Probing lung microstructure with hyperpolarized 3He gradient echo MRI

Assessment of pulmonary microstructural changes by hyperpolarized 129Xe diffusion-weighted imaging in an elastase-instilled rat model of emphysema

BACKGROUND

The purpose of this study was to explore the feasibility of hyperpolarized ¹²⁹Xe diffusion-weighted imaging (DWI) for the evaluation of pulmonary microstructural changes in the presence of pancreatic porcine elastase (PPE)-induced pulmonary emphysema rat model.

METHODS

Sixteen male Sprague-Dawley (SD) rats were randomly divided into two groups, the emphysema model group and control group. Experimental emphysematous models were made by instilling elastase into rat lungs of model group, the control group were instilled with isodose saline. Hyperpolarized ¹²⁹Xe magnetic resonance imaging (MRI) and histology were performed in all 16 rats after 30 days. DWIs were performed on a Bruker 7.0 T micro MRI, and the apparent diffusion coefficients (ADCs) were measured in all rats. Mean linear intercepts (MLIs) of pulmonary alveoli were measured on histology. The statistical analyses were performed about the correlation between the mean ADC of hyperpolarized ¹²⁹Xe in the whole lung and MLI of pulmonary histology metric.

RESULTS

The pulmonary emphysematous model was successfully confirmed by the histology and all scans were also successful. The ADC value of ¹²⁹Xe in the model group (0.0313±0.0005 cm²/s) was significantly increased compared with that of the control group (0.0288±0.0007 cm²/s, P<0.0001). Morphological differences such as MLI of pulmonary alveoli were observed between the two groups, the MLI of pulmonary alveoli in model group significantly increased (91±5 µm) than that of control group (50±3 µm, P<0.0001). Furthermore, the ADCs was moderately correlated with MLIs (r=0.724, P<0.01).

CONCLUSIONS

These results indicate that ¹²⁹Xe ADC value can quantitatively reflect the alveolar space enlargement and it is a promising biomarker for the detection of pulmonary emphysema.

Diffusion lung imaging with hyperpolarized gas MRI

Lung imaging using conventional ¹ H MRI presents great challenges because of the low density of lung tissue, lung motion and very fast lung tissue transverse relaxation (typical T₂ * is about 1-2 ms). MRI with hyperpolarized gases (³ He and ¹²⁹ Xe) provides a valuable alternative because of the very strong signal originating from inhaled gas residing in the lung airspaces and relatively slow gas T₂ * relaxation (typical T₂ * is about 20-30 ms). However, in vivo human experiments should be performed very rapidly - usually during a single breath-hold. In this review, we describe the recent developments in diffusion lung MRI with hyperpolarized gases. We show that a combination of the results of modeling of gas diffusion in lung airspaces and diffusion measurements with variable diffusion-sensitizing gradients allows the extraction of quantitative information on the lung microstructure at the alveolar level. From an MRI scan of less than 15 s, this approach, called in vivo lung morphometry, allows the provision of quantitative values and spatial distributions of the same physiological parameters as measured by means of 'standard' invasive stereology (mean linear intercept, surface-to-volume ratio, density of alveoli, etc.). In addition, the approach makes it possible to evaluate some advanced Weibel parameters characterizing lung microstructure: average radii of alveolar sacs and ducts, as well as the depth of their alveolar sleeves. Such measurements, providing in vivo information on the integrity of pulmonary acinar airways and their changes in different diseases, are of great importance and interest to a broad range of physiologists and clinicians. We also discuss a new type of experiment based on the in vivo lung morphometry technique combined with quantitative computed tomography measurements, as well as with gradient echo MRI measurements of hyperpolarized gas transverse relaxation in the lung airspaces. Such experiments provide additional information on the blood vessel volume fraction, specific gas volume and length of the acinar airways, and allow the evaluation of lung parenchymal and non-parenchymal tissue. Copyright © 2015 John Wiley & Sons, Ltd.

COPD: Do Imaging Measurements of Emphysema and Airway Disease Explain Symptoms and Exercise Capacity?

PURPOSE

To determine the role of imaging measurements of emphysema and airway disease in determining chronic obstructive pulmonary disease (COPD) symptoms and exercise limitation in patients with COPD, particularly in patients with mild-to-moderate disease.

MATERIALS AND METHODS

Participants (n = 116) with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade U (unclassified) or grade I-IV COPD provided informed consent to an ethics board-approved HIPAA-compliant protocol and underwent spirometry and plethysmography, completed the St George's Respiratory Questionnaire (SGRQ), completed a 6-minute walk test for the 6-minute walk distance (6MWD), and underwent hyperpolarized helium 3 ((3)He) magnetic resonance (MR) imaging and computed tomography (CT). Emphysema was estimated by using the MR imaging apparent diffusion coefficient (ADC) and the relative area of the CT attenuation histogram with attenuation of -950 HU or less (RA950). Airway disease was measured by using the CT airway wall thickness of airways with an internal perimeter of 10 mm and total airway count. Ventilation defect percentage at (3)He MR imaging was used to measure ventilation. Multivariable regression models for the 6MWD and SGRQ symptom subscore were used to evaluate the relationships between physiologic and imaging measurements.

RESULTS

Multivariate modeling for the 6MWD in 80 patients with GOLD grade U-II COPD showed that ADC (β = 0.34, P = .04), diffusing capacity of the lung for carbon monoxide (β = 0.60, P = .0008), and residual volume/total lung capacity (β = -0.26, P = .02) were significant variables, while forced expiratory volume in 1 second (FEV1) and airway disease measurements were not. In 36 patients with GOLD grade III or IV disease, FEV1 (β = 0.48, P = .01) was the only significant contributor in a multivariate model for 6MWD. MR imaging emphysema measurements also made the greatest relative contribution to symptoms in patients with milder (GOLD grade U-II) COPD (ADC: β = 0.60, P = .005; RA950: β = -0.52, P = .02; FEV1: β = -0.45, P = .0002) and in grade III or IV disease (ADC: β = 0.95, P = .01; RA950: β = -0.62, P = .07; airway count: β = -0.49, P = .01).

CONCLUSION

In patients with mild-to-moderate COPD, MR imaging emphysema measurements played a dominant role in the expression of exercise limitation, while both CT and MR imaging measurements of emphysema explained symptoms.

Numerical study of a cylinder model of the diffusion MRI signal for neuronal dendrite trees

We study numerically how the neuronal dendrite tree structure can affect the diffusion magnetic resonance imaging (dMRI) signal in brain tissue. For a large set of randomly generated dendrite trees, synthetic dMRI signals are computed and fitted to a cylinder model to estimate the effective longitudinal diffusivity D(L) in the direction of neurites. When the dendrite branches are short compared to the diffusion length, D(L) depends significantly on the ratio between the average branch length and the diffusion length. In turn, D(L) has very weak dependence on the distribution of branch lengths and orientations of a dendrite tree, and the number of branches per node. We conclude that the cylinder model which ignores the connectivity of the dendrite tree, can still be adapted to describe the apparent diffusion coefficient in brain tissue.