange saturation transfer (CEST). Different systems have been investigated for implementing various types of so-called Xe biosensors where the gas binds to a targeted host to address molecular markers or to sense biophysical parameters. This review summarizes developments in biosensor design and synthesis for achieving molecular sensing with NMR at unprecedented sensitivity. Aspects regarding Xe exchange kinetics and chemical engineering of various classes of hosts for an efficient build-up of the CEST effect will also be discussed as well as the cavity design of host molecules to identify a pool of bound Xe. The concept is presented in the broader context of reporter design with insights from other modalities that are helpful for advancing the field of Xe biosensors.

Cyst Ventilation Heterogeneity and Alveolar Airspace Dilation as Early Disease Markers in Lymphangioleiomyomatosis

Rationale: Lymphangioleiomyomatosis (LAM) is a rare disease associated with cystic destruction of the pulmonary parenchyma and chronic respiratory failure, and there are trials underway to determine if early intervention can prevent disease progression. An imaging technique that is sensitive to early regional disease would therefore be valuable for patient care and clinical trials.Objectives: We postulated that hyperpolarized ¹²⁹Xe MRI would be sensitive to ventilation abnormalities and alveolar airspace dilation in patients with mild LAM disease and normal pulmonary function and that ¹²⁹Xe MRI would reveal important features of cyst ventilation.Methods: ¹²⁹Xe ventilation and diffusion-weighted MR images were acquired in 22 patients with LAM during two breath-holds of hyperpolarized ¹²⁹Xe. ¹²⁹Xe ventilation defect percentage (VDP; percentage of voxels <60% of the mean whole-lung ¹²⁹Xe MRI signal) and apparent diffusion coefficient (ADC), a measure of alveolar airspace size, were quantified and compared with pulmonary function test parameters with Spearman statistics. Sixteen patients with LAM had a recent, clinical chest computed tomography (CT) scan available, and cyst ventilation was assessed by thresholding cysts on the CT images and registration to the ¹²⁹Xe ventilation images.Results: Ventilation deficits were observed in all patients with LAM, including those with normal pulmonary function and few cysts, and the mean VDP was 19.2% (95% confidence interval [CI], 14.8-23.5%). ¹²⁹Xe VDP was strongly correlated with forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) ratio (r = -0.51, P = 0.02) and diffusing capacity of the lung for carbon monoxide (Dl_CO) (r = -0.60, P = 0.009) but not with FEV₁ (r = -0.33, P = 0.13), likely because of the sensitivity of ¹²⁹Xe MRI to mild LAM disease in patients with normal FEV₁. The mean ADC was 0.048 cm²/s (95% CI, 0.042-0.053 cm²/s). In many cases, ADC was elevated relative to previously reported values in adults, and ADC was correlated with FEV₁, FEV₁/FVC ratio, and Dl_CO (P ≤ 0.02 for all). Co-registered ¹²⁹Xe MRI and CT imaging revealed considerable ventilation heterogeneity within individual patients with LAM and across patients with similarly sized cysts.Conclusions: ¹²⁹Xe MRI provides a means to assess the complex regional ventilation and alveolar airspace size changes of LAM with high sensitivity and may be a clinically useful future tool for screening, managing patients, and measuring treatment efficacy.

Helium-rich mixtures for improved batch-mode clinical-scale spin-exchange optical pumping of Xenon-129

