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Kim M, Naish JH, Needleman SH, Tibiletti M, Taylor Y, O'Connor JPB, Parker GJM. Feasibility of dynamic T 2 *-based oxygen-enhanced lung MRI at 3T. Magn Reson Med 2024; 91:972-986. [PMID: 38013206 PMCID: PMC10952203 DOI: 10.1002/mrm.29914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE To demonstrate proof-of-concept of a T2 *-sensitized oxygen-enhanced MRI (OE-MRI) method at 3T by assessing signal characteristics, repeatability, and reproducibility of dynamic lung OE-MRI metrics in healthy volunteers. METHODS We performed sequence-specific simulations for protocol optimisation and acquired free-breathing OE-MRI data from 16 healthy subjects using a dual-echo RF-spoiled gradient echo approach at 3T across two institutions. Non-linear registration and tissue density correction were applied. Derived metrics included percent signal enhancement (PSE), ∆R2 * and wash-in time normalized for breathing rate (τ-nBR). Inter-scanner reproducibility and intra-scanner repeatability were evaluated using intra-class correlation coefficient (ICC), repeatability coefficient, reproducibility coefficient, and Bland-Altman analysis. RESULTS Simulations and experimental data show negative contrast upon oxygen inhalation, due to substantial dominance of ∆R2 * at TE > 0.2 ms. Density correction improved signal fluctuations. Density-corrected mean PSE values, aligned with simulations, display TE-dependence, and an anterior-to-posterior PSE reduction trend at TE1 . ∆R2 * maps exhibit spatial heterogeneity in oxygen delivery, featuring anterior-to-posterior R2 * increase. Mean T2 * values across 32 scans were 0.68 and 0.62 ms for pre- and post-O2 inhalation, respectively. Excellent or good agreement emerged from all intra-, inter-scanner and inter-rater variability tests for PSE and ∆R2 *. However, ICC values for τ-nBR demonstrated limited agreement between repeated measures. CONCLUSION Our results demonstrate the feasibility of a T2 *-weighted method utilizing a dual-echo RF-spoiled gradient echo approach, simultaneously capturing PSE, ∆R2 * changes, and oxygen wash-in during free-breathing. The excellent or good repeatability and reproducibility on intra- and inter-scanner PSE and ∆R2 * suggest potential utility in multi-center clinical applications.
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Affiliation(s)
- Mina Kim
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC)University College LondonLondonUK
| | - Josephine H. Naish
- Bioxydyn LimitedManchesterUK
- BHF Manchester Centre for Heart and Lung Magnetic Resonance Research (MCMR)Manchester University NHS Foundation TrustManchesterUK
| | - Sarah H. Needleman
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC)University College LondonLondonUK
| | | | - Yohn Taylor
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC)University College LondonLondonUK
| | - James P. B. O'Connor
- Division of Cancer SciencesUniversity of ManchesterManchesterUK
- Division of Radiotherapy and ImagingInstitute of Cancer ResearchLondonUK
| | - Geoff J. M. Parker
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC)University College LondonLondonUK
- Bioxydyn LimitedManchesterUK
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2
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Needleman SH, Kim M, McClelland JR, Naish JH, Tibiletti M, O'Connor JPB, Parker GJM. Independent component analysis (ICA) applied to dynamic oxygen-enhanced MRI (OE-MRI) for robust functional lung imaging at 3 T. Magn Reson Med 2024; 91:955-971. [PMID: 37984456 PMCID: PMC10952250 DOI: 10.1002/mrm.29912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/03/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Dynamic lung oxygen-enhanced MRI (OE-MRI) is challenging due to the presence of confounding signals and poor signal-to-noise ratio, particularly at 3 T. We have created a robust pipeline utilizing independent component analysis (ICA) to automatically extract the oxygen-induced signal change from confounding factors to improve the accuracy and sensitivity of lung OE-MRI. METHODS Dynamic OE-MRI was performed on healthy participants using a dual-echo multi-slice spoiled gradient echo sequence at 3 T and cyclical gas delivery. ICA was applied to each echo within a thoracic mask. The ICA component relating to the oxygen-enhancement signal was automatically identified using correlation analysis. The oxygen-enhancement component was reconstructed, and the percentage signal enhancement (PSE) was calculated. The lung PSE of current smokers was compared with nonsmokers; scan-rescan repeatability, ICA pipeline repeatability, and reproducibility between two vendors were assessed. RESULTS ICA successfully extracted a consistent oxygen-enhancement component for all participants. Lung tissue and oxygenated blood displayed the opposite oxygen-induced signal enhancements. A significant difference in PSE was observed between the lungs of current smokers and nonsmokers. The scan-rescan repeatability and the ICA pipeline repeatability were good. CONCLUSION The developed pipeline demonstrated sensitivity to the signal enhancements of the lung tissue and oxygenated blood at 3 T. The difference in lung PSE between current smokers and nonsmokers indicates a likely sensitivity to lung function alterations that may be seen in mild pathology, supporting future use of our methods in patient studies.
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Affiliation(s)
- Sarah H. Needleman
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Mina Kim
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Jamie R. McClelland
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Josephine H. Naish
- Bioxydyn LimitedManchesterUK
- BHF Manchester Centre for Heart and Lung Magnetic Resonance Research (MCMR), Manchester University NHS Foundation TrustManchesterUK
| | | | | | - Geoff J. M. Parker
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Bioxydyn LimitedManchesterUK
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Xu P, Meersmann T, Wang J, Wang C. Review of oxygen-enhanced lung mri: Pulse sequences for image acquisition and T 1 measurement. Med Phys 2023; 50:5987-6007. [PMID: 37345214 DOI: 10.1002/mp.16553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/23/2023] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Oxygen-enhanced MR imaging (OE-MRI) is a special proton imaging technique that can be performed without modifying the scanner hardware. Many fundamental studies have been conducted following the initial reporting of this technique in 1996, illustrating the high potential for its clinical application. This review aims to summarise and analyse current pulse sequences and T1 measurement methods for OE-MRI, including fundamental theories, existing pulse sequences applied to OE-MRI acquisition and T1 mapping. Wash-in and wash-out time identify lung function and are sensitive to ventilation; thus, dynamic OE-MRI is also discussed in this review. We compare OE-MRI with the primary competitive technique, hyperpolarised gas MRI. Finally, an overview of lower-field applications of OE-MRI is highlighted, as relatively recent publications demonstrated positive results. Lower-field OE-MRI, which is lower than 1.5 T, could be an alternative modality for detecting lung diseases. This educational review is aimed at researchers who want a quick summary of the steps needed to perform pulmonary OE-MRI with a particular focus on sequence design, settings, and quantification methods.
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Affiliation(s)
- Pengfei Xu
- Department of Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
| | - Thomas Meersmann
- Sir Peter Mansfield Magnetic Imaging Centre, University of Nottingham, Nottingham, UK
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, China
| | - Jing Wang
- Department of Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, China
| | - Chengbo Wang
- Department of Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo, China
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Zou Q, Miller Z, Dzelebdzic S, Abadeer M, Johnson KM, Hussain T. Time-Resolved 3D cardiopulmonary MRI reconstruction using spatial transformer network. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:15982-15998. [PMID: 37919998 DOI: 10.3934/mbe.2023712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
The accurate visualization and assessment of the complex cardiac and pulmonary structures in 3D is critical for the diagnosis and treatment of cardiovascular and respiratory disorders. Conventional 3D cardiac magnetic resonance imaging (MRI) techniques suffer from long acquisition times, motion artifacts, and limited spatiotemporal resolution. This study proposes a novel time-resolved 3D cardiopulmonary MRI reconstruction method based on spatial transformer networks (STNs) to reconstruct the 3D cardiopulmonary MRI acquired using 3D center-out radial ultra-short echo time (UTE) sequences. The proposed reconstruction method employed an STN-based deep learning framework, which used a combination of data-processing, grid generator, and sampler. The reconstructed 3D images were compared against the start-of-the-art time-resolved reconstruction method. The results showed that the proposed time-resolved 3D cardiopulmonary MRI reconstruction using STNs offers a robust and efficient approach to obtain high-quality images. This method effectively overcomes the limitations of conventional 3D cardiac MRI techniques and has the potential to improve the diagnosis and treatment planning of cardiopulmonary disorders.
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Affiliation(s)
- Qing Zou
- Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zachary Miller
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - Sanja Dzelebdzic
- Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Maher Abadeer
- Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Metz C, Weng AM, Heidenreich JF, Slawig A, Benkert T, Köstler H, Veldhoen S. Reproducibility of non-contrast enhanced multi breath-hold ultrashort echo time functional lung MRI. Magn Reson Imaging 2023; 98:149-154. [PMID: 36681313 DOI: 10.1016/j.mri.2023.01.020] [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: 08/15/2022] [Revised: 11/14/2022] [Accepted: 01/14/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate the intraindividual reproducibility of functional lung imaging using non-contrast enhanced multi breath-hold 3D-UTE MRI. METHODS Ten healthy volunteers underwent non-contrast enhanced 3D-UTE MRI at three time points for same-day and different-day measurements employing a stack-of-spirals trajectory at 3 T. At each time point, inspiratory and expiratory breathing states were acquired for tidal and deep breathing, each within a single breath-hold. For functional image analysis, fractional ventilation (FV) was calculated pixelwise after image registration from the MR signal change. To decouple FV from breathing depth, the individual lung volume was used for volume adjustment (rFV). Reproducibility evaluation was performed in eight lung segments. Statistical analyses included two way mixed intraclass correlation (ICC), sign-test, Friedman-test and modified Bland-Altman analyses. RESULTS FV from tidal breathing showed an ICC of 0.81, a bias of 1.3% and an interval of confidence (CI) ranging from -67.1 to 69.6%. FV from deep breathing was higher reproducible with an ICC of 0.92 (bias, -0.2%; CI, -34.2 to 33.7%). Following volume adjustment, reproducibility of rFV for tidal breathing improved (ICC, 0,86; bias, 2.0%; CI, -34.3 to 38.3%), whereas it did not bear significant benefits for deep breathing (ICC, 0.89; bias, 2.8%; CI, -24.9 to 30.5%). Reproducibility was independent from the examination day. CONCLUSION Non-contrast-enhanced multi breath-hold 3D-UTE MRI allows for highly reproducible ventilation imaging.
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Affiliation(s)
- C Metz
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.
| | - A M Weng
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - J F Heidenreich
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - A Slawig
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - T Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - H Köstler
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
| | - S Veldhoen
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany
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Hsia CCW, Bates JHT, Driehuys B, Fain SB, Goldin JG, Hoffman EA, Hogg JC, Levin DL, Lynch DA, Ochs M, Parraga G, Prisk GK, Smith BM, Tawhai M, Vidal Melo MF, Woods JC, Hopkins SR. Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report. Ann Am Thorac Soc 2023; 20:161-195. [PMID: 36723475 PMCID: PMC9989862 DOI: 10.1513/annalsats.202211-915st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Multiple thoracic imaging modalities have been developed to link structure to function in the diagnosis and monitoring of lung disease. Volumetric computed tomography (CT) renders three-dimensional maps of lung structures and may be combined with positron emission tomography (PET) to obtain dynamic physiological data. Magnetic resonance imaging (MRI) using ultrashort-echo time (UTE) sequences has improved signal detection from lung parenchyma; contrast agents are used to deduce airway function, ventilation-perfusion-diffusion, and mechanics. Proton MRI can measure regional ventilation-perfusion ratio. Quantitative imaging (QI)-derived endpoints have been developed to identify structure-function phenotypes, including air-blood-tissue volume partition, bronchovascular remodeling, emphysema, fibrosis, and textural patterns indicating architectural alteration. Coregistered landmarks on paired images obtained at different lung volumes are used to infer airway caliber, air trapping, gas and blood transport, compliance, and deformation. This document summarizes fundamental "good practice" stereological principles in QI study design and analysis; evaluates technical capabilities and limitations of common imaging modalities; and assesses major QI endpoints regarding underlying assumptions and limitations, ability to detect and stratify heterogeneous, overlapping pathophysiology, and monitor disease progression and therapeutic response, correlated with and complementary to, functional indices. The goal is to promote unbiased quantification and interpretation of in vivo imaging data, compare metrics obtained using different QI modalities to ensure accurate and reproducible metric derivation, and avoid misrepresentation of inferred physiological processes. The role of imaging-based computational modeling in advancing these goals is emphasized. Fundamental principles outlined herein are critical for all forms of QI irrespective of acquisition modality or disease entity.
