Chronic Obstructive Pulmonary Disease: Quantification of Bronchodilator Effects by Using Hyperpolarized He MR Imaging

Kirby, Miranda; Mathew, Lindsay; Heydarian, Mohammadreza; Etemad-Rezai, Roya; McCormack, David G.; Párraga, Grace

doi:10.1148/radiol.11110403

Cited by 74 publications

(53 citation statements)

References 42 publications

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“…Using hyperpolarized 3 He MRI, lung function is typically quantified based on signal intensity, which is interpreted as "ventilation", and regions of signal void are referred to as ventilation defects that are believed to represent areas of the lung that do not participate in gas distribution [5]. However, in subjects with respiratory disease, unventilated regions cannot be ascribed to specific parenchymal or airway abnormalities because 3He MRI does not provide sufficient lung structural information [4].…”

Section: Introductionmentioning

confidence: 99%

Development and application of pulmonary structure-function registration methods: towards pulmonary image-guidance tools for improved airway targeted therapies and outcomes

et al. 2014

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Objectives:We aimed to develop a way to rapidly generate multi-modality (MRI-CT) pulmonary imaging structurefunction maps using novel non-rigid image registration methods. This objective is part of our overarching goal to provide an image processing pipeline to generate pulmonary structure-function maps and guide airway-targeted therapies.Methods: Anatomical 1 H and functional 3 He MRI were acquired in 5 healthy asymptomatic ex-smokers and 7 ex-smokers with chronic obstructive pulmonary disease (COPD) at inspiration breath-hold. Thoracic CT was performed within ten minutes of MRI using the same breath-hold volume. Landmark-based affine registration methods previously validated for imaging of COPD, was based on corresponding fiducial markers located in both CT and 1 H MRI coronal slices and compared with shape-based CT-MRI non-rigid registration. Shape-based CT-MRI registration was developed by first identifying the shapes of the lung cavities manually, and then registering the two shapes using affine and thin-plate spline algorithms. We compared registration accuracy using the fiducial localization error (FLE) and target registration error (TRE). Results:For landmark-based registration, the TRE was 8.4±5.3 mm for whole lung and 7.8±4.6 mm for the R and L lungs registered independently (p=0.4). For shape-based registration, the TRE was 8.0±4.6 mm for whole lung as compared to 6.9±4.4 mm for the R and L lung registered independently and this difference was significant (p=0.01). The difference for shape-based (6.9±4.4 mm) and landmark-based R and L lung registration (7.8±4.6 mm) was also significant (p=.04) Conclusion: Shape-based registration TRE was significantly improved compared to landmark-based registration when considering L and R lungs independently.

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Section: Introductionmentioning

confidence: 99%

Development and application of pulmonary structure-function registration methods: towards pulmonary image-guidance tools for improved airway targeted therapies and outcomes

et al. 2014

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“…Hyperpolarized 3 He magnetic resonance imaging (MRI) ventilation heterogeneity has been shown in patients with pulmonary diseases such as COPD (4,5), asthma (6,7), and cystic fibrosis (8). At the same time, however, preclinical or subclinical 3 He ventilation heterogeneity has also been observed in volunteers without clinical signs or symptoms of lung disease such as healthy elderly never-smokers (9), ex-smokers without airflow limitation (10), in second-hand smoke exposed adults (11), and current-smokers without disease (12).…”

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Ventilation Heterogeneity in Ex-smokers without Airflow Limitation

et al. 2015

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“…Although experience with 129 Xe and 19 F is still limited, 128,129 these inhaled gas MRI methods provide the strongest translational potential because of the relative abundance and low cost of these gases. Notwithstanding these challenges, recent acute therapy studies in COPD post-salbutamol 130 and post-COPD exacerbation therapy requiring hospitalization 131 show the potential for inhaled gas MRI ventilation defect measurements to represent the subtle (post-exacerbation) and not so subtle (post-salbutamol) ventilation improvements after therapy. It is important to note that the visibly obvious and statistically-significant improvements in ventilation in these cases were not related to FEV 1 improvements.…”

Section: Pulmonary Mri Measurements Of Copdmentioning

confidence: 99%

Pulmonary CT and MRI phenotypes that help explain chronic pulmonary obstruction disease pathophysiology and outcomes

Hoffman

Lynch

Barr

et al. 2015

Magnetic Resonance Imaging

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Pulmonary X-ray computed tomographic (CT) and magnetic resonance imaging (MRI) research and development has been motivated, in part, by the quest to sub-phenotype common chronic lung diseases such as chronic obstructive pulmonary disease (COPD). For thoracic CT and MRI, the main COPD research tools, disease biomarkers are being validated that go beyond anatomy and structure to include pulmonary functional measurements such as regional ventilation, perfusion and inflammation. In addition, there has also been a drive to improve spatial and contrast resolution while at the same time reducing or eliminating radiation exposure. Therefore, this review focuses on our evolving understanding of patient-relevant and clinically-important COPD endpoints and how current and emerging MRI and CT tools and measurements may be exploited for their identification, quantification and utilization. Since reviews of the imaging physics of pulmonary CT and MRI and reviews of other COPD imaging methods were previously published and well-summarized, we focus on the current clinical challenges in COPD and the potential of newly emerging MR and CT imaging measurements to address them. Here we summarize MRI and CT imaging methods and their clinical translation for generating reproducible and sensitive measurements of COPD related to pulmonary ventilation and perfusion as well as parenchyma morphology. The key clinical problems in COPD provide an important framework in which pulmonary imaging needs to rapidly move in order to address the staggering burden, costs as well as the mortality and morbidity associated with COPD.

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Chronic Obstructive Pulmonary Disease: Quantification of Bronchodilator Effects by Using Hyperpolarized He MR Imaging

Abstract: ³He MR imaging depicted significant improvements in the distribution of ³He gas after bronchodilator therapy in ex-smokers with COPD with and those without clinically important changes in FEV₁.

Cited by 74 publications

References 42 publications

Development and application of pulmonary structure-function registration methods: towards pulmonary image-guidance tools for improved airway targeted therapies and outcomes

Development and application of pulmonary structure-function registration methods: towards pulmonary image-guidance tools for improved airway targeted therapies and outcomes

Ventilation Heterogeneity in Ex-smokers without Airflow Limitation

Pulmonary CT and MRI phenotypes that help explain chronic pulmonary obstruction disease pathophysiology and outcomes

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