We present studies of spin-exchange optical pumping (SEOP) using ternary xenon-nitrogen-helium gas mixtures at high xenon partial pressures (up to 1330 Torr partial pressure at loading, out of 2660 Torr total pressure) in a 500-mL volume SEOP cell, using two automated batch-mode clinical-scale ¹²⁹Xe hyperpolarizers operating under continuous high-power (~170 W) pump laser irradiation. In this pilot study, we explore SEOP in gas mixtures with up to 45% ⁴He content under a wide range of experimental conditions. When an aluminum jacket cooling/heating design was employed (GEN-3 hyperpolarizer), ¹²⁹Xe polarization (%P_Xe) of 55.9 ± 0.9% was observed with mono-exponential build-up rate γ_SEOP of 0.049 ± 0.001 min^-1 for the ⁴He-rich mixture (1000 Torr Xe/900 Torr He, 100 Torr N₂), compared to %P_Xe of 49.3 ± 3.3% at γ_SEOP of 0.035 ± 0.004 min^-1 for the N₂-rich gas mixture (1000 Torr Xe/100 Torr He, 900 Torr N₂). When forced-air cooling/heating was used (GEN-2 hyperpolarizer), %P_Xe of 83.9 ± 2.7% was observed at γ_SEOP of 0.045 ± 0.005 min^-1 for the ⁴He-rich mixture (1000 Torr Xe/900 Torr He, 100 Torr N₂), compared to %P_Xe of 73.5 ± 1.3% at γ_SEOP of 0.028 ± 0.001 min^-1 for the N₂-rich gas mixture (1000 Torr Xe and 1000 Torr N₂). Additionally, %P_Xe of 72.6 ± 1.4% was observed at a build-up rate γ_SEOP of 0.041 ± 0.003 min^-1 for a super-high-density ⁴He-rich mixture (1330 Torr Xe/1200 Torr ⁴He/130 Torr N₂), compared to %P_Xe = 56.6 ± 1.3% at a build-up rate of γ_SEOP of 0.034 ± 0.002 min^-1 for an N₂-rich mixture (1330 Torr Xe/1330 Torr N₂) using forced air cooling/heating. The observed SEOP hyperpolarization performance under these conditions corresponds to %P_Xe improvement by a factor of 1.14 ± 0.04 at 1000 Torr Xe density and by up to a factor of 1.28 ± 0.04 at 1330 Torr Xe density at improved SEOP build-up rates by factors of 1.61 ± 0.18 and 1.21 ± 0.11 respectively. Record %P_Xe levels have been obtained here: 83.9 ± 2.7% at 1000 Torr Xe partial pressure and 72.6 ± 1.4% at 1330 Torr Xe partial pressure. In addition to improved thermal stability for SEOP, the use of ⁴He-rich gas mixtures also reduces the overall density of produced inhalable HP contrast agents; this property may be desirable for HP ¹²⁹Xe inhalation by human subjects in clinical settings-especially in populations with heavily impaired lung function. The described approach should enjoy ready application in the production of inhalable ¹²⁹Xe contrast agent with near-unity ¹²⁹Xe nuclear spin polarization.

Batch-Mode Clinical-Scale Optical Hyperpolarization of Xenon-129 Using an Aluminum Jacket with Rapid Temperature Ramping

We present spin-exchange optical pumping (SEOP) using a third-generation (GEN-3) automated batch-mode clinical-scale ¹²⁹Xe hyperpolarizer utilizing continuous high-power (∼170 W) pump laser irradiation and a novel aluminum jacket design for rapid temperature ramping of xenon-rich gas mixtures (up to 2 atm partial pressure). The aluminum jacket design is capable of heating SEOP cells from ambient temperature (typically 25 °C) to 70 °C (temperature of the SEOP process) in 4 min, and perform cooling of the cell to the temperature at which the hyperpolarized gas mixture can be released from the hyperpolarizer (with negligible amounts of Rb metal leaving the cell) in approximately 4 min, substantially faster (by a factor of 6) than previous hyperpolarizer designs relying on air heat exchange. These reductions in temperature cycling time will likely be highly advantageous for the overall increase of production rates of batch-mode (i.e., stopped-flow) ¹²⁹Xe hyperpolarizers, which is particularly beneficial for clinical applications. The additional advantage of the presented design is significantly improved thermal management of the SEOP cell. Accompanying the heating jacket design and performance, we also evaluate the repeatability of SEOP experiments conducted using this new architecture, and present typically achievable hyperpolarization levels exceeding 40% at exponential build-up rates on the order of 0.1 min^-1.

High Xe density, high photon flux, stopped-flow spin-exchange optical pumping: Simulations versus experiments

Spin-exchange optical pumping (SEOP) can enhance the NMR sensitivity of noble gases by up to five orders of magnitude at Tesla-strength magnetic fields. SEOP-generated hyperpolarised (HP) ¹²⁹Xe is a promising contrast agent for lung imaging but an ongoing barrier to widespread clinical usage has been economical production of sufficient quantities with high ¹²⁹Xe polarisation. Here, the 'standard model' of SEOP, which was previously used in the optimisation of continuous-flow ¹²⁹Xe polarisers, is modified for validation against two Xe-rich stopped-flow SEOP datasets. We use this model to examine ways to increase HP Xe production efficiency in stopped-flow ¹²⁹Xe polarisers and provide further insight into the underlying physics of Xe-rich stopped-flow SEOP at high laser fluxes.