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7
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Xu P, Zhang J, Nan Z, Meersmann T, Wang C. Free-Breathing Phase-Resolved Oxygen-Enhanced Pulmonary MRI Based on 3D Stack-of-Stars UTE Sequence. SENSORS (BASEL, SWITZERLAND) 2022; 22:3270. [PMID: 35590959 PMCID: PMC9105788 DOI: 10.3390/s22093270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
Compared with hyperpolarized noble gas MRI, oxygen-enhanced lung imaging is a cost-effective approach to investigate lung function. In this study, we investigated the feasibility of free-breathing phase-resolved oxygen-enhanced pulmonary MRI based on a 3D stack-of-stars ultra-short echo time (UTE) sequence. We conducted both computer simulation and in vivo experiments and calculated percent signal enhancement maps of four different respiratory phases on four healthy volunteers from the end of expiration to the end of inspiration. The phantom experiment was implemented to verify simulation results. The respiratory phase was segmented based on the extracted respiratory signal and sliding window reconstruction, providing phase-resolved pulmonary MRI. Demons registration algorithm was applied to compensate for respiratory motion. The mean percent signal enhancement of the average phase increases from anterior to posterior region, matching previous literature. More details of pulmonary tissues were observed on post-oxygen inhalation images through the phase-resolved technique. Phase-resolved UTE pulmonary MRI shows the potential as a valuable method for oxygen-enhanced MRI that enables the investigation of lung ventilation on middle states of the respiratory cycle.
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Affiliation(s)
- Pengfei Xu
- Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (P.X.); (J.Z.); (Z.N.)
| | - Jichang Zhang
- Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (P.X.); (J.Z.); (Z.N.)
| | - Zhen Nan
- Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (P.X.); (J.Z.); (Z.N.)
| | - Thomas Meersmann
- Sir Peter Mansfield Magnetic Imaging Center, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Chengbo Wang
- Electrical and Electronic Engineering, Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo 315100, China; (P.X.); (J.Z.); (Z.N.)
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, Ningbo 315040, China
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Niedbalski PJ, Choi J, Hall CS, Castro M. Imaging in Asthma Management. Semin Respir Crit Care Med 2022; 43:613-626. [PMID: 35211923 DOI: 10.1055/s-0042-1743289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Asthma is a heterogeneous disease characterized by chronic airway inflammation that affects more than 300 million people worldwide. Clinically, asthma has a widely variable presentation and is defined based on a history of respiratory symptoms alongside airflow limitation. Imaging is not needed to confirm a diagnosis of asthma, and thus the use of imaging in asthma has historically been limited to excluding alternative diagnoses. However, significant advances continue to be made in novel imaging methodologies, which have been increasingly used to better understand respiratory impairment in asthma. As a disease primarily impacting the airways, asthma is best understood by imaging methods with the ability to elucidate airway impairment. Techniques such as computed tomography, magnetic resonance imaging with gaseous contrast agents, and positron emission tomography enable assessment of the small airways. Others, such as optical coherence tomography and endobronchial ultrasound enable high-resolution imaging of the large airways accessible to bronchoscopy. These imaging techniques are providing new insights in the pathophysiology and treatments of asthma and are poised to impact the clinical management of asthma.
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Affiliation(s)
- Peter J Niedbalski
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Jiwoong Choi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Chase S Hall
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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9
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Javed A, Ramasawmy R, O'Brien K, Mancini C, Su P, Majeed W, Benkert T, Bhat H, Suffredini AF, Malayeri A, Campbell-Washburn AE. Self-gated 3D stack-of-spirals UTE pulmonary imaging at 0.55T. Magn Reson Med 2021; 87:1784-1798. [PMID: 34783391 DOI: 10.1002/mrm.29079] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/22/2021] [Accepted: 10/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To develop an isotropic high-resolution stack-of-spirals UTE sequence for pulmonary imaging at 0.55 Tesla by leveraging a combination of robust respiratory-binning, trajectory correction, and concomitant-field corrections. METHODS A stack-of-spirals golden-angle UTE sequence was used to continuously acquire data for 15.5 minutes. The data was binned to a stable respiratory phase based on superoinferior readout self-navigator signals. Corrections for trajectory errors and concomitant field artifacts, along with image reconstruction with conjugate gradient SENSE, were performed inline within the Gadgetron framework. Finally, data were retrospectively reconstructed to simulate scan times of 5, 8.5, and 12 minutes. Image quality was assessed using signal-to-noise, image sharpness, and qualitative reader scores. The technique was evaluated in healthy volunteers, patients with coronavirus disease 2019 infection, and patients with lung nodules. RESULTS The technique provided diagnostic quality images with parenchymal lung SNR of 3.18 ± 0.0.60, 4.57 ± 0.87, 5.45 ± 1.02, and 5.89 ± 1.28 for scan times of 5, 8.5, 12, and 15.5 minutes, respectively. The respiratory binning technique resulted in significantly sharper images (p < 0.001) as measured with relative maximum derivative at the diaphragm. Concomitant field corrections visibly improved sharpness of anatomical structures away from iso-center. The image quality was maintained with a slight loss in SNR for simulated scan times down to 8.5 minutes. Inline image reconstruction and artifact correction were achieved in <5 minutes. CONCLUSION The proposed pulmonary imaging technique combined efficient stack-of-spirals imaging with robust respiratory binning, concomitant field correction, and trajectory correction to generate diagnostic quality images with 1.75 mm isotropic resolution in 8.5 minutes on a high-performance 0.55 Tesla system.
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Affiliation(s)
- Ahsan Javed
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rajiv Ramasawmy
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kendall O'Brien
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Christine Mancini
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Pan Su
- Siemens Medical Solutions USA Inc., Malvern, Pennsylvania, USA
| | - Waqas Majeed
- Siemens Medical Solutions USA Inc., Malvern, Pennsylvania, USA
| | | | - Himanshu Bhat
- Siemens Medical Solutions USA Inc., Malvern, Pennsylvania, USA
| | - Anthony F Suffredini
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Ashkan Malayeri
- Department of Radiology and Imaging Sciences, Clinical Center, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Bhattacharya I, Ramasawmy R, Javed A, Chen MY, Benkert T, Majeed W, Lederman RJ, Moss J, Balaban RS, Campbell-Washburn AE. Oxygen-enhanced functional lung imaging using a contemporary 0.55 T MRI system. NMR IN BIOMEDICINE 2021; 34:e4562. [PMID: 34080253 PMCID: PMC8377594 DOI: 10.1002/nbm.4562] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 05/14/2023]
Abstract
The purpose of this study was to evaluate oxygen-enhanced pulmonary imaging at 0.55 T with 3D stack-of-spirals ultrashort-TE (UTE) acquisition. Oxygen-enhanced pulmonary MRI offers the measurement of regional lung ventilation and perfusion using inhaled oxygen as a contrast agent. Low-field MRI systems equipped with contemporary hardware can provide high-quality structural lung imaging by virtue of the prolonged T2 *. Fortuitously, the T1 relaxivity of oxygen increases at lower field strengths, which is expected to improve the sensitivity of oxygen-enhanced lung MRI. We implemented a breath-held T1 -weighted 3D stack-of-spirals UTE acquisition with a 7 ms spiral-out readout. Measurement repeatability was assessed using five repetitions of oxygen-enhanced lung imaging in healthy volunteers (n = 7). The signal intensity at both normoxia and hyperoxia was strongly dependent on lung tissue density modulated by breath-hold volume during the five repetitions. A voxel-wise correction for lung tissue density improved the repeatability of percent signal enhancement maps (coefficient of variation = 34 ± 16%). Percent signal enhancement maps were compared in 15 healthy volunteers and 10 patients with lymphangioleiomyomatosis (LAM), a rare cystic disease known to reduce pulmonary function. We measured a mean percent signal enhancement of 9.0 ± 3.5% at 0.55 T in healthy volunteers, and reduced signal enhancement in patients with LAM (5.4 ± 4.8%, p = 0.02). The heterogeneity, estimated by the percent of lung volume exhibiting low enhancement, was significantly increased in patients with LAM compared with healthy volunteers (11.1 ± 6.0% versus 30.5 ± 13.1%, p = 0.01), illustrating the capability to measure regional functional deficits.
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Affiliation(s)
- Ipshita Bhattacharya
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
| | - Rajiv Ramasawmy
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
| | - Ahsan Javed
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
| | - Marcus Y Chen
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
| | - Thomas Benkert
- Siemens Healthcare GmbH, Henkestraße 127, 91052 Erlangen, Germany
| | - Waqas Majeed
- Siemens Medical Solutions USA Inc., 40 Liberty Boulevard, Malvern PA, 1935 USA
| | - Robert J Lederman
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
| | - Joel Moss
- Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
| | - Robert S Balaban
- Systems Biology Center, Division of Intramural Research, National Heart, Lung, and Blood I nstitute, National Institutes of Health, Bethesda MD, USA 20892
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD, USA 20892
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11
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Liu H, Zheng L, Shi G, Xu Q, Wang Q, Zhu H, Feng H, Wang L, Zhang N, Xue M, Dai Y. Pulmonary Functional Imaging for Lung Adenocarcinoma: Combined MRI Assessment Based on IVIM-DWI and OE-UTE-MRI. Front Oncol 2021; 11:677942. [PMID: 34307146 PMCID: PMC8292137 DOI: 10.3389/fonc.2021.677942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/11/2021] [Indexed: 01/11/2023] Open
Abstract
Purpose The goal of current study was to introduce noninvasive and reproducible MRI methods for in vivo functional assessment of lung adenocarcinoma (LUAD). Methods Forty-four patients with pathologically confirmed LUAD were included in this study. All the lesions were classified as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IA). The IA lesions were further divided into five subtype patterns, including acinar, lepidic, papillary, micropapillary and solid. Tumors were grouped depending on predominant subtype: low grade (AIS, MIA or lepidic predominant), intermediate grade (papillary or acinar predominant) and high grade (micropapillary, or solid predominant). Spirometry was performed according to American Thoracic Society guidelines. For each patient, Intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) analysis and oxygen-enhanced MRI (OE-MRI) analysis were performed. Spearman's test was used to assess the relationship between a) whole lung mean percent signal enhancement (PSE) and pulmonary function tests (PFTs) parameters; b) IVIM-derived parameters and PFTs parameters; c) tumor mean PSE and IVIM-derived parameters. Kruskal -Wallis tests were applied to test the difference of tumor mean PSE and IVIM-derived parameters between different histological tumor grades. Receiver operating characteristics (ROC) analysis was used to evaluate the diagnostic performance. Results Whole lung mean PSE was significantly positively correlated with PFTs parameters (r = 0.40 ~ 0.44, P < 0.05). f value derived from IVIM-DWI was significantly negatively correlated with PFTs parameters (r = -0.38 ~ -0.47, P < 0.05). Both tumor mean PSE (P = 0.030 < 0.05) and f (P = 0.022 < 0.05) could differentiate different histological grades. f was negatively correlated with tumor mean PSE (r = -0.61, P < 0.001). For the diagnostic performance, the combination of tumor mean PSE and f outperformed than using tumor mean PSE or f alone in both sensitivity and area under the ROC curve. Conclusions The combined measurement of OE-MRI and IVIM-DWI may serve as a promising method for the noninvasive and non-radiation evaluation of pulmonary function. Quantitative analyses achieved by OE-MRI and IVIM-DWI offer an approach of the classification of LUAD subtypes.
