Experimental validation of the hyperpolarized <sup>129</sup>Xe chemical shift saturation recovery technique in healthy volunteers and subjects with interstitial lung disease

Stewart, Neil J.; Leung, General; Norquay, Graham; Marshall, Helen; Parra‐Robles, Juan; Murphy, Philip S.; Schulte, Rolf F.; Elliot, Charlie; Condliffe, Robin; Griffiths, Paul D.; Kiely, David G.; Whyte, Moira K. B.; Wolber, Jan; Wild, Jim M.

doi:10.1002/mrm.25400

Cited by 89 publications

(112 citation statements)

References 48 publications

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“…Upon inhalation, xenon diffuses from the alveoli, through pulmonary barrier tissues comprised of alveolar epithelial cells, interstitial tissues, capillary endothelial cells, and plasma, and finally into capillary red blood cells (RBCs). Moreover, in each of these compartments, 129 Xe exhibits distinct resonance frequency shifts 1617 (Figure 1a and b), that enable its uptake in them to be measured separately 18–22 .…”

Section: Introductionmentioning

confidence: 99%

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Wang

Robertson

Wang³

et al. 2017

Thorax

130

136

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Background Assessing functional impairment, therapeutic response, and disease progression in patients with idiopathic pulmonary fibrosis (IPF) continues to be challenging. Hyperpolarized 129Xe MRI can address this gap through its unique capability to image gas transfer three-dimensionally from airspaces to interstitial barrier tissues to RBCs. This must be validated by testing the degree to which it correlates with pulmonary function tests (PFTs) and CT scores and its spatial distribution reflects known physiology and patterns of disease. Methods 13 healthy individuals (33.6±15.7 years) and 12 IPF patients (66.0±6.4 years) underwent 129Xe MRI to generate 3D quantitative maps depicting the 129Xe ventilation distribution, its uptake in interstitial barrier tissues, and its transfer to RBCs. For each map, mean values were correlated with PFTs and CT fibrosis scores and their patterns were tested for the ability to depict functional gravitational gradients in healthy lung, and to detect the known basal and peripheral predominance of disease in IPF. Results 129Xe MRI depicted functional impairment in IPF patients, whose mean barrier uptake increased by 188% compared to the healthy reference population. 129Xe MRI metrics correlated poorly and insignificantly with CT fibrosis scores, but strongly with pulmonary function tests. Barrier uptake and RBC transfer both correlated significantly with DLCO (r=−0.75, p<0.01 and r=0.72, p<0.01), while their ratio (RBC/barrier) correlated strongly (r=0.94, p<0.01). RBC transfer exhibited significant anterior-posterior gravitational gradients in healthy volunteers, but not in IPF, where it was significantly impaired in the basal (p=0.02) and sub-pleural (p<0.01) lung. Conclusions Hyperpolarized 129Xe MRI is a rapid and well-tolerated exam that provides region-specific quantification of interstitial barrier thickness and RBC transfer efficiency. With further development, it could become a robust tool for measuring disease progression and therapeutic response in IPF patients, sensitively and non-invasively.

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Section: Introductionmentioning

confidence: 99%

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Wang

Robertson

Wang³

et al. 2017

Thorax

130

136

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“…[95] Studies specifically designed to investigate the safety and tolerability of 129 Xe-MRI have not shown major common side effects in various patient groups, including those with asthma, [93a] and mild-moderate COPD, [93a, 96] with light-headedness of very short duration as the main reported minor side effect.…”

Section: Clinical Application Of Hyperpolarized Xenon-129 Mrimentioning

confidence: 99%

NMR Hyperpolarization Techniques of Gases

Barskiy

Coffey

Nikolaou

et al. 2016

Chemistry A European J

157

117

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

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“…In addition there are decades of safe use of 133 Xe applied for lung scintigraphy. Since this initial study, numerous other centers have applied this technology safely in different patient populations [56,65,66]. …”

Section: 3helium (3he) Vs 129xenon (129xe)mentioning

confidence: 99%

“…7) to quantify the effective gas exchange by taking the relative ratios of the spectral signal peaks within the gas, barrier tissue, and RBC compartments. Such ratios have shown promise as a semi-quantitative measures of global gas exchange impairment and correlate well with clinical tests such as diffusion capacity of carbon monoxide (DLCO) [65,79]. While the total fraction of dissolved 129 Xe is only 2% of the total signal at any given instant, Cleveland et al [80] recognized that the continuous exchange of 129 Xe between barrier, RBC, and airspaces permitted this magnetization to be replenished and imaged 3-dimensionally.…”

Section: Mri With Hp 129xe Mrimentioning

confidence: 99%

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

Ebner

Kammerman

Driehuys

et al. 2017

European Journal of Radiology

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In the last two decades, functional imaging of the lungs using hyperpolarized noble gases has entered the clinical stage. Both helium (3 He) 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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Experimental validation of the hyperpolarized ¹²⁹Xe chemical shift saturation recovery technique in healthy volunteers and subjects with interstitial lung disease

Abstract: CSSR with hyperpolarized Xe is sensitive to pathology-induced degradation of lung structure/function and shows promise for quantification of disease severity and monitoring treatment response. Magn Reson Med 74:196-207, 2015. © 2014 Wiley Periodicals, Inc.

Cited by 89 publications

References 48 publications

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

NMR Hyperpolarization Techniques of Gases

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

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Experimental validation of the hyperpolarized 129Xe chemical shift saturation recovery technique in healthy volunteers and subjects with interstitial lung disease

Abstract: CSSR with hyperpolarized Xe is sensitive to pathology-induced degradation of lung structure/function and shows promise for quantification of disease severity and monitoring treatment response. Magn Reson Med 74:196-207, 2015. © 2014 Wiley Periodicals, Inc.

Cited by 89 publications

References 48 publications

Using hyperpolarized 129Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Using hyperpolarized 129Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

NMR Hyperpolarization Techniques of Gases

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

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Product

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Experimental validation of the hyperpolarized ¹²⁹Xe chemical shift saturation recovery technique in healthy volunteers and subjects with interstitial lung disease

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis

Using hyperpolarized ¹²⁹Xe MRI to quantify regional gas transfer in idiopathic pulmonary fibrosis