Nanoparticle-Based Contrast Agents for 129Xe HyperCEST NMR and MRI Applications

Spin hyperpolarization techniques have enabled important advancements in preclinical and clinical MRI applications to overcome the intrinsic low sensitivity of nuclear magnetic resonance. Functionalized xenon biosensors represent one of these approaches. They combine two amplification strategies, namely, spin exchange optical pumping (SEOP) and chemical exchange saturation transfer (CEST). The latter one requires host structures that reversibly bind the hyperpolarized noble gas. Different nanoparticle approaches have been implemented and have enabled molecular MRI with 129Xe at unprecedented sensitivity. This review gives an overview of the Xe biosensor concept, particularly how different nanoparticles address various critical aspects of gas binding and exchange, spectral dispersion for multiplexing, and targeted reporter delivery. As this concept is emerging into preclinical applications, comprehensive sensor design will be indispensable in translating the outstanding sensitivity potential into biomedical molecular imaging applications.

Dynamic susceptibility contrast 19 F-MRI of inhaled perfluoropropane: a novel approach to combined pulmonary ventilation and perfusion imaging

PURPOSE

To assess alveolar perfusion by applying dynamic susceptibility contrast MRI to ¹⁹ F-MRI of inhaled perfluoropropane (PFP). We hypothesized that passage of gadolinium-based contrast agent (GBCA) through the pulmonary microvasculature would reduce magnetic susceptibility differences between water and gas components of the lung, elevating the T 2 ∗ of PFP.

METHODS

Lung-representative phantoms were constructed of aqueous PFP-filled foams to characterize the impact of aqueous/gas phase magnetic susceptibility differences on PFP T 2 ∗ . Aqueous phase magnetic susceptibility was modulated by addition of different concentrations of GBCA. In vivo studies were performed to measure the impact of intravenously administered GBCA on the T 2 ∗ of inhaled PFP in mice (7.0 Tesla) and in healthy volunteers (3.0 Tesla).

RESULTS

Perfluoropropane T 2 ∗ was sensitive to modulation of magnetic susceptibility difference between gas and water components of the lung, both in phantom models and in vivo. Negation of aqueous/gas phase magnetic susceptibility difference was achieved in lung-representative phantoms and in mice, resulting in a ~2 to 3× elevation in PFP T 2 ∗ (3.7 to 8.5 ms and 0.7 to 2.6 ms, respectively). Human studies demonstrated a transient elevation of inhaled PFP T 2 ∗ (1.50 to 1.64 ms) during passage of GBCA bolus through the lung circulation, demonstrating sensitivity to lung perfusion.

CONCLUSION

We demonstrate indirect detection of a GBCA in the pulmonary microvasculature via changes to the T 2 ∗ of gas phase PFP within directly adjacent alveoli. This approach holds potential for assessing alveolar perfusion by dynamic susceptibility contrast ¹⁹ F-MRI of inhaled PFP, with concurrent assessment of lung ventilation properties, relevant to lung physiology and disease.

Clinical-Scale Batch-Mode Production of Hyperpolarized Propane Gas for MRI

NMR spectroscopy and imaging (MRI) are two of the most important methods to study structure, function, and dynamics from atom to organism scale. NMR approaches often suffer from an insufficient sensitivity, which, however, can be transiently boosted using hyperpolarization techniques. One of these techniques is parahydrogen-induced polarization, which has been used to produce catalyst-free hyperpolarized propane gas with proton polarization that is 3 orders of magnitude greater than equilibrium thermal polarization at a 1.5 T field of a clinical MRI scanner. Here we show that more than 0.3 L of hyperpolarized propane gas can be produced in 2 s. This production rate is more than an order of magnitude greater than that demonstrated previously, and the reported production rate is comparable to that employed for in-human MRI using HP noble gas (e.g., ¹²⁹Xe) produced via a spin exchange optical pumping (SEOP) hyperpolarization technique. We show that high polarization values can be retained despite the significant increase in the production rate of hyperpolarized propane. The enhanced signals of produced hyperpolarized propane gas were revealed by stopped-flow MRI visualization at 4.7 T. Achieving this high production rate enables the future use of this compound (already approved for unlimited use in foods by the corresponding regulating agencies, e.g., FDA in the USA, and more broadly as an E944 food additive) as a new inhalable contrast agent for diagnostic detection via MRI.