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Affiliation(s)
- Hui Liu
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Liyun Zheng
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
| | - Gaofeng Shi
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qian Xu
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qi Wang
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongshan Zhu
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hui Feng
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lijia Wang
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ning Zhang
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meng Xue
- Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yongming Dai
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China
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12
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Balasch A, Büttner MS, Metze P, Stumpf K, Beer M, Rottbauer W, Rasche V. Tiny golden angle stack-of-stars (tygaSoS) free-breathing functional lung imaging. Magn Reson Imaging 2021; 82:24-30. [PMID: 34153438 DOI: 10.1016/j.mri.2021.06.016] [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: 02/19/2021] [Revised: 04/21/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE MRI of the lung parenchyma is still challenging due to cardiac and respiratory motion, and the low proton density and short T2*. Clinical feasible MRI methods for functional lung assessment are of great interest. It was the objective of this study to evaluate the potential of combining the ultra-short echo-time stack-of-stars approach with tiny golden angle (tyGASoS) profile ordering for self-gated free-breathing lung imaging. METHODS Free-breathing tyGASoS data were acquired in 10 healthy volunteers (3 smoker (S), 7 non-smoker (NS)). Images in different respiratory phases were reconstructed applying an image-based self-gating technique. Resulting image quality and sharpness, and parenchyma visibility were qualitatively scored by three blinded independent reader, and the signal-to-noise ratio (SNR), proton fraction (fP) and fractional ventilation (FV) quantified. RESULT The imaging protocol was well tolerated by all volunteers. Image quality was sufficient for subsequent quantitative analysis in all cases with good to excellent inter-reader reliability. Between expiration (EX) and inspiration (IN) significant differences (p < 0.001) were observed in SNR (EX: 3.73 ± 0.89, IN: 3.14 ± 0.74) and fP (EX: 0.27 ± 0.09, IN: 0.25 ± 0.08). A significant (p < 0.05) higher fP (EX/IN: 0.22 ± 0.07/0.21 ± 0.07 (NS), 0.33 ± 0.07/0.30 ± 0.06 (S)) was observed in the smoker group. No significant FV differences resulted between S and NS. CONCLUSION The study proves the feasibility of free-breathing tyGASoS for multiphase lung imaging. Changes in fP may indicate an initial response in the smoker group and as such proves the sensitivity of the proposed technique. A major limitation in FV quantification rises from the large inter-subject variability of breathing patterns and amplitudes, requiring further consideration.
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Affiliation(s)
- A Balasch
- Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany.
| | - M S Büttner
- Department of Radiology, Ulm University Medical Centre, Ulm, Germany.
| | - P Metze
- Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany.
| | - K Stumpf
- Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany.
| | - M Beer
- Department of Radiology, Ulm University Medical Centre, Ulm, Germany.
| | - W Rottbauer
- Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany.
| | - V Rasche
- Department of Internal Medicine II, Ulm University Medical Centre, Ulm, Germany.
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Brooke JP, Hall IP. Novel Thoracic MRI Approaches for the Assessment of Pulmonary Physiology and Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1304:123-145. [PMID: 34019267 DOI: 10.1007/978-3-030-68748-9_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Excessive pulmonary inflammation can lead to damage of lung tissue, airway remodelling and established structural lung disease. Novel therapeutics that specifically target inflammatory pathways are becoming increasingly common in clinical practice, but there is yet to be a similar stepwise change in pulmonary diagnostic tools. A variety of thoracic magnetic resonance imaging (MRI) tools are currently in development, which may soon fulfil this emerging clinical need for highly sensitive assessments of lung structure and function. Given conventional MRI techniques are poorly suited to lung imaging, alternate strategies have been developed, including the use of inhaled contrast agents, intravenous contrast and specialized lung MR sequences. In this chapter, we discuss technical challenges of performing MRI of the lungs and how they may be overcome. Key thoracic MRI modalities are reviewed, namely, hyperpolarized noble gas MRI, oxygen-enhanced MRI (OE-MRI), ultrashort echo time (UTE) MRI and dynamic contrast-enhanced (DCE) MRI. Finally, we consider potential clinical applications of these techniques including phenotyping of lung disease, evaluation of novel pulmonary therapeutic efficacy and longitudinal assessment of specific patient groups.
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Affiliation(s)
- Jonathan P Brooke
- Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
| | - Ian P Hall
- Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK.
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14
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Zhao F, Zheng L, Shan F, Dai Y, Shen J, Yang S, Shi Y, Xue K, Zhang Z. Evaluation of pulmonary ventilation in COVID-19 patients using oxygen-enhanced three-dimensional ultrashort echo time MRI: a preliminary study. Clin Radiol 2021; 76:391.e33-391.e41. [PMID: 33712292 PMCID: PMC7906509 DOI: 10.1016/j.crad.2021.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 02/17/2021] [Indexed: 01/15/2023]
Abstract
AIM To evaluate the lung function of coronavirus disease 2019 (COVID-19) patients using oxygen-enhanced (OE) ultrashort echo time (UTE) MRI. MATERIALS AND METHODS Forty-nine patients with COVID-19 were included in the study. The OE-MRI was based on a respiratory-gated three-dimensional (3D) radial UTE sequence. For each patient, the percent signal enhancement (PSE) map was calculated using the expression PSE = (S100% – S21%)/S21%, where S21% and S100% are signals acquired during room air and 100% oxygen inhalation, respectively. Agreement of lesion detectability between UTE-MRI and computed tomography (CT) was performed using the kappa test. The Mann–Whitney U-test was used to evaluate the difference in the mean PSE between mild-type COVID-19 and common-type COVID-19. Spearman's test was used to assess the relationship between lesion mean PSE and lesion size. Furthermore, the Mann–Whitney U-test was used to evaluate the difference in region of interest (ROI) mean PSE between normal pulmonary parenchyma and lesions. The Kruskal–Wallis test was applied to test the difference in the mean PSE between different lesion types. RESULTS CT and UTE-MRI reached good agreement in lesion detectability. Ventilation measures in mild-type patients (5.3 ± 5.5%) were significantly different from those in common-type patients (3 ± 3.9%). Besides, there was no significant correlation between lesion mean PSE and lesion size. The mean PSE of COVID-19 lesions (3.2 ± 4.9%) was significantly lower than that of the pulmonary parenchyma (5.4 ± 3.9%). No significant difference was found among different lesion types. CONCLUSION OE-UTE-MRI could serve as a promising method for the assessment of lung function or treatment management of COVID-19 patients.
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Affiliation(s)
- F Zhao
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China; Department of Radiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - L Zheng
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai 201800, China
| | - F Shan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Y Dai
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai 201800, China
| | - J Shen
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - S Yang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Y Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - K Xue
- MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai 201800, China
| | - Z Zhang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China; Department of the Principal's Office, Fudan University, Shanghai 200433, China.
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Goralski JL, Stewart NJ, Woods JC. Novel imaging techniques for cystic fibrosis lung disease. Pediatr Pulmonol 2021; 56 Suppl 1:S40-S54. [PMID: 32592531 PMCID: PMC7808406 DOI: 10.1002/ppul.24931] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/25/2020] [Indexed: 12/24/2022]
Abstract
With an increasing number of patients with cystic fibrosis (CF) receiving highly effective CFTR (cystic fibrosis transmembrane regulator protein) modulator therapy, particularly at a young age, there is an increasing need to identify imaging tools that can detect and regionally visualize mild CF lung disease and subtle changes in disease state. In this review, we discuss the latest developments in imaging modalities for both structural and functional imaging of the lung available to CF clinicians and researchers, from the widely available, clinically utilized imaging methods for assessing CF lung disease-chest radiography and computed tomography-to newer techniques poised to become the next phase of clinical tools-structural/functional proton and hyperpolarized gas magnetic resonance imaging (MRI). Finally, we provide a brief discussion of several newer lung imaging techniques that are currently available only in selected research settings, including chest tomosynthesis, and fluorinated gas MRI. We provide an update on the clinical and/or research status of each technique, with a focus on sensitivity, early disease detection, and possibilities for monitoring treatment efficacy.
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Affiliation(s)
- Jennifer L Goralski
- UNC Cystic Fibrosis Center, Marsico Lung Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Pulmonary and Critical Care Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Pediatric Pulmonology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neil J Stewart
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Infection, Immunity & Cardiovascular Disease, POLARIS Group, Imaging Sciences, University of Sheffield, Sheffield, UK
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.,Department of Radiology, Cincinnati Children's Hospital, Cincinnati, Ohio
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Ohno Y, Yui M, Yoshikawa T, Seki S, Takenaka D, Kassai Y, Hattori H, Murayama K, Toyama H. 3D Oxygen-Enhanced MRI at 3T MR System: Comparison With Thin-Section CT of Quantitative Capability for Pulmonary Functional Loss Assessment and Clinical Stage Classification of COPD in Smokers. J Magn Reson Imaging 2020; 53:1042-1051. [PMID: 33205499 DOI: 10.1002/jmri.27441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Oxygen (O2 )-enhanced MRI is mainly performed by a 2D sequence using 1.5T MR systems but trying to be obtained by a 3D sequence using a 3T MR system. PURPOSE To compare the capability of 3D O2 -enhanced MRI and that of thin-section computed tomography (CT) for pulmonary functional loss assessment and clinical stage classification of chronic obstructive pulmonary disease (COPD) in smokers. STUDY TYPE Prospective study. POPULATION Fifty six smokers were included. FIELD STRENGTH/ SEQUENCE 3T, 3D O2 -enhanced MRIs were performed with a 3D T1 -weighted fast field echo pulse sequence using the multiple flip angles. ASSESSMENTS Smokers were classified into four stages ("Without COPD," "Mild COPD," "Moderate COPD," "Severe or very severe COPD"). Maps of regional changes in T1 values were generated from O2 -enhanced MR data. Regions of interest (ROIs) were then placed over the lung on all slices and averaged to determine mean T1 value change (ΔT1 ). Quantitative CT used the percentage of low attenuation areas within the entire lung (LAA%). STATISTICAL TESTS ΔT1 and LAA% were correlated with pulmonary functional parameters, and compared for four stages using Tukey's Honestly Significant Difference test. Discrimination analyses were performed and McNemar's test was used for a comparison of the accuracy of the indexes. RESULTS There were significantly higher correlations between ΔT1 and pulmonary functional parameters (-0.83 ≤ r ≤ -0.71, P < 0.05) than between LAA% and the same pulmonary functional parameters (-0.76 ≤ r ≤ -0.69, P < 0.05). ΔT1 and LAA% of the "Mild COPD" and "Moderate COPD" groups were significantly different from those of the "Severe or Very Severe COPD" group (P < 0.05). Discriminatory accuracy of ΔT1 (62.5%) and ΔT1 with LAA% (67.9%) was significantly greater than that of LAA% (48.2%, P < 0.05). DATA CONCLUSION Compared with thin-section CT, 3D O2 -enhanced MRI has a similar capability for pulmonary functional assessment but better potential for clinical stage classification in smokers. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan.,Joint Laboratory Research of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan.,Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masao Yui
- Canon Medical Systems Corporation, Otawara, Japan
| | - Takeshi Yoshikawa
- Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
| | - Shinichiro Seki
- Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Takenaka
- Department of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
| | | | - Hidekazu Hattori
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuhiro Murayama
- Joint Laboratory Research of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
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17
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Three-dimensional Ultrashort Echotime Magnetic Resonance Imaging for Combined Morphologic and Ventilation Imaging in Pediatric Patients With Pulmonary Disease. J Thorac Imaging 2020; 36:43-51. [PMID: 32453280 DOI: 10.1097/rti.0000000000000537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE Ultrashort echotime (UTE) sequences aim to improve the signal yield in pulmonary magnetic resonance imaging (MRI). We demonstrate the initial results of spiral 3-dimensional (3D) UTE-MRI for combined morphologic and functional imaging in pediatric patients. METHODS Seven pediatric patients with pulmonary abnormalities were included in this observational, prospective, single-center study, with the patients having the following conditions: cystic fibrosis (CF) with middle lobe atelectasis, CF with allergic bronchopulmonary aspergillosis, primary ciliary dyskinesia, air trapping, congenital lobar overinflation, congenital pulmonary airway malformation, and pulmonary hamartoma.Patients were scanned during breath-hold in 5 breathing states on a 3-Tesla system using a prototypical 3D stack-of-spirals UTE sequence. Ventilation maps and signal intensity maps were calculated. Morphologic images, ventilation-weighted maps, and signal intensity maps of the lungs of each patient were assessed intraindividually and compared with reference examinations. RESULTS With a scan time of ∼15 seconds per breathing state, 3D UTE-MRI allowed for sufficient imaging of both "plus" pathologies (atelectasis, inflammatory consolidation, and pulmonary hamartoma) and "minus" pathologies (congenital lobar overinflation, congenital pulmonary airway malformation, and air trapping). Color-coded maps of normalized signal intensity and ventilation increased diagnostic confidence, particularly with regard to "minus" pathologies. UTE-MRI detected new atelectasis in an asymptomatic CF patient, allowing for rapid and successful therapy initiation, and it was able to reproduce atelectasis and hamartoma known from multidetector computed tomography and to monitor a patient with allergic bronchopulmonary aspergillosis. CONCLUSION 3D UTE-MRI using a stack-of-spirals trajectory enables combined morphologic and functional imaging of the lungs within ~115 second acquisition time and might be suitable for monitoring a wide spectrum of pulmonary diseases.
