Noninvasive Quantification of Airway Inflammation Following Segmental Allergen Challenge with Functional MR Imaging: A Proof of Concept Study

Renne, Julius; Hinrichs, Jan B.; Schönfeld, Christian; Gutberlet, Marcel; Winkler, Carla; Faulenbach, Cornelia; Jakob, Peter M.; Schaumann, Frank; Krug, Norbert; Wacker, Frank; Hohlfeld, Jens M.; Vogel‐Claussen, Jens

doi:10.1148/radiol.14132607

Cited by 22 publications

(13 citation statements)

References 35 publications

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“…Therefore, MRI techniques are emerging that use short echo time sequences in conjunction with oxygen shortening lung tissue T1 to provide a surrogate of regional ventilation (9). Although the oxygen-enhancement signal depends on more than regional ventilation, it has been shown to significantly correlate with PFT measurements.…”

Section: Introductionmentioning

confidence: 99%

Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma

Ebner¹,

He²,

Virgincar³

et al. 2017

Invest Radiol

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Objectives To investigate ventilation in mild to moderate asthmatics and age-matched controls using hyperpolarized (HP)129Xenon-MR imaging and correlate findings with pulmonary function tests (PFTs). Materials and Methods This single-center, HIPAA-compliant prospective study was approved by our IRB. Thirty subjects (10 young asthmatics, 26±6 years; 3 males, 7 females; 10 older asthmatics, 64±6 years; 3 males, 7 females; 10 healthy controls) were enrolled. After repeated PFTs 1 week apart, subjects underwent 2 MRI-scans within 10 minutes, inhaling 1 liter volumes containing 0.5–1 liter of 129Xe. 129Xe 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 was evaluated using one-tailed t-tests. Correlation of VDP with PFTs was tested using Pearson’s correlation coefficient. Reproducibility of VDP was assessed using Bland-Altman plots, linear regression (R2), intra-class correlation coefficient (ICC) and concordance correlation coefficient (CCC). Results VDP was significantly higher in young asthmatics vs. young healthy subjects (8.4±3.2% vs. 5.6±1.7%, P=.031), but not in older asthmatics versus age-matched controls (16.8±10.3% vs. 11.6±6.6%; P=.13). VDP was found to increase significantly with age (healthy: P=.05; asthmatics: P=.033). VDP was highly reproducible (R2=0.976, ICC=0.977, CCC=0.976) and significantly correlated with FEV1% (r=−0.42, P=.025), FEF25–75% (r=−0.45, P=.019), FEV1/FVC (r=−0.71, P<.0001), FeNO (r=0.69, P<.0001), and RV/TLC (r=0.51, P=.0067). Bland-Altman analysis showed a bias for VDP of −0.88±1.52 (FEV1%: −0.33±7.18). Conclusion 129Xenon-MR imaging is able to depict airway obstructions in mild to moderate asthma and significantly correlates with PFTs.

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Section: Introductionmentioning

confidence: 99%

Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma

Ebner¹,

He²,

Virgincar³

et al. 2017

Invest Radiol

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“…In addition, in studies of lung volume reduction surgery candidates and asthma patients, OE MRI showed equal or superior performance in detecting treatment effect and disease severity compared with PFT, CT, and/or nuclear medicine study. More recently the OTF was shown to decrease in asthmatics after allergen challenge and correlated with the percentage of eosinophils in bronchoalveolar lavage at the site of challenge …”

Section: Applicationsmentioning

confidence: 99%

Functional imaging of the lungs with gas agents

Kruger

Nagle

Couch

et al. 2015

Magnetic Resonance Imaging

105

116

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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 multi-detector computed tomography (CT). However, MRI also offers capabilities for fast multi-spectral and functional imaging using gas agents that are not technically feasible with CT. Recent improvements in gradient performance and radial acquisition methods using ultra-short echo time (UTE) have contributed to advances in these functional pulmonary MRI techniques. 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 (COPD), asthma, and cystic fibrosis (CF) in both adults and children.

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“…MRI was increasingly applied also in patients with asthma, demonstrating the occurrence of segmental lung edema and being a robust method for monitoring the response to treatment. [164][165][166][167]. Furthermore, it has been shown that hyperpolarized gases allow the evaluation of functional changes in distal small airways of asthmatic patients.…”

Section: Magnetic Resonance Imaging (Mri) and Pet/mrimentioning

confidence: 99%

Molecular Imaging of Pulmonary Inflammation and Infection

Giraudo

Evangelista

Fraia

et al. 2020

IJMS

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Infectious and inflammatory pulmonary diseases are a leading cause of morbidity and mortality worldwide. Although infrequently used in this setting, molecular imaging may significantly contribute to their diagnosis using techniques like single photon emission tomography (SPET), positron emission tomography (PET) with computed tomography (CT) or magnetic resonance imaging (MRI) with the support of specific or unspecific radiopharmaceutical agents. 18F-Fluorodeoxyglucose (18F-FDG), mostly applied in oncological imaging, can also detect cells actively involved in infectious and inflammatory conditions, even if with a low specificity. SPET with nonspecific (e.g., 67Gallium-citrate (67Ga citrate)) and specific tracers (e.g., white blood cells radiolabeled with 111Indium-oxine (111In) or 99mTechnetium (99mTc)) showed interesting results for many inflammatory lung diseases. However, 67Ga citrate is unfavorable by a radioprotection point of view while radiolabeled white blood cells scan implies complex laboratory settings and labeling procedures. Radiolabeled antibiotics (e.g., ciprofloxacin) have been recently tested, although they seem to be quite unspecific and cause antibiotic resistance. New radiolabeled agents like antimicrobic peptides, binding to bacterial cell membranes, seem very promising. Thus, the aim of this narrative review is to provide a comprehensive overview about techniques, including PET/MRI, and tracers that can guide the clinicians in the appropriate diagnostic pathway of infectious and inflammatory pulmonary diseases.

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Noninvasive Quantification of Airway Inflammation Following Segmental Allergen Challenge with Functional MR Imaging: A Proof of Concept Study

Abstract: OTF oxygen transfer function and volume over threshold are noninvasive MR imaging-derived parameters to visualize and quantify the regional allergic reaction after segmental endobronchial allergen challenge.

Cited by 22 publications

References 35 publications

Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma

Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma

Functional imaging of the lungs with gas agents

Molecular Imaging of Pulmonary Inflammation and Infection

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