Mapping and correcting hyperpolarized magnetization decay with radial keyhole imaging

PURPOSE

Hyperpolarized (HP) media enable biomedical imaging applications that cannot be achieved with conventional MRI contrast agents. Unfortunately, quantifying HP images is challenging, because relaxation and radio-frequency pulsing generate spatially varying signal decay during acquisition. We demonstrate that, by combining center-out k-space sampling with postacquisition keyhole reconstruction, voxel-by-voxel maps of regional HP magnetization decay can be generated with no additional data collection.

THEORY AND METHODS

Digital phantom, HP ¹²⁹ Xe phantom, and in vivo ¹²⁹ Xe human (N = 4 healthy; N = 2 with cystic fibrosis) imaging was performed using radial sampling. Datasets were reconstructed using a postacquisition keyhole approach in which 2 temporally resolved images were created and used to generate maps of regional magnetization decay following a simple analytical model.

RESULTS

Mean, keyhole-derived decay terms showed excellent agreement with the decay used in simulations (R² = 0.996) and with global attenuation terms in HP ¹²⁹ Xe phantom imaging (R² > 0.97). Mean regional decay from in vivo imaging agreed well with global decay values and displayed spatial heterogeneity that matched expected variations in flip angle and oxygen partial pressure. Moreover, these maps could be used to correct variable signal decay across the image volume.

CONCLUSIONS

We have demonstrated that center-out trajectories combined with keyhole reconstruction can be used to map regional HP signal decay and to quantitatively correct images. This approach may be used to improve the accuracy of quantitative measures obtained from hyperpolarized media. Although validated with gaseous HP ¹²⁹ Xe in this work, this technique can be generalized to any hyperpolarized agent.

T1 , T1 contrast, and Ernst-angle images of four rat-lung pathologies

PURPOSE

To initiate the archive of relaxation-weighted images that may help discriminate between pulmonary pathologies relevant to acute respiratory distress syndrome. MRI has the ability to distinguish pathologies by providing a variety of different contrast mechanisms. Lungs have historically been difficult to image with MRI but image quality is sufficient to begin cataloging the appearance of pathologies in T₁ - and T₂ -weighted images. This study documents T₁ and the use of T₁ contrast with four experimental rat lung pathologies.

METHODS

Inversion-recovery and spoiled steady state images were made at 1.89 T to measure T₁ and document contrast in rats with atelectasis, lipopolysaccharide-induced inflammation, ventilator-induced lung injury (VILI), and injury from saline lavage. Higher-resolution Ernst-angle images were made to see patterns of lung infiltrations.

RESULTS

T₁ -weighted images showed minimal contrast between pathologies, similar to T₁ -weighted images of other soft tissues. Images taken shortly after magnetization inversion and displayed with inverted contrast highlight lung pathologies. Ernst-angle images distinguish the effects of T₁ relaxation and spin density and display distinctive patterns. T₁ for pathologies were: atelectasis, 1.25 ± 0.046 s; inflammation from instillation of lipopolysaccharide, 1.24 ± 0.015 s; VILI, 1.55 ± 0.064 s (p = 0.0022 vs. normal lung); and injury from saline lavage, 1.90±0.080 s (p = 0.0022 vs. normal lung; p = 0.0079 vs. VILI). T₁ of normal lung and erector spinae muscle were 1.25 ± 0.028 s and 1.02 ± 0.027 s, respectively (p = 0.0022).

CONCLUSIONS

Traditional T₁ -weighting is subtle. However, images made with inverted magnetization and inverted contrast highlight the pathologies and Ernst-angle images aid in distinguishing pathologies.