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Heidenreich JF, Weng AM, Metz C, Benkert T, Pfeuffer J, Hebestreit H, Bley TA, Köstler H, Veldhoen S. Three-dimensional Ultrashort Echo Time MRI for Functional Lung Imaging in Cystic Fibrosis. Radiology 2020; 296:191-199. [PMID: 32343212 DOI: 10.1148/radiol.2020192251] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background In cystic fibrosis (CF), recurrent imaging and pulmonary function tests (PFTs) are needed for the assessment of lung function during disease management. Purpose To assess the clinical feasibility of pulmonary three-dimensional ultrashort echo time (UTE) MRI at breath holding for quantitative image analysis of ventilation inhomogeneity and hyperinflation in CF compared with PFT. Materials and Methods In this prospective study from May 2018 to June 2019, participants with CF and healthy control participants underwent PFTs and functional lung MRI by using a prototypical single breath-hold three-dimensional UTE sequence. Fractional ventilation (FV) was calculated from acquired data in normal inspiration and normal expiration. FV of each voxel was normalized to the whole lung mean (FVN), and interquartile range of normalized ventilation (IQRN; as a measure of ventilation heterogeneity) was calculated. UTE signal intensity (SI) was assessed in full expiration (SIN, normalized to aortic blood). Obtained metrics were compared between participants with CF and control participants. For participants with CF, MRI metrics were correlated with the standard lung clearance index (LCI) and PFT. Mann-Whitney U tests and Spearman correlation were used for statistical analysis. Results Twenty participants with CF (mean age, 17 years ± 9 [standard deviation]; 12 men) and 10 healthy control participants (24 years ± 8; five men) were included. IQRN was higher for participants with CF than for control participants (mean, 0.66 ± 0.16 vs 0.50 ± 0.04, respectively; P = .007). In the 20 participants with CF, IQRN correlated with obstruction markers forced expiratory volume in 1 second-to-forced vital capacity ratio (r = -0.70; 95% confidence interval [CI]: -0.92, -0.28; P < .001), mean expiratory flow 25% (r = 0.78; 95% CI: -0.95, -0.39; P < .001), and with the ventilation inhomogeneity parameter LCI (r = 0.90; 95% CI: 0.69, 0.96; P < .001). Mean SIN in full expiration was lower in participants with CF than in control participants (0.34 ± 0.08 vs 0.39 ± 0.03, respectively; P = .03). Conclusion Three-dimensional ultrashort echo time MRI in the lungs allowed for functional imaging of ventilation inhomogeneity within a few breath holds in patients with cystic fibrosis. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Wielpütz in this issue.
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Affiliation(s)
- Julius F Heidenreich
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Andreas M Weng
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Corona Metz
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Thomas Benkert
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Josef Pfeuffer
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Helge Hebestreit
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Thorsten A Bley
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Herbert Köstler
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
| | - Simon Veldhoen
- From the Department of Diagnostic and Interventional Radiology (J.F.H., A.M.W., C.M., T.A.B., H.K., S.V.) and Department of Pediatrics (H.H.), University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany; and Department of Application Development, Siemens Healthcare GmbH, Erlangen, Germany (T.B., J.P.)
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Voskrebenzev A, Vogel-Claussen J. Proton MRI of the Lung: How to Tame Scarce Protons and Fast Signal Decay. J Magn Reson Imaging 2020; 53:1344-1357. [PMID: 32166832 DOI: 10.1002/jmri.27122] [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: 12/11/2019] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 12/19/2022] Open
Abstract
Pulmonary proton MRI techniques offer the unique possibility of assessing lung function and structure without the requirement for hyperpolarization or dedicated hardware, which is mandatory for multinuclear acquisition. Five popular approaches are presented and discussed in this review: 1) oxygen enhanced (OE)-MRI; 2) arterial spin labeling (ASL); 3) Fourier decomposition (FD) MRI and other related methods including self-gated noncontrast-enhanced functional lung (SENCEFUL) MR and phase-resolved functional lung (PREFUL) imaging; 4) dynamic contrast-enhanced (DCE) MRI; and 5) ultrashort TE (UTE) MRI. While DCE MRI is the most established and well-studied perfusion measurement, FD MRI offers a free-breathing test without any contrast agent and is predestined for application in patients with renal failure or with low compliance. Additionally, FD MRI and related methods like PREFUL and SENCEFUL can act as an ionizing radiation-free V/Q scan, since ventilation and perfusion information is acquired simultaneously during one scan. For OE-MRI, different concentrations of oxygen are applied via a facemask to assess the regional change in T1 , which is caused by the paramagnetic property of oxygen. Since this change is governed by a combination of ventilation, diffusion, and perfusion, a compound functional measurement can be achieved with OE-MRI. The known problem of fast T2 * decay of the lung parenchyma leading to a low signal-to-noise ratio is bypassed by the UTE acquisition strategy. Computed tomography (CT)-like images allow the assessment of lung structure with high spatial resolution without ionizing radiation. Despite these different branches of proton MRI, common trends are evident among pulmonary proton MRI: 1) free-breathing acquisition with self-gating; 2) application of UTE to preserve a stronger parenchymal signal; and 3) transition from 2D to 3D acquisition. On that note, there is a visible convergence of the different methods and it is not difficult to imagine that future methods will combine different aspects of the presented methods.
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Affiliation(s)
- Andreas Voskrebenzev
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
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Shammi UA, Thomen RP. Role of New Imaging Capabilities with MRI and CT in the Evaluation of Bronchiectasis. CURRENT PULMONOLOGY REPORTS 2019. [DOI: 10.1007/s13665-019-00240-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Zha W, Fain SB, Schiebler ML, Nagle SK, Liu F. Deep convolutional neural networks with multiplane consensus labeling for lung function quantification using UTE proton MRI. J Magn Reson Imaging 2019; 50:1169-1181. [PMID: 30945385 PMCID: PMC7039686 DOI: 10.1002/jmri.26734] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Ultrashort echo time (UTE) proton MRI has gained popularity for assessing lung structure and function in pulmonary imaging; however, the development of rapid biomarker extraction and regional quantification has lagged behind due to labor-intensive lung segmentation. PURPOSE To evaluate a deep learning (DL) approach for automated lung segmentation to extract image-based biomarkers from functional lung imaging using 3D radial UTE oxygen-enhanced (OE) MRI. STUDY TYPE Retrospective study aimed to evaluate a technical development. POPULATION Forty-five human subjects, including 16 healthy volunteers, 5 asthma, and 24 patients with cystic fibrosis. FIELD STRENGTH/SEQUENCE 1.5T MRI, 3D radial UTE (TE = 0.08 msec) sequence. ASSESSMENT Two 3D radial UTE volumes were acquired sequentially under normoxic (21% O2 ) and hyperoxic (100% O2 ) conditions. Automated segmentation of the lungs using 2D convolutional encoder-decoder based DL method, and the subsequent functional quantification via adaptive K-means were compared with the results obtained from the reference method, supervised region growing. STATISTICAL TESTS Relative to the reference method, the performance of DL on volumetric quantification was assessed using Dice coefficient with 95% confidence interval (CI) for accuracy, two-sided Wilcoxon signed-rank test for computation time, and Bland-Altman analysis on the functional measure derived from the OE images. RESULTS The DL method produced strong agreement with supervised region growing for the right (Dice: 0.97; 95% CI = [0.96, 0.97]; P < 0.001) and left lungs (Dice: 0.96; 95% CI = [0.96, 0.97]; P < 0.001). The DL method averaged 46 seconds to generate the automatic segmentations in contrast to 1.93 hours using the reference method (P < 0.001). Bland-Altman analysis showed nonsignificant intermethod differences of volumetric (P ≥ 0.12) and functional measurements (P ≥ 0.34) in the left and right lungs. DATA CONCLUSION DL provides rapid, automated, and robust lung segmentation for quantification of regional lung function using UTE proton MRI. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1169-1181.
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Affiliation(s)
- Wei Zha
- Department of Medical Physics, University of Wisconsin-Madison
| | - Sean B. Fain
- Department of Medical Physics, University of Wisconsin-Madison
- Department of Radiology, University of Wisconsin-Madison
- Department of Biomedical Engineering, University of Wisconsin-Madison
| | | | - Scott K. Nagle
- Department of Medical Physics, University of Wisconsin-Madison
- Department of Radiology, University of Wisconsin-Madison
- Department of Pediatrics, University of Wisconsin-Madison
| | - Fang Liu
- Department of Radiology, University of Wisconsin-Madison
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Weiger M, Pruessmann KP. Short-T 2 MRI: Principles and recent advances. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2019; 114-115:237-270. [PMID: 31779882 DOI: 10.1016/j.pnmrs.2019.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/14/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
Among current modalities of biomedical and diagnostic imaging, MRI stands out by virtue of its versatile contrast obtained without ionizing radiation. However, in various cases, e.g., water protons in tissues such as bone, tendon, and lung, MRI performance is limited by the rapid decay of resonance signals associated with short transverse relaxation times T2 or T2*. Efforts to address this shortcoming have led to a variety of specialized short-T2 techniques. Recent progress in this field expands the choice of methods and prompts fresh considerations with regard to instrumentation, data acquisition, and signal processing. In this review, the current status of short-T2 MRI is surveyed. In an attempt to structure the growing range of techniques, the presentation highlights overarching concepts and basic methodological options. The most frequently used approaches are described in detail, including acquisition strategies, image reconstruction, hardware requirements, means of introducing contrast, sources of artifacts, limitations, and applications.
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Affiliation(s)
- Markus Weiger
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland.
| | - Klaas P Pruessmann
- Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland
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Young HM, Eddy RL, Parraga G. MRI and CT lung biomarkers: Towards an in vivo understanding of lung biomechanics. Clin Biomech (Bristol, Avon) 2019; 66:107-122. [PMID: 29037603 DOI: 10.1016/j.clinbiomech.2017.09.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/22/2017] [Accepted: 09/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The biomechanical properties of the lung are necessarily dependent on its structure and function, both of which are complex and change over time and space. This makes in vivo evaluation of lung biomechanics and a deep understanding of lung biomarkers, very challenging. In patients and animal models of lung disease, in vivo evaluations of lung structure and function are typically made at the mouth and include spirometry, multiple-breath gas washout tests and the forced oscillation technique. These techniques, and the biomarkers they provide, incorporate the properties of the whole organ system including the parenchyma, large and small airways, mouth, diaphragm and intercostal muscles. Unfortunately, these well-established measurements mask regional differences, limiting their ability to probe the lung's gross and micro-biomechanical properties which vary widely throughout the organ and its subcompartments. Pulmonary imaging has the advantage in providing regional, non-invasive measurements of healthy and diseased lung, in vivo. Here we summarize well-established and emerging lung imaging tools and biomarkers and how they may be used to generate lung biomechanical measurements. METHODS We review well-established and emerging lung anatomical, microstructural and functional imaging biomarkers generated using synchrotron x-ray tomographic-microscopy (SRXTM), micro-x-ray computed-tomography (micro-CT), clinical CT as well as magnetic resonance imaging (MRI). FINDINGS Pulmonary imaging provides measurements of lung structure, function and biomechanics with high spatial and temporal resolution. Imaging biomarkers that reflect the biomechanical properties of the lung are now being validated to provide a deeper understanding of the lung that cannot be achieved using measurements made at the mouth.
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Affiliation(s)
- Heather M Young
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Rachel L Eddy
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Grace Parraga
- Robarts Research Institute, Western University, London, Canada; Department of Medical Biophysics, Western University, London, Canada; Graduate Program in Biomedical Engineering, Western University, London, Canada.
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Structural and Functional Pulmonary Magnetic Resonance Imaging in Pediatrics-From the Neonate to the Young Adult. Acad Radiol 2019; 26:424-430. [PMID: 30228041 DOI: 10.1016/j.acra.2018.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 06/11/2018] [Accepted: 08/21/2018] [Indexed: 12/25/2022]
Abstract
The clinical imaging modalities available to investigate pediatric pulmonary conditions such as bronchopulmonary dysplasia, cystic fibrosis, and asthma are limited primarily to chest x-ray radiograph and computed tomography. As the challenges that historically limited the application of magnetic resonance imaging (MRI) to the lung have been overcome, its clinical potential has greatly expanded. In this review article, recent advances in pulmonary MRI including ultrashort echo time and hyperpolarized-gas MRI techniques are discussed with an emphasis on pediatric research and translational applications.
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Torres L, Kammerman J, Hahn AD, Zha W, Nagle SK, Johnson K, Sandbo N, Meyer K, Schiebler M, Fain SB. "Structure-Function Imaging of Lung Disease Using Ultrashort Echo Time MRI". Acad Radiol 2019; 26:431-441. [PMID: 30658930 DOI: 10.1016/j.acra.2018.12.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this review is to acquaint the reader with recent advances in ultrashort echo time (UTE) magnetic resonance imaging (MRI) of the lung and its implications for pulmonary MRI when used in conjunction with functional MRI technique. MATERIALS AND METHODS We provide an overview of recent technical advances of UTE and explore the advantages of combined structure-function pulmonary imaging in the context of restrictive and obstructive pulmonary diseases such as idiopathic pulmonary fibrosis (IPF) and cystic fibrosis (CF). RESULTS UTE MRI clearly shows the lung parenchymal changes due to IPF and CF. The use of UTE MRI, in conjunction with established functional lung MRI in chronic lung diseases, will serve to mitigate the need for computed tomography in children. CONCLUSION Current limitations of UTE MRI include long scan times, poor delineation of thin-walled structures (e.g. cysts and reticulation) due to limited spatial resolution, low signal to noise ratio, and imperfect motion compensation. Despite these limitations, UTE MRI can now be considered as an alternative to multidetector computed tomography for the longitudinal follow-up of the morphological changes from lung diseases in neonates, children, and young adults, particularly as a complement to the unique functional capabilities of MRI.
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Gadolinium-Based Blood Volume Mapping From MRI With Ultrashort TE Versus CT and SPECT for Predicting Postoperative Lung Function in Patients With Non-Small Cell Lung Cancer. AJR Am J Roentgenol 2018; 212:57-66. [PMID: 30422708 DOI: 10.2214/ajr.18.20095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study is to directly compare the capability of gadolinium-based blood volume (BV) mapping from MRI (BV-MRI) with ultrashort TE (UTE) with that of CT and perfusion SPECT in predicting the postoperative lung function of patients with non-small cell lung cancer (NSCLC). SUBJECTS AND METHODS Unenhanced and contrast-enhanced MRI with UTE, thin-section CT, and perfusion SPECT examinations and measurements of the percentage of forced expiratory volume in 1 second (FEV1) before and after lung resection were performed for 29 patients with NSCLC (16 men [mean age, 66 years] and 13 women [mean age, 66 years]). BV-MRI with UTE was generated as a percentage of the signal change between unenhanced and contrast-enhanced MRI. The postoperative percentage of FEV1 was predicted from perfusion fractions derived from BV-MRI with UTE and from SPECT. Quantitatively and qualitatively predicted postoperative percentages of FEV1 from CT were calculated from the functional lung volumes and the number of segments. Each predicted postoperative percentage of FEV1 was then correlated with the actual postoperative percentage of FEV1, and the limits of agreement for each actual and predicted postoperative percentage of FEV1 were evaluated by Bland-Altman analysis. RESULTS Correlations between actual and predicted postoperative percentages of FEV1 for all methods were strong and significant (0.88 ≤ r ≤ 0.95). The limits of agreement (mean ± 1.96 × SD) for BV-MRI with UTE (4.2% ± 6.5%) and quantitatively assessed CT (4.1% ± 6.5%) were smaller than those for qualitatively assessed CT (4.2% ± 9.8%) and perfusion SPECT (5.7% ± 8.7%). CONCLUSION BV-MRI with UTE has the potential to predict the postoperative lung function of patients with NSCLC more accurately than qualitatively assessed CT and SPECT, and it can be considered to be at least as useful as quantitatively assessed CT.
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Mendes Pereira L, Wech T, Weng AM, Kestler C, Veldhoen S, Bley TA, Köstler H. UTE-SENCEFUL: first results for 3D high-resolution lung ventilation imaging. Magn Reson Med 2018; 81:2464-2473. [PMID: 30393947 DOI: 10.1002/mrm.27576] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/27/2018] [Accepted: 10/01/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aimed to develop a 3D MRI technique to assess lung ventilation in free-breathing and without the administration of contrast agent. METHODS A 3D-UTE sequence with a koosh ball trajectory was developed for a 3 Tesla scanner. An oversampled k-space was acquired, and the direct current signal from the k-space center was used as a navigator to sort the acquired data into 8 individual breathing phases. Gradient delays were corrected, and iterative SENSE was used to reconstruct the individual timeframes. Subsequently, the signal changes caused by motion were eliminated using a 3D image registration technique, and ventilation-weighted maps were created by analyzing the signal changes in the lung tissue. Six healthy volunteers and 1 patient with lung cancer were scanned with the new 3D-UTE and the standard 2D technique. Image quality and quantitative ventilation values were compared between both methods. RESULTS UTE-based self-gated noncontrast-enhanced functional lung (SENCEFUL) MRI provided a time-resolved reconstruction of the breathing motion, with a 49% increase of the SNR. Ventilation quantification for healthy subjects was in statistical agreement with 2D-SENCEFUL and the literature, with a mean value of 0.11 ± 0.08 mL/mL for the whole lung. UTE-SENCEFUL was able to visualize and quantify ventilation deficits in a patient with lung tumor that were not properly depicted by 2D-SENCEFUL. CONCLUSION UTE-SENCEFUL represents a robust MRI method to assess both morphological and functional information of the lungs in 3D. When compared to the 2D approach, 3D-UTE offered ventilation maps with higher resolution, improved SNR, and reduced ventilation artifacts.
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Affiliation(s)
- L Mendes Pereira
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - T Wech
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - A M Weng
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - C Kestler
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - S Veldhoen
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
| | - H Köstler
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Germany
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Zha W, Nagle SK, Cadman RV, Schiebler ML, Fain SB. Three-dimensional Isotropic Functional Imaging of Cystic Fibrosis Using Oxygen-enhanced MRI: Comparison with Hyperpolarized 3He MRI. Radiology 2018; 290:229-237. [PMID: 30351258 DOI: 10.1148/radiol.2018181148] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose To compare the performance of three-dimensional radial ultrashort echo time (UTE) oxygen-enhanced (OE) MRI with that of hyperpolarized helium 3 (3He) MRI with respect to quantitative ventilation measurements in patients with cystic fibrosis (CF). Materials and Methods In this prospective study conducted from June 2013 to May 2015, 25 participants with CF aged 10-55 years (14 male; age range, 13-55 years; 11 female; age range, 10-37 years) successfully underwent pulmonary function tests, hyperpolarized 3He MRI, and OE MRI. OE MRI used two sequential 3.5-minute normoxic and hyperoxic steady-state free-breathing UTE acquisitions. Seven participants underwent imaging at two separate examinations 1-2 weeks apart to assess repeatability. Regional ventilation was quantified as ventilation defect percentage (VDP) individually from OE MRI and hyperpolarized 3He MRI by using the same automated quantification tool. Bland-Altman analysis, intraclass correlation coefficient (ICC), Spearman correlation coefficient, and Wilcoxon signed-rank test were used to evaluate repeatability. Results In all 24 participants, the global VDP measurements from either OE MRI (ρ = -0.66, P < .001) or hyperpolarized 3He MRI (ρ = -0.75, P < .001) were significantly correlated with the percentage predicted forced expiratory volume in 1 second. VDP reported at OE MRI was 5.0% smaller than (P = .014) but highly correlated with (ρ = 0.78, P < .001) VDP reported at hyperpolarized 3He MRI. Both OE MRI-based VDP and hyperpolarized 3He MRI-based VDP demonstrated good repeatability (ICC = 0.91 and 0.95, respectively; P ≤ .001). Conclusion In lungs with cystic fibrosis, ultrashort echo time oxygen-enhanced MRI showed similar performance compared with hyperpolarized 3He MRI for quantitative measures of ventilation defects and their repeatability. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Wei Zha
- From the Departments of Medical Physics (W.Z., S.K.N., R.V.C., S.B.F.), Radiology (S.K.N., M.L.S., S.B.F.), Pediatrics (S.K.N.), and Biomedical Engineering (S.B.F.), University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Ave, Room 2492, Madison, WI 53792
| | - Scott K Nagle
- From the Departments of Medical Physics (W.Z., S.K.N., R.V.C., S.B.F.), Radiology (S.K.N., M.L.S., S.B.F.), Pediatrics (S.K.N.), and Biomedical Engineering (S.B.F.), University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Ave, Room 2492, Madison, WI 53792
| | - Robert V Cadman
- From the Departments of Medical Physics (W.Z., S.K.N., R.V.C., S.B.F.), Radiology (S.K.N., M.L.S., S.B.F.), Pediatrics (S.K.N.), and Biomedical Engineering (S.B.F.), University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Ave, Room 2492, Madison, WI 53792
| | - Mark L Schiebler
- From the Departments of Medical Physics (W.Z., S.K.N., R.V.C., S.B.F.), Radiology (S.K.N., M.L.S., S.B.F.), Pediatrics (S.K.N.), and Biomedical Engineering (S.B.F.), University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Ave, Room 2492, Madison, WI 53792
| | - Sean B Fain
- From the Departments of Medical Physics (W.Z., S.K.N., R.V.C., S.B.F.), Radiology (S.K.N., M.L.S., S.B.F.), Pediatrics (S.K.N.), and Biomedical Engineering (S.B.F.), University of Wisconsin-Madison, Wisconsin Institutes for Medical Research, 1111 Highland Ave, Room 2492, Madison, WI 53792
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Feng L, Delacoste J, Smith D, Weissbrot J, Flagg E, Moore WH, Girvin F, Raad R, Bhattacharji P, Stoffel D, Piccini D, Stuber M, Sodickson DK, Otazo R, Chandarana H. Simultaneous Evaluation of Lung Anatomy and Ventilation Using 4D Respiratory-Motion-Resolved Ultrashort Echo Time Sparse MRI. J Magn Reson Imaging 2018; 49:411-422. [PMID: 30252989 DOI: 10.1002/jmri.26245] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/14/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Computed tomography (CT) and spirometry are the current standard methods for assessing lung anatomy and pulmonary ventilation, respectively. However, CT provides limited ventilation information and spirometry only provides global measures of lung ventilation. Thus, a method that can enable simultaneous examination of lung anatomy and ventilation is of clinical interest. PURPOSE To develop and test a 4D respiratory-resolved sparse lung MRI (XD-UTE: eXtra-Dimensional Ultrashort TE imaging) approach for simultaneous evaluation of lung anatomy and pulmonary ventilation. STUDY TYPE Prospective. POPULATION In all, 23 subjects (11 volunteers and 12 patients, mean age = 63.6 ± 8.4). FIELD STRENGTH/SEQUENCE 3T MR; a prototype 3D golden-angle radial UTE sequence, a Cartesian breath-hold volumetric-interpolated examination (BH-VIBE) sequence. ASSESSMENT All subjects were scanned using the 3D golden-angle radial UTE sequence during normal breathing. Ten subjects underwent an additional scan during alternating normal and deep breathing. Respiratory-motion-resolved sparse reconstruction was performed for all the acquired data to generate dynamic normal-breathing or deep-breathing image series. For comparison, BH-VIBE was performed in 12 subjects. Lung images were visually scored by three experienced chest radiologists and were analyzed by two observers who segmented the left and right lung to derive ventilation parameters in comparison with spirometry. STATISTICAL TESTS Nonparametric paired two-tailed Wilcoxon signed-rank test; intraclass correlation coefficient, Pearson correlation coefficient. RESULTS XD-UTE achieved significantly improved image quality compared both with Cartesian BH-VIBE and radial reconstruction without motion compensation (P < 0.05). The global ventilation parameters (a sum of the left and right lung measures) were in good correlation with spirometry in the same subjects (correlation coefficient = 0.724). There were excellent correlations between the results obtained by two observers (intraclass correlation coefficient ranged from 0.8855-0.9995). DATA CONCLUSION Simultaneous evaluation of lung anatomy and ventilation using XD-UTE is demonstrated, which have shown good potential for improved diagnosis and management of patients with heterogeneous lung diseases. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:411-422.