Heterogeneous Parahydrogen Pairwise Addition to Cyclopropane

Hyperpolarized gases revolutionize functional pulmonary imaging. Hyperpolarized propane is a promising emerging contrast agent for pulmonary MRI. Unlike hyperpolarized noble gases, proton-hyperpolarized propane gas can be imaged using conventional MRI scanners with proton imaging capability. Moreover, it is non-toxic odorless anesthetic. Furthermore, propane hyperpolarization can be accomplished by pairwise addition of parahydrogen to propylene. Here, we demonstrate the feasibility of propane hyperpolarization via hydrogenation of cyclopropane with parahydrogen. 1 H propane polarization up to 2.4 % is demonstrated here using 82 % parahydrogen enrichment and heterogeneous Rh/TiO2 hydrogenation catalyst. This level of polarization is several times greater than that obtained with propylene as a precursor under the same conditions despite the fact that direct pairwise addition of parahydrogen to cyclopropane may also lead to formation of propane with NMR-invisible hyperpolarization due to magnetic equivalence of nascent parahydrogen protons in two CH3 groups. NMR-visible hyperpolarized propane demonstrated here can be formed only via a reaction pathway involving cleavage of at least one C-H bond in the reactant molecule. The resulting NMR signal enhancement of hyperpolarized propane was sufficient for 2D gradient echo MRI of ∼5.5 mL phantom with 1×1 mm2 spatial resolution and 64×64 imaging matrix despite relatively low chemical conversion of cyclopropane substrate.

Assessment of pulmonary structure-function relationships in young children and adolescents with cystic fibrosis by multivolume proton-MRI and CT

BACKGROUND

Lung disease is the most frequent cause of morbidity and mortality in patients with cystic fibrosis (CF), and there is a shortage of sensitive biomarkers able to regionally monitor disease progression and to assess early responses to therapy.

PURPOSE

To determine the feasibility of noncontrast-enhanced multivolume MRI, which assesses intensity changes between expiratory and inspiratory breath-hold images, to detect and quantify regional ventilation abnormalities in CF lung disease, with a focus on the structure-function relationship.

STUDY TYPE

Retrospective.

POPULATION

Twenty-nine subjects, including healthy young children (n = 9, 7-37 months), healthy adolescents (n = 4, 14-22 years), young children with CF lung disease (n = 10, 7-47 months), and adolescents with CF lung disease (n = 6, 8-18 years) were studied.

FIELD STRENGTH/SEQUENCE

3D spoiled gradient-recalled sequence at 1.5T.

ASSESSMENT

Subjects were scanned during breath-hold at functional residual capacity (FRC) and total lung capacity (TLC) through noncontrast-enhanced MRI and CT. Expiratory-inspiratory differences in MR signal-intensity (Δ1 H-MRI) and CT-density (ΔHU) were computed to estimate regional ventilation. MR and CT images were also evaluated using a CF-specific scoring system.

STATISTICAL TESTS

Quadratic regression, Spearman's correlation, one-way analysis of variance (ANOVA).

RESULTS

Δ1 H-MRI maps were sensitive to ventilation heterogeneity related to gravity dependence in healthy lung and to ventilation impairment in CF lung disease. A high correlation was found between MRI and CT ventilation maps (R2  = 0.79, P < 0.001). Globally, Δ1 H-MRI and ΔHU decrease with increasing morphological score (respectively, R2  = 0.56, P < 0.001 and R2  = 0.31, P < 0.001). Locally, Δ1 H-MRI was higher in healthy regions (median 15%) compared to regions with bronchiectasis, air trapping, consolidation, and to segments fed by airways with bronchial wall thickening (P < 0.001).

DATA CONCLUSION

Multivolume noncontrast-enhanced MRI, as a nonionizing imaging modality that can be used on nearly any MRI scanner without specialized equipment or gaseous tracers, may be particularly valuable in CF care, providing a new imaging biomarker to detect early alterations in regional lung structure-function.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2018;48:531-542.