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Affiliation(s)
- Li Feng
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jean Delacoste
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - David Smith
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Joseph Weissbrot
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Eric Flagg
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - William H Moore
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Francis Girvin
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Roy Raad
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Priya Bhattacharji
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - David Stoffel
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Davide Piccini
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Daniel K Sodickson
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ricardo Otazo
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.,Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hersh Chandarana
- Center for Advanced Imaging Innovation and Research (CAIR), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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Couch MJ, Ball IK, Li T, Fox MS, Biman B, Albert MS. 19 F MRI of the Lungs Using Inert Fluorinated Gases: Challenges and New Developments. J Magn Reson Imaging 2018; 49:343-354. [PMID: 30248212 DOI: 10.1002/jmri.26292] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/23/2018] [Accepted: 07/26/2018] [Indexed: 12/27/2022] Open
Abstract
Fluorine-19 (19 F) MRI using inhaled inert fluorinated gases is an emerging technique that can provide functional images of the lungs. Inert fluorinated gases are nontoxic, abundant, relatively inexpensive, and the technique can be performed on any MRI scanner with broadband multinuclear imaging capabilities. Pulmonary 19 F MRI has been performed in animals, healthy human volunteers, and in patients with lung disease. In this review, the technical requirements of 19 F MRI are discussed, along with various imaging approaches used to optimize the image quality. Lung imaging is typically performed in humans using a gas mixture containing 79% perfluoropropane (PFP) or sulphur hexafluoride (SF6 ) and 21% oxygen. In lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF), ventilation defects are apparent in regions that the inhaled gas cannot access. 19 F lung images are typically acquired in a single breath-hold, or in a time-resolved, multiple breath fashion. The former provides measurements of the ventilation defect percent (VDP), while the latter provides measurements of gas replacement (ie, fractional ventilation). Finally, preliminary comparisons with other functional lung imaging techniques are discussed, such as Fourier decomposition MRI and hyperpolarized gas MRI. Overall, functional 19 F lung MRI is expected to complement existing proton-based structural imaging techniques, and the combination of structural and functional lung MRI will provide useful outcome measures in the future management of pulmonary diseases in the clinic. Level of Evidence: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:343-354.
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Affiliation(s)
- Marcus J Couch
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Iain K Ball
- Philips Electronics Australia, North Ryde, Sydney, Australia
| | - Tao Li
- Department of Chemistry, Lakehead University, Thunder Bay, Ontario, Canada
| | - Matthew S Fox
- Imaging Program, Lawson Health Research Institute, London, Ontario, Canada.,Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Birubi Biman
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada.,Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mitchell S Albert
- Department of Chemistry, Lakehead University, Thunder Bay, Ontario, Canada.,Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.,Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
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Kinematic Magnetic Resonance Imaging of the Thorax Using 2-Dimensional Balanced Subsecond Steady-state Free Precession Sequence During Forced Breathing in Comparison With Spirometry. J Thorac Imaging 2018; 33:184-190. [DOI: 10.1097/rti.0000000000000314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Alamidi DF, Smailagic A, Bidar AW, Parker NS, Olsson M, Hockings PD, Lagerstrand KM, Olsson LE. Variable flip angle 3D ultrashort echo time (UTE) T 1 mapping of mouse lung: A repeatability assessment. J Magn Reson Imaging 2018; 48:846-852. [PMID: 29517831 DOI: 10.1002/jmri.25999] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/13/2018] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Lung T1 is a potential translational biomarker of lung disease. The precision and repeatability of variable flip angle (VFA) T1 mapping using modern 3D ultrashort echo time (UTE) imaging of the whole lung needs to be established before it can be used to assess response to disease and therapy. PURPOSE To evaluate the feasibility of regional lung T1 quantification with VFA 3D-UTE and to investigate long- and short-term T1 repeatability in the lungs of naive mice. STUDY TYPE Prospective preclinical animal study. POPULATION Eight naive mice and phantoms. FIELD STRENGTH/SEQUENCE 3D free-breathing radial UTE (8 μs) at 4.7T. ASSESSMENT VFA 3D-UTE T1 calculations were validated against T1 values measured with inversion recovery (IR) in phantoms. Lung T1 and proton density (S0 ) measurements of whole lung and muscle were repeated five times over 1 month in free-breathing naive mice. Two consecutive T1 measurements were performed during one of the imaging sessions. STATISTICAL TESTS Agreement in T1 between VFA 3D-UTE and IR in phantoms was assessed using Bland-Altman and Pearson 's correlation analysis. The T1 repeatability in mice was evaluated using coefficient of variation (CV), repeated-measures analysis of variance (ANOVA), and paired t-test. RESULTS Good T1 agreement between the VFA 3D-UTE and IR methods was found in phantoms. T1 in lung and muscle showed a 5% and 3% CV (1255 ± 63 msec and 1432 ± 42 msec, respectively, mean ± SD) with no changes in T1 or S0 over a month. Consecutive measurements resulted in an increase of 2% in both lung T1 and S0 . DATA CONCLUSION VFA 3D-UTE shows promise as a reliable T1 mapping method that enables full lung coverage, high signal-to-noise ratio (∼25), and spatial resolution (300 μm) in freely breathing animals. The precision of the VFA 3D-UTE method will enable better design and powering of studies. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Daniel F Alamidi
- Philips Health Systems, Stockholm, Sweden
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | | | | | - Paul D Hockings
- Antaros Medical, BioVenture Hub, Mölndal, Sweden
- Medtech West, Chalmers University of Technology, Gothenburg, Sweden
| | - Kerstin M Lagerstrand
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars E Olsson
- Department of Translational Sciences, Medical Radiation Physics, Malmö, Lund University, Sweden
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Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma: A Prospective Comparison Between Semiautomated Ventilation Defect Percentage Calculation and Pulmonary Function Tests. Invest Radiol 2017; 52:120-127. [PMID: 27662575 DOI: 10.1097/rli.0000000000000322] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to investigate ventilation in mild to moderate asthmatic patients and age-matched controls using hyperpolarized (HP) Xenon magnetic resonance imaging (MRI) and correlate findings with pulmonary function tests (PFTs). MATERIALS AND METHODS This single-center, Health Insurance Portability and Accountability Act-compliant prospective study was approved by our institutional review board. Thirty subjects (10 young asthmatic patients, 26 ± 6 years; 3 males, 7 females; 10 older asthmatic patients, 64 ± 6 years; 3 males, 7 females; 10 healthy controls) were enrolled. After repeated PFTs 1 week apart, the subjects underwent 2 MRI scans within 10 minutes, inhaling 1-L volumes containing 0.5 to 1 L of Xe. Xe ventilation signal was quantified by linear binning, from which the ventilation defect percentage (VDP) was derived. Differences in VDP among subgroups and variability with age were evaluated using 1-tailed t tests. Correlation of VDP with PFTs was tested using Pearson correlation coefficient. Reproducibility of VDP was assessed using Bland-Altman plots, linear regression (R), intraclass correlation coefficient, and concordance correlation coefficient. RESULTS Ventilation defect percentage was significantly higher in young asthmatic patients versus young healthy subjects (8.4% ± 3.2% vs 5.6% ± 1.7%, P = 0.031), but not in older asthmatic patients versus age-matched controls (16.8% ± 10.3% vs 11.6% ± 6.6%, P = 0.13). Ventilation defect percentage was found to increase significantly with age (healthy, P = 0.05; asthmatic patients, P = 0.033). Ventilation defect percentage was highly reproducible (R = 0.976; intraclass correlation coefficient, 0.977; concordance correlation coefficient, 0.976) and significantly correlated with FEV1% (r = -0.42, P = 0.025), FEF25%-75% (r = -0.45, P = 0.019), FEV1/FVC (r = -0.71, P < 0.0001), FeNO (r = 0.69, P < 0.0001), and RV/TLC (r = 0.51, P = 0.0067). Bland-Altman analysis showed a bias for VDP of -0.88 ± 1.52 (FEV1%, -0.33 ± 7.18). CONCLUSIONS Xenon MRI is able to depict airway obstructions in mild to moderate asthma and significantly correlates with PFTs.
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Zha W, Kruger SJ, Johnson KM, Cadman RV, Bell LC, Liu F, Hahn AD, Evans MD, Nagle SK, Fain SB. Pulmonary ventilation imaging in asthma and cystic fibrosis using oxygen-enhanced 3D radial ultrashort echo time MRI. J Magn Reson Imaging 2017; 47:1287-1297. [PMID: 29086454 DOI: 10.1002/jmri.25877] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/10/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A previous study demonstrated the feasibility of using 3D radial ultrashort echo time (UTE) oxygen-enhanced MRI (UTE OE-MRI) for functional imaging of healthy human lungs. The repeatability of quantitative measures from UTE OE-MRI needs to be established prior to its application in clinical research. PURPOSE To evaluate repeatability of obstructive patterns in asthma and cystic fibrosis (CF) with UTE OE-MRI with isotropic spatial resolution and full chest coverage. STUDY TYPE Volunteer and patient repeatability. POPULATION Eighteen human subjects (five asthma, six CF, and seven normal subjects). FIELD STRENGTH/SEQUENCE Respiratory-gated free-breathing 3D radial UTE (80 μs) sequence at 1.5T. ASSESSMENT Two 3D radial UTE volumes were acquired sequentially under normoxic and hyperoxic conditions. A subset of subjects underwent repeat acquisitions on either the same day or ≤15 days apart. Asthma and CF subjects also underwent spirometry. A workflow including deformable registration and retrospective lung density correction was used to compute 3D isotropic percent signal enhancement (PSE) maps. Median PSE (MPSE) and ventilation defect percent (VDP) of the lung were measured from the PSE map. STATISTICAL TESTS The relations between MPSE, VDP, and spirometric measures were assessed using Spearman correlations. The test-retest repeatability was evaluated using Bland-Altman analysis and intraclass correlation coefficients (ICC). RESULTS Ventilation measures in normal subjects (MPSE = 8.0%, VDP = 3.3%) were significantly different from those in asthma (MPSE = 6.0%, P = 0.042; VDP = 21.7%, P = 0.018) and CF group (MPSE = 4.5%, P = 0.0006; VDP = 27.2%, P = 0.002). MPSE correlated significantly with forced expiratory lung volume in 1 second percent predicted (ρ = 0.72, P = 0.017). The ICC of the test-retest VDP and MPSE were both ≥0.90. In all subject groups, an anterior/posterior gradient was observed with higher MPSE and lower VDP in the posterior compared to anterior regions (P ≤ 0.0021 for all comparisons). DATA CONCLUSION 3D radial UTE OE-MRI supports quantitative differentiation of diseased vs. healthy lungs using either whole lung VDP or MPSE with excellent test-retest repeatability. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1287-1297.