3He diffusion MRI in human lungs

Hyperpolarized 3He gas allows the air spaces of the lungs to be imaged via MRI. Imaging of restricted diffusion is addressed here, which allows the microstructure of the lung to be characterized through the physical restrictions to gas diffusion presented by airway and alveolar walls in the lung. Measurements of the apparent diffusion coefficient (ADC) of 3He at time scales of milliseconds and seconds are compared; measurement of acinar airway sizes by determination of the microscopic anisotropy of diffusion is discussed. This is where Dr. JJH Ackerman's influence was greatest in aiding the formation of the Washington University 3He group, involving early a combination of physicists, radiologists, and surgeons, as the first applications of 3He ADC were to COPD and its destruction/modification of lung microstructure via emphysema. The sensitivity of the method to early COPD is demonstrated, as is its validation by direct comparison to histology. More recently the method has been used broadly in adult and pediatric obstructive lung diseases, from severe asthma to cystic fibrosis to bronchopulmonary dysplasia, a result of premature birth. These applications of the technique are discussed briefly.

Using imaging as a biomarker for asthma

There have been significant advancements in the various imaging techniques being used for the evaluation of asthmatic patients, both from a clinical and research perspective. Imaging characteristics can be used to identify specific asthmatic phenotypes and provide a more detailed understanding of endotypes contributing to the pathophysiology of the disease. Computed tomography, magnetic resonance imaging, and positron emission tomography can be used to assess pulmonary structure and function. It has been shown that specific airway and lung density measurements using computed tomography correlate with clinical parameters, including severity of disease and pathology, but also provide unique phenotypes. Hyperpolarized ¹²⁹Xe and ³He are gases used as contrast media for magnetic resonance imaging that provide measurement of distal lung ventilation reflecting small-airway disease. Positron emission tomography can be useful to identify and target lung inflammation in asthmatic patients. Furthermore, imaging techniques can serve as a potential biomarker and be used to assess response to therapies, including newer biological treatments and bronchial thermoplasty.

Toward Hyperpolarized 19 F Molecular Imaging via Reversible Exchange with Parahydrogen

Fluorine-19 has high NMR detection sensitivity-similar to that of protons-owing to its large gyromagnetic ratio and high natural abundance (100 %). Unlike protons, however, fluorine-19 (¹⁹ F) has a negligible occurrence in biological objects, as well as a more sensitive chemical shift. As a result, in vivo ¹⁹ F NMR spectroscopy and MR imaging offer advantages of negligible background signal and sensitive reporting of the local molecular environment. Here we report on NMR hyperpolarization of ¹⁹ F nuclei using reversible exchange reactions with parahydrogen gas as the source of nuclear spin order. NMR signals of 3-fluoropyridine were enhanced by ≈100 fold, corresponding to 0.3 % ¹⁹ F nuclear spin polarization (at 9.4 T), using about 50 % parahydrogen. While future optimization efforts will likely significantly increase the hyperpolarization levels, we already demonstrate the utility of ¹⁹ F hyperpolarization for high-resolution hyperpolarized ¹⁹ F imaging and hyperpolarized ¹⁹ F pH sensing.

NMR Hyperpolarization Techniques of Gases

Nuclear spin polarization can be significantly increased through the process of hyperpolarization, leading to an increase in the sensitivity of nuclear magnetic resonance (NMR) experiments by 4-8 orders of magnitude. Hyperpolarized gases, unlike liquids and solids, can often be readily separated and purified from the compounds used to mediate the hyperpolarization processes. These pure hyperpolarized gases enabled many novel MRI applications including the visualization of void spaces, imaging of lung function, and remote detection. Additionally, hyperpolarized gases can be dissolved in liquids and can be used as sensitive molecular probes and reporters. This Minireview covers the fundamentals of the preparation of hyperpolarized gases and focuses on selected applications of interest to biomedicine and materials science.

Feasibility, tolerability and safety of pediatric hyperpolarized 129Xe magnetic resonance imaging in healthy volunteers and children with cystic fibrosis

BACKGROUND

Hyperpolarized ¹²⁹Xe is a promising contrast agent for MRI of pediatric lung function, but its safety and tolerability in children have not been rigorously assessed.

OBJECTIVE

To assess the feasibility, safety and tolerability of hyperpolarized ¹²⁹Xe gas as an inhaled contrast agent for pediatric pulmonary MRI in healthy control subjects and in children with cystic fibrosis.

MATERIALS AND METHODS

Seventeen healthy control subjects (ages 6-15 years, 11 boys) and 11 children with cystic fibrosis (ages 8-16 years, 4 boys) underwent ¹²⁹Xe MRI, receiving up to three doses of ¹²⁹Xe gas prepared by either a commercially available or a homebuilt ¹²⁹Xe polarizer. Subject heart rate and SpO₂ were monitored for 2 min post inhalation and compared to resting baseline values. Adverse events were reported via follow-up phone call at days 1 and 30 (range ±7 days) post-MRI.

RESULTS

All children tolerated multiple doses of ¹²⁹Xe, and no children withdrew from the study. Relative to baseline, most children who received a full dose of gas for imaging (10 of 12 controls and 8 of 11 children with cystic fibrosis) experienced a nadir in SpO₂ (mean -6.0 ± standard deviation 7.2%, P≤0.001); however within 2 min post inhalation SpO₂ values showed no significant difference from baseline (P=0.11). There was a slight elevation in heart rate (mean +6.6 ± 13.9 beats per minute [bpm], P=0.021), which returned from baseline within 2 min post inhalation (P=0.35). Brief side effects related to the anesthetic properties of xenon were mild and quickly resolved without intervention. No serious or severe adverse events were observed; in total, four minor adverse events (14.3%) were reported following ¹²⁹Xe MRI, but all were deemed unrelated to the study.

CONCLUSION

The feasibility, safety and tolerability of ¹²⁹Xe MRI has been assessed in a small group of children as young as 6 years. SpO₂ changes were consistent with the expected physiological effects of a short anoxic breath-hold, and other mild side effects were consistent with the known anesthetic properties of xenon and with previous safety assessments of ¹²⁹Xe MRI in adults. Hyperpolarized ¹²⁹Xe is a safe and well-tolerated inhaled contrast agent for pulmonary MR imaging in healthy children and in children with cystic fibrosis who have mild to moderate lung disease.

Hyperpolarized (129) Xe MRI using isobutene as a new quenching gas

The use of a quenching gas, isobutene, with a low vapor pressure was investigated to enhance the utility of hyperpolarized (129) Xe (HP Xe) MRI. Xenon mixed with isobutene was hyperpolarized using a home-built apparatus for continuously producing HP Xe. The isobutene was then readily liquefied and separated almost totally by continuous condensation at about 173 K, because the vapor pressure of isobutene (0.247 kPa) is much lower than that of Xe (157 kPa). Finally, the neat Xe gas was continuously delivered to mice by spontaneous inhalation. The HP Xe MRI was enhanced twofold in polarization level and threefold in signal intensity when isobutene was adopted as the quenching gas instead of N2 . The usefulness of the HP Xe MRI was verified by application to pulmonary functional imaging of spontaneously breathing mice, where the parameters of fractional ventilation (ra ) and gas exchange (fD ) were evaluated, aiming at future extension to preclinical studies. This is the first application of isobutene as a quenching gas for HP Xe MRI.

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

In the last two decades, functional imaging of the lungs using hyperpolarized noble gases has entered the clinical stage. Both helium (³He) and xenon (¹²⁹Xe) gas have been thoroughly investigated for their ability to assess both the global and regional patterns of lung ventilation. With advances in polarizer technology and the current transition towards the widely available ¹²⁹Xe gas, this method is ready for translation to the clinic. Currently, hyperpolarized (HP) noble gas lung MRI is limited to selected academic institutions; yet, the promising results from initial clinical trials have drawn the attention of the pulmonary medicine community. HP ¹²⁹Xe MRI provides not only 3-dimensional ventilation imaging, but also unique capabilities for probing regional lung physiology. In this review article, we aim to (1) provide a brief overview of current ventilation MR imaging techniques, (2) emphasize the role of HP ¹²⁹Xe MRI within the array of different imaging strategies, (3) discuss the unique imaging possibilities with HP ¹²⁹Xe MRI, and (4) propose clinical applications.