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Affiliation(s)
- Wei Zha
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Stanley J Kruger
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Robert V Cadman
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laura C Bell
- Division of Imaging Research, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Fang Liu
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Andrew D Hahn
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael D Evans
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott K Nagle
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Bauman G, Pusterla O, Santini F, Bieri O. Dynamic and steady-state oxygen-dependent lung relaxometry using inversion recovery ultra-fast steady-state free precession imaging at 1.5 T. Magn Reson Med 2017; 79:839-845. [PMID: 28520198 DOI: 10.1002/mrm.26739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE To demonstrate the feasibility of oxygen-dependent relaxometry in human lung using an inversion recovery ultra-fast steady-state free precession (IR-ufSSFP) technique. METHODS Electrocardiogram-triggered pulmonary relaxometry with IR-ufSSFP was performed in 7 healthy human subjects at 1.5 T. The data were acquired under both normoxic and hyperoxic conditions. In a single breath-hold of less than 9 seconds, 30 transient state IR-ufSSFP images were acquired, yielding longitudinal (T1) and transversal (T2) relaxometry parameter maps using voxel-wise nonlinear fitting. Possible spatial misalignments between consecutive IR-ufSSFP parameter maps were corrected using elastic image registration. Furthermore, dynamic relaxometry oxygen wash-in and wash-out scans were performed in one volunteer. From this, T1 -related wash-in and wash-out time constants (τwi , τwo ) were calculated voxel-wise on registered maps using an exponential fitting model. RESULTS For healthy lung, observed T1 values were 1399 ± 77 and 1290 ± 76 ms under normoxic and hyperoxic conditions, respectively. Oxygen-related reduction of T1 was statistically significant in every volunteer. No statistically significant change, however, was observed in T2, with normoxic and hyperoxic T2 values of 55 ± 16 and 56 ± 17 ms, respectively. The observed average τwi was 87.0 ± 28.7 seconds, whereas the average τwo was 73.5 ± 21.6 seconds. CONCLUSION IR-ufSSFP allows fast, steady-state, and dynamic oxygen-dependent relaxometry of the human lung. Magn Reson Med 79:839-845, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Grzegorz Bauman
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Deparment of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Orso Pusterla
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Deparment of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Francesco Santini
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Deparment of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Deparment of Biomedical Engineering, University of Basel, Basel, Switzerland
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Kindvall SSI, Diaz S, Svensson J, Wollmer P, Olsson LE. The change of longitudinal relaxation rate in oxygen enhanced pulmonary MRI depends on age and BMI but not diffusing capacity of carbon monoxide in healthy never-smokers. PLoS One 2017; 12:e0177670. [PMID: 28494006 PMCID: PMC5426684 DOI: 10.1371/journal.pone.0177670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 05/01/2017] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Oxygen enhanced pulmonary MRI is a promising modality for functional lung studies and has been applied to a wide range of pulmonary conditions. The purpose of this study was to characterize the oxygen enhancement effect in the lungs of healthy, never-smokers, in light of a previously established relationship between oxygen enhancement and diffusing capacity of carbon monoxide in the lung (DL,CO) in patients with lung disease. METHODS In 30 healthy never-smoking volunteers, an inversion recovery with gradient echo read-out (Snapshot-FLASH) was used to quantify the difference in longitudinal relaxation rate, while breathing air and 100% oxygen, ΔR1, at 1.5 Tesla. Measurements were performed under multiple tidal inspiration breath-holds. RESULTS In single parameter linear models, ΔR1 exhibit a significant correlation with age (p = 0.003) and BMI (p = 0.0004), but not DL,CO (p = 0.33). Stepwise linear regression of ΔR1 yields an optimized model including an age-BMI interaction term. CONCLUSION In this healthy, never-smoking cohort, age and BMI are both predictors of the change in MRI longitudinal relaxation rate when breathing oxygen. However, DL,CO does not show a significant correlation with the oxygen enhancement. This is possibly because oxygen transfer in the lung is not diffusion limited at rest in healthy individuals. This work stresses the importance of using a physiological model to understand results from oxygen enhanced MRI.
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Affiliation(s)
| | - Sandra Diaz
- Medical Radiology, Translational Medicine, Lund University, Malmö, Sweden
| | - Jonas Svensson
- Medical Imaging and Physiology, Skane University Hospital, Lund, Sweden
| | - Per Wollmer
- Clinical Physiology, Translational Medicine, Lund University, Malmö, Sweden
| | - Lars E. Olsson
- Medical Radiation Physics, Translational Medicine, Lund University, Malmö, Sweden
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Current and future approaches to large airways imaging in adults and children. Clin Radiol 2017; 72:356-374. [DOI: 10.1016/j.crad.2017.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 01/07/2017] [Accepted: 01/23/2017] [Indexed: 01/04/2023]
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Pusterla O, Bauman G, Bieri O. Three-dimensional oxygen-enhanced MRI of the human lung at 1.5T with ultra-fast balanced steady-state free precession. Magn Reson Med 2017; 79:246-255. [PMID: 28337782 DOI: 10.1002/mrm.26665] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/11/2017] [Accepted: 02/13/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE To assess the feasibility of 3D oxygen-enhanced (OE) MRI of the lung at 1.5T using multi-volumetric ultra-fast balanced steady-state free precession (ufSSFP) acquisitions. METHODS Isotropic imaging of the lung for OE-MRI was performed with an adapted 3D ufSSFP sequence using five breath-hold acquisitions ranging from functional residual capacity to tidal inspiration under both normoxic (room air) and hyperoxic (100% O2 ) gas conditions. For each O2 concentration, a sponge model (which captures the parenchymal signal intensity variation as a function of the lung volume) was fitted to the acquired multi-volumetric datasets after semiautomatic lung segmentation and deformable image registration. From the retrieved model parameters, 3D oxygen-enhancement maps were calculated. RESULTS For OE ufSSFP imaging, the maximum parenchymal signal is observed for flip angles around 23° under both normoxic and hyperoxic conditions. It is found that the sponge model accurately describes parenchymal signal at different breathing positions, thereby mitigating the confounding bias in the estimated oxygen enhancement from residual density modulations. From the model, an average lung oxygen enhancement of 7.0% ± 0.3% was found in the healthy volunteers, and the oxygen-enhancement maps indicate a ventral to dorsal gravitation-related gradient. CONCLUSION The study demonstrates the feasibility of whole-lung OE-MRI from multi-volumetric ufSSFP in healthy volunteers. Magn Reson Med 79:246-255, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Orso Pusterla
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Grzegorz Bauman
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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Ohno Y, Koyama H, Yoshikawa T, Kishida Y, Seki S, Takenaka D, Yui M, Miyazaki M, Sugimura K. Standard-, Reduced-, and No-Dose Thin-Section Radiologic Examinations: Comparison of Capability for Nodule Detection and Nodule Type Assessment in Patients Suspected of Having Pulmonary Nodules. Radiology 2017; 284:562-573. [PMID: 28263700 DOI: 10.1148/radiol.2017161037] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Purpose To compare the capability of pulmonary thin-section magnetic resonance (MR) imaging with ultrashort echo time (UTE) with that of standard- and reduced-dose thin-section computed tomography (CT) in nodule detection and evaluation of nodule type. Materials and Methods The institutional review board approved this study, and written informed consent was obtained from each patient. Standard- and reduced-dose chest CT (60 and 250 mA) and MR imaging with UTE were used to examine 52 patients; 29 were men (mean age, 66.4 years ± 7.3 [standard deviation]; age range, 48-79 years) and 23 were women (mean age, 64.8 years ± 10.1; age range, 42-83 years). Probability of nodule presence was assessed for all methods with a five-point visual scoring system. All nodules were then classified as missed, ground-glass, part-solid, or solid nodules. To compare nodule detection capability of the three methods, consensus for performances was rated by using jackknife free-response receiver operating characteristic analysis, and κ analysis was used to compare intermethod agreement for nodule type classification. Results There was no significant difference (F = 0.70, P = .59) in figure of merit between methods (standard-dose CT, 0.86; reduced-dose CT, 0.84; MR imaging with UTE, 0.86). There was no significant difference in sensitivity between methods (standard-dose CT vs reduced-dose CT, P = .50; standard-dose CT vs MR imaging with UTE, P = .50; reduced-dose CT vs MR imaging with UTE, P >.99). Intermethod agreement was excellent (standard-dose CT vs reduced-dose CT, κ = 0.98, P < .001; standard-dose CT vs MR imaging with UTE, κ = 0.98, P < .001; reduced-dose CT vs MR imaging with UTE, κ = 0.99, P < .001). Conclusion Pulmonary thin-section MR imaging with UTE was useful in nodule detection and evaluation of nodule type, and it is considered at least as efficacious as standard- or reduced-dose thin-section CT. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Yoshiharu Ohno
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Hisanobu Koyama
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Takeshi Yoshikawa
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Yuji Kishida
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Shinichiro Seki
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Daisuke Takenaka
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Masao Yui
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Mitsue Miyazaki
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
| | - Kazuro Sugimura
- From the Division of Functional and Diagnostic Imaging Research, Department of Radiology (Y.O., T.Y.), Advanced Biomedical Imaging Research Center (Y.O., T.Y.), and Division of Radiology, Department of Radiology (H.K., Y.K., S.S., K.S.), Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan; Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan (D.T.); Toshiba Medical Systems, Otawara, Tochigi, Japan (M.Y.); and Toshiba Medical Research Institute USA, Vernon Hills, Il (M.M.)
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Ebner L, Kammerman J, Driehuys B, Schiebler ML, Cadman RV, Fain SB. The role of hyperpolarized 129xenon in MR imaging of pulmonary function. Eur J Radiol 2016; 86:343-352. [PMID: 27707585 DOI: 10.1016/j.ejrad.2016.09.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/15/2016] [Indexed: 01/29/2023]
Abstract
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.
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Affiliation(s)
- Lukas Ebner
- Cardiothoracic Imaging, Duke University Medical Center, Department of Radiology, Duke University, Durham, NC, USA
| | - Jeff Kammerman
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
| | | | - Mark L Schiebler
- Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Robert V Cadman
- Department of Medical Physics, University of Wisconsin, Madison, WI, USA
| | - Sean B Fain
- Departments of Medical Physics, Radiology, and Biomedical Engineering, University of Wisconsin, Madison, WI, USA.