Molecular hydrogen and catalytic combustion in the production of hyperpolarized 83Kr and 129Xe MRI contrast agents

Hyperpolarized (hp) (83)Kr is a promising MRI contrast agent for the diagnosis of pulmonary diseases affecting the surface of the respiratory zone. However, the distinct physical properties of (83)Kr that enable unique MRI contrast also complicate the production of hp (83)Kr. This work presents a previously unexplored approach in the generation of hp (83)Kr that can likewise be used for the production of hp (129)Xe. Molecular nitrogen, typically used as buffer gas in spin-exchange optical pumping (SEOP), was replaced by molecular hydrogen without penalty for the achievable hyperpolarization. In this particular study, the highest obtained nuclear spin polarizations were P =29% for(83)Kr and P= 63% for (129)Xe. The results were reproduced over many SEOP cycles despite the laser-induced on-resonance formation of rubidium hydride (RbH). Following SEOP, the H2 was reactively removed via catalytic combustion without measurable losses in hyperpolarized spin state of either (83)Kr or (129)Xe. Highly spin-polarized (83)Kr can now be purified for the first time, to our knowledge, to provide high signal intensity for the advancement of in vivo hp (83)Kr MRI. More generally, a chemical reaction appears as a viable alternative to the cryogenic separation process, the primary purification method of hp(129)Xe for the past 2 1/2 decades. The inherent simplicity of the combustion process will facilitate hp (129)Xe production and should allow for on-demand continuous flow of purified and highly spin-polarized (129)Xe.

Synchronous Spin-Exchange Optical Pumping

We demonstrate a new approach to precision NMR with hyperpolarized gases designed to mitigate NMR shifts due to the alkali spin-exchange field. The NMR bias field is implemented as a sequence of alkali (Rb) 2π pulses, allowing the Rb polarization to be optically pumped transverse to the bias field. When the Rb polarization is modulated at the noble-gas (Xe) NMR resonance, spin-exchange collisions buildup a precessing transverse Xe polarization. We study and mitigate novel NMR broadening effects due to the oscillating spin-exchange field. Spin-exchange frequency shifts are suppressed 2500×, and Rb magnetometer gain measurements project photon shot-noise limited NMR frequency uncertainties below 10  nHz/sqrt[Hz].

Newer Imaging Techniques for Bronchopulmonary Dysplasia

Imaging has played a vital role in the clinical assessment of bronchopulmonary dysplasia (BPD) since its first recognition. In this review, how chest radiograph, computerized tomography (CT), nuclear medicine, and MRI have contributed to the understanding of BPD pathology and how emerging advancements in these methods, including low-dose and quantitative CT, sophisticated proton and hyperpolarized-gas MRI, influence the future of BPD imaging are discussed.

Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment

RATIONALE

Bronchopulmonary dysplasia (BPD) is a prevalent yet poorly characterized pulmonary complication of premature birth; the current definition is based solely on oxygen dependence at 36 weeks postmenstrual age without objective measurements of structural abnormalities across disease severity.

OBJECTIVES

We hypothesize that magnetic resonance imaging (MRI) can spatially resolve and quantify the structural abnormalities of the neonatal lung parenchyma associated with premature birth.

METHODS

Using a unique, small-footprint, 1.5-T MRI scanner within our neonatal intensive care unit (NICU), diagnostic-quality MRIs using commercially available sequences (gradient echo and spin echo) were acquired during quiet breathing in six patients with BPD, six premature patients without diagnosed BPD, and six full-term NICU patients (gestational ages, 23-39 wk) at near term-equivalent age, without administration of sedation or intravenous contrast. Images were scored by a radiologist using a modified Ochiai score, and volumes of high- and low-signal intensity lung parenchyma were quantified by segmentation and threshold analysis.

MEASUREMENTS AND MAIN RESULTS

Signal increases, putatively combinations of fibrosis, edema, and atelectasis, were present in all premature infants. Infants with diagnosed BPD had significantly greater volume of high-signal lung (mean ± SD, 26.1 ± 13.8%) compared with full-term infants (7.3 ± 8.2%; P = 0.020) and premature infants without BPD (8.2 ± 6.4%; P = 0.026). Signal decreases, presumably alveolar simplification, only appeared in the most severe BPD cases, although cystic appearance did increase with severity.

CONCLUSIONS

Pulmonary MRI reveals quantifiable, significant differences between patients with BPD, premature patients without BPD, and full-term control subjects. These methods could be implemented to individually phenotype disease, which may impact clinical care and predict future outcomes.