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Hahn AD, Higano NS, Walkup LL, Thomen RP, Cao X, Merhar SL, Tkach JA, Woods JC, Fain SB. Pulmonary MRI of neonates in the intensive care unit using 3D ultrashort echo time and a small footprint MRI system. J Magn Reson Imaging 2016; 45:463-471. [PMID: 27458992 DOI: 10.1002/jmri.25394] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/01/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To determine the feasibility of pulmonary magnetic resonance imaging (MRI) of neonatal lung structures enabled by combining two novel technologies: first, a 3D radial ultrashort echo time (UTE) pulse sequence capable of high spatial resolution full-chest imaging in nonsedated quiet-breathing neonates; and second, a unique, small-footprint 1.5T MRI scanner design adapted for neonatal imaging and installed within the neonatal intensive care unit (NICU). MATERIALS AND METHODS Ten patients underwent MRI within the NICU, in accordance with an approved Institutional Review Board protocol. Five had clinical diagnoses of bronchopulmonary dysplasia (BPD), and five had putatively normal lung function. Pulmonary imaging was performed at 1.5T using 3D radial UTE and standard 3D fast gradient recalled echo (FGRE). Diagnostic quality, presence of motion artifacts, and apparent severity of lung pathology were evaluated by two radiologists. Quantitative metrics were additionally used to evaluate lung parenchymal signal. RESULTS UTE images showed significantly higher signal in lung parenchyma (P < 0.0001) and fewer apparent motion artifacts compared to FGRE (P = 0.046). Pulmonary pathology was more severe in patients diagnosed with BPD relative to controls (P = 0.001). Infants diagnosed with BPD also had significantly higher signal in lung parenchyma, measured using UTE, relative to controls (P = 0.002). CONCLUSION These results demonstrate the technical feasibility of pulmonary MRI in free-breathing, nonsedated infants in the NICU at high, isotropic resolutions approaching that achievable with computed tomography (CT). There is potential for pulmonary MRI to play a role in improving how clinicians understand and manage care of neonatal and pediatric pulmonary diseases. J. Magn. Reson. Imaging 2016. LEVEL OF EVIDENCE 2 J. Magn. Reson. Imaging 2017;45:463-471.
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Affiliation(s)
- Andrew D Hahn
- Department of Medical Physics, University of Wisconsin, Madison, WI
| | - Nara S Higano
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, Washington University in St. Louis, St. Louis, MO
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert P Thomen
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, Washington University in St. Louis, St. Louis, MO
| | - Xuefeng Cao
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, University of Cincinnati, Cincinnati, OH
| | - Stephanie L Merhar
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jean A Tkach
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Physics, Washington University in St. Louis, St. Louis, MO
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin, Madison, WI
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43
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Zurek M, Sladen L, Johansson E, Olsson M, Jackson S, Zhang H, Mayer G, Hockings PD. Assessing the Relationship between Lung Density and Function with Oxygen-Enhanced Magnetic Resonance Imaging in a Mouse Model of Emphysema. PLoS One 2016; 11:e0151211. [PMID: 26977928 PMCID: PMC4792441 DOI: 10.1371/journal.pone.0151211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/23/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose A magnetic resonance imaging method is presented that allows for the simultaneous assessment of oxygen delivery, oxygen uptake, and parenchymal density. The technique is applied to a mouse model of porcine pancreatic elastase (PPE) induced lung emphysema in order to investigate how structural changes affect lung function. Method Nine-week-old female C57BL6 mice were instilled with saline or PPE at days 0 and 7. At day 19, oxygen delivery, oxygen uptake, and lung density were quantified from T1 and proton-density measurements obtained via oxygen-enhanced magnetic resonance imaging (OE-MRI) using an ultrashort echo-time imaging sequence. Subsequently, the lungs were sectioned for histological observation. Blood-gas analyses and pulmonary functional tests via FlexiVent were performed in separate cohorts. Principal Findings PPE-challenged mice had reduced density when assessed via MRI, consistent with the parenchyma loss observed in the histology sections, and an increased lung compliance was detected via FlexiVent. The oxygenation levels, as assessed via the blood-gas analysis, showed no difference between PPE-challenged animals and control. This finding was mirrored in the global MRI assessments of oxygen delivery and uptake, where the changes in relaxation time indices were matched between the groups. The heterogeneity of the same parameters however, were increased in PPE-challenged animals. When the oxygenation status was investigated in regions of varying density, a reduced oxygen-uptake was found in low-density regions of PPE-challenged mice. In high-density regions the uptake was higher than that of regions of corresponding density in control animals. The oxygen delivery was proportional to the oxygen uptake in both groups. Conclusions The proposed method allowed for the regional assessment of the relationship between lung density and two aspects of lung function, the oxygen delivery and uptake. When compared to global indices of lung function, an increased sensitivity for detecting heterogeneous lung disorders was found. This indicated that the technique has potential for early detection of lung dysfunction–before global changes occur.
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Affiliation(s)
- Magdalena Zurek
- Personalised Healthcare and Biomarkers, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
- * E-mail:
| | - Louise Sladen
- Respiratory, Inflammation & Autoimmunity, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Edvin Johansson
- Personalised Healthcare and Biomarkers, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Marita Olsson
- Discovery Sciences, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Sonya Jackson
- Respiratory, Inflammation & Autoimmunity, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Hui Zhang
- Drug Safety and Metabolism, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Gaell Mayer
- Respiratory, Inflammation & Autoimmunity, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Paul D. Hockings
- Personalised Healthcare and Biomarkers, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
- MedTech West, Chalmers University of Technology, Gothenburg, Sweden
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44
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Higano NS, Hahn AD, Tkach JA, Cao X, Walkup LL, Thomen RP, Merhar SL, Kingma PS, Fain SB, Woods JC. Retrospective respiratory self-gating and removal of bulk motion in pulmonary UTE MRI of neonates and adults. Magn Reson Med 2016; 77:1284-1295. [PMID: 26972576 DOI: 10.1002/mrm.26212] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/09/2016] [Accepted: 02/20/2016] [Indexed: 12/30/2022]
Abstract
PURPOSE To implement pulmonary three-dimensional (3D) radial ultrashort echo-time (UTE) MRI in non-sedated, free-breathing neonates and adults with retrospective motion tracking of respiratory and intermittent bulk motion, to obtain diagnostic-quality, respiratory-gated images. METHODS Pulmonary 3D radial UTE MRI was performed at 1.5 tesla (T) during free breathing in neonates and adult volunteers for validation. Motion-tracking waveforms were obtained from the time course of each free induction decay's initial point (i.e., k-space center), allowing for respiratory-gated image reconstructions that excluded data acquired during bulk motion. Tidal volumes were calculated from end-expiration and end-inspiration images. Respiratory rates were calculated from the Fourier transform of the motion-tracking waveform during quiet breathing, with comparison to physiologic prediction in neonates and validation with spirometry in adults. RESULTS High-quality respiratory-gated anatomic images were obtained at inspiration and expiration, with less respiratory blurring at the expense of signal-to-noise for narrower gating windows. Inspiration-expiration volume differences agreed with physiologic predictions (neonates; Bland-Altman bias = 6.2 mL) and spirometric values (adults; bias = 0.11 L). MRI-measured respiratory rates compared well with the observed rates (biases = -0.5 and 0.2 breaths/min for neonates and adults, respectively). CONCLUSIONS Three-dimensional radial pulmonary UTE MRI allows for retrospective respiratory self-gating and removal of intermittent bulk motion in free-breathing, non-sedated neonates and adults. Magn Reson Med 77:1284-1295, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Nara S Higano
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Physics, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Andrew D Hahn
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jean A Tkach
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Xuefeng Cao
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Physics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Laura L Walkup
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Robert P Thomen
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Physics, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Stephanie L Merhar
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Paul S Kingma
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sean B Fain
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jason C Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Physics, Washington University in St. Louis, St. Louis, Missouri, USA.,Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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45
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Kruger SJ, Nagle SK, Couch MJ, Ohno Y, Albert M, Fain SB. Functional imaging of the lungs with gas agents. J Magn Reson Imaging 2016; 43:295-315. [PMID: 26218920 PMCID: PMC4733870 DOI: 10.1002/jmri.25002] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/26/2015] [Indexed: 12/22/2022] Open
Abstract
This review focuses on the state-of-the-art of the three major classes of gas contrast agents used in magnetic resonance imaging (MRI)-hyperpolarized (HP) gas, molecular oxygen, and fluorinated gas--and their application to clinical pulmonary research. During the past several years there has been accelerated development of pulmonary MRI. This has been driven in part by concerns regarding ionizing radiation using multidetector computed tomography (CT). However, MRI also offers capabilities for fast multispectral and functional imaging using gas agents that are not technically feasible with CT. Recent improvements in gradient performance and radial acquisition methods using ultrashort echo time (UTE) have contributed to advances in these functional pulmonary MRI techniques. The relative strengths and weaknesses of the main functional imaging methods and gas agents are compared and applications to measures of ventilation, diffusion, and gas exchange are presented. Functional lung MRI methods using these gas agents are improving our understanding of a wide range of chronic lung diseases, including chronic obstructive pulmonary disease, asthma, and cystic fibrosis in both adults and children.
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Affiliation(s)
- Stanley J. Kruger
- Department of Medical Physics, University of Wisconsin – Madison, WI, U.S.A
| | - Scott K. Nagle
- Department of Medical Physics, University of Wisconsin – Madison, WI, U.S.A
- Department of Radiology, University of Wisconsin – Madison, WI, U.S.A
- Department of Pediatrics, University of Wisconsin – Madison, WI, U.S.A
| | - Marcus J. Couch
- Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
- Biotechnology Program, Lakehead University, Thunder Bay, ON, Canada
| | - Yoshiharu Ohno
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mitchell Albert
- Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
- Department of Chemistry, Lakehead University, Thunder Bay, ON, Canada
| | - Sean B. Fain
- Department of Medical Physics, University of Wisconsin – Madison, WI, U.S.A
- Department of Radiology, University of Wisconsin – Madison, WI, U.S.A
- Department of Biomedical Engineering, University of Wisconsin – Madison, WI, U.S.A
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46
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Abstract
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.
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Affiliation(s)
- Laura L Walkup
- Division of Pulmonary Medicine, Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MC 5033, Cincinnati, OH 42229, USA
| | - Jason C Woods
- Division of Pulmonary Medicine, Department of Radiology, Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MC 5033, Cincinnati, OH 42229, USA.
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47
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Ohno Y, Koyama H, Yoshikawa T, Seki S, Takenaka D, Yui M, Lu A, Miyazaki M, Sugimura K. Pulmonary high-resolution ultrashort TE MR imaging: Comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases. J Magn Reson Imaging 2015. [PMID: 26223818 DOI: 10.1002/jmri.25008] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To determine the accuracy of pulmonary MR imaging with ultrashort echo time (UTE) for lung and mediastinum assessments using computed tomography (CT) as the reference standard, for various pulmonary parenchyma diseases. METHODS Eight-five consecutive patients (46 males: mean age, 69 years and 39 females: mean age, 69 years) with various pulmonary parenchyma diseases were examined with chest standard- and low-dose CTs and pulmonary MR imaging with UTE. This was followed by visual assessment using a 5-point system of the presence of nodules or masses, ground-glass opacity, micronodules, nodules, patchy shadow or consolidation, emphysema or bullae, bronchiectasis, reticular opacity, and honeycomb and traction bronchiectasis. Presence of aneurysms, pleural or pericardial effusions, pleural thickening or tumor, and lymph adenopathy was also evaluated using a 5-point system. To compare the capability of the methods for lung parenchyma and mediastinum evaluation, intermethod agreement was evaluated by means of kappa statistics and χ2 test. Receiver operating characteristic analyses were used to compare diagnostic performance of all methods. RESULTS Intermethod agreements between pulmonary MR imaging and standard-dose and low-dose CT were significant and either substantial or almost perfect (0.67 ≤ κ ≤ 0.98; P < 0.0001). Areas under the curve for emphysema or bullae, bronchiectasis or traction bronchiectasis and reticular opacity on standard-dose CT were significantly larger than those on low-dose CT (emphysema or bullae: P = 0.0002; reticular opacity: P < 0.0001) and pulmonary MR imaging (emphysema or bullae: P < 0.0001; bronchiectasis: P = 0.008; reticular opacity: P < 0.0001). CONCLUSION Pulmonary MR imaging with UTE is useful for lung and mediastinum assessment and evaluation of radiological findings for patients with various pulmonary parenchyma diseases.
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Affiliation(s)
- Yoshiharu Ohno
- Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.,Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hisanobu Koyama
- Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Takeshi Yoshikawa
- Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.,Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Shinichiro Seki
- Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Daisuke Takenaka
- Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Masao Yui
- Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan
| | - Aiming Lu
- Toshiba Medical Research Institute USA, Vernon Hills, Illinois, USA
| | - Mitsue Miyazaki
- Toshiba Medical Research Institute USA, Vernon Hills, Illinois, USA
| | - Kazuro Sugimura
- Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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