Quantitative Evaluation of Hyperpolarized Helium-3 Magnetic Resonance Imaging of Lung Function Variability in Cystic Fibrosis

Kirby, Miranda; Svenningsen, Sarah; Ahmed, Hassaan; Wheatley, Andrew; Etemad-Rezai, Roya; Paterson, Nigel A. M.; Párraga, Grace

doi:10.1016/j.acra.2011.03.005

Cited by 53 publications

(124 citation statements)

References 23 publications

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“…The sequential images provide quantitative information about lung function through the regional quantitation of ventilation volume relative to total volume (VV) and ventilation defects per image can then be presented as percentages of total area. The reproducibility of the analysis and technique has been measured at 96% [35,36]. The HP 3 He MRI results correlate strongly with spirometry values (r = 0.89, p < 0.01) and HRCT (r = 0.89, p < 0.01), and there is also a trend to correlate with chest X-ray (r = −0.38, p < 0.06) in adults with Cystic Fibrosis.…”

Section: Hyperpolarized Helium-3 Mrimentioning

confidence: 67%

“…Following this, hyperpolarized helium-3 MRI (HP 3 He MRI) has been examined in multiple settings and has shown high sensitivity for the detection of ventilation impairments [34][35][36][37][38][39][40][41][42][43][44]. This typically requires production of hyperpolarized gas on site which is then mixed with nitrogen and administered to patients with a one litre Tedlar Bag.…”

Section: Hyperpolarized Helium-3 Mrimentioning

confidence: 99%

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Evaluation of high resolution computed tomography findings of cystic fibrosis

Şaşihüseyinoğlu

Altıntaş

Soyupak

et al. 2019

Korean J Intern Med

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Monitoring of pulmonary physiology is fundamental to the clinical management of patients with Cystic Fibrosis. The current standard clinical practise uses spirometry to assess lung function which delivers a clinically relevant functional readout of total lung function, however does not supply any visible or localised information. High Resolution Computed Tomography (HRCT) is a well-established current 'gold standard' method for monitoring lung anatomical changes in Cystic Fibrosis patients. HRCT provides excellent morphological information, however, the X-ray radiation dose can become significant if multiple scans are required to monitor chronic diseases such as cystic fibrosis. X-ray phase-contrast imaging is another emerging X-ray based methodology for Cystic Fibrosis lung assessment which provides dynamic morphological and functional information, albeit with even higher X-ray doses than HRCT. Magnetic Resonance Imaging (MRI) is a non-ionising radiation imaging method that is garnering growing interest among researchers and clinicians working with Cystic Fibrosis patients. Recent advances in MRI have opened up the possibilities to observe lung function in real time to potentially allow sensitive and accurate assessment of disease progression. The use of hyperpolarized gas or non-contrast enhanced MRI can be tailored to clinical needs. While MRI offers significant promise it still suffers from poor spatial resolution and the development of an objective scoring system especially for ventilation assessment.

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Section: Hyperpolarized Helium-3 Mrimentioning

confidence: 67%

Section: Hyperpolarized Helium-3 Mrimentioning

confidence: 99%

Evaluation of high resolution computed tomography findings of cystic fibrosis

Şaşihüseyinoğlu

Altıntaş

Soyupak

et al. 2019

Korean J Intern Med

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“…As shown in Table 1, there was no mean change in VDP or pulmonary function measurements with the exception of FEV 1 /FVC (BL ¼ 74 6 11%, FU ¼ 68 6 13%, P ¼ 0.01) at 4-year follow-up. The baseline and 7-day short-term variability of VDP and pulmonary function measurements was previously reported (9). Briefly, no significant difference in spirometry or plethysmography were detected after 7 days but there was a difference in VDP (3 6 4%, P < 0.0001) (9).…”

Section: Resultsmentioning

confidence: 98%

Differences in hyperpolarized ³He ventilation imaging after 4 years in adults with cystic fibrosis

Paulin

Svenningsen

Jobse

et al. 2014

Magnetic Resonance Imaging

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For two CF subjects, VDP was significantly worse at baseline and worsened over 4 years, which was in agreement with a greater number of hospitalizations and clinic visits. These results are limited by the very small sample size, but the strong VDP correlation with longitudinal changes in FEV1 generates the hypothesis that abnormal VDP may temporally precede FEV1 decline in CF subjects; this must be tested in a larger CF study.

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“…It is tempting to suggest that our MBW data are compatible with the very patchy ventilation images obtained in adult CF patients by hyperpolarised helium-3 magnetic resonance imaging ( 3 He-MRI) [26][27][28][29], where the extent of ventilation defects correlated with FEV1 [26][27][28]. When the extent of ventilation defects (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…When the extent of ventilation defects (i.e. underventilated lung zones with a signal intensity below the imaging threshold) was expressed as percentage lung volume, this averaged 26% in CF patients with FEV1 ranging 27-93% pred [27] and 17-20% in CF patients with FEV1 ranging 50-96% pred [28]. If, in addition to unventilated lung, the hypo-, normal and hyperventilated lung volumes are also considered, only ,30% of the lung was ventilated normally [29].…”

Section: Discussionmentioning

confidence: 99%

Lung clearance index in adult cystic fibrosis patients: the role of convection-dependent lung units

Verbanck¹,

Paiva

Paeps³

et al. 2012

Eur Respir J

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We investigated the extent of convective ventilation heterogeneity contributing to the observed lung clearance index values in adult cystic fibrosis patients, as the result of two simulated scenarios, either 1) a fixed part of the lungs becoming increasingly less compliant, or 2) an increasingly greater part of the lung being less compliant.In 25 cystic fibrosis patients and 25 matched controls, we computed the lung clearance index and also quantified curvilinearity of the washout concentration curve, where curvilinearity is equal to 0 (linear in semilog plot) reflects homogeneous ventilation and curvilinearity equal to 1 corresponds to the presence of an infinitesimally slowly emptying lung unit.In the cystic fibrosis group (forced expiratory volume in 1 s 27-100% predicted), lung clearance index and curvilinearity average¡SD values were 10.3¡2.3 and 0.57¡0.13, respectively, and were significantly different from control values (6.2¡0.4 and 0.18¡0.07; both p,0.001); lung clearance index and curvilinearity were also correlated (R50.67; p,0.001). The average curvilinearity value in the cystic fibrosis group was found to be compatible with a cumulative volume of underventilated lung of 40-50%, depending on the simulation scenario considered.The degree of washout curvilinearity observed here indicates that a major determinant of the abnormal lung clearance index values observed in adult cystic fibrosis patients is ventilation heterogeneity generated between convection-dependent lung units, while the remainder of lung clearance index abnormality with respect to normal controls potentially represents the small airways within these lung zones. @ERSpublications A major determinant of the lung clearance index can be identified by considering washout curvilinearity.

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Quantitative Evaluation of Hyperpolarized Helium-3 Magnetic Resonance Imaging of Lung Function Variability in Cystic Fibrosis

Cited by 53 publications

References 23 publications

Evaluation of high resolution computed tomography findings of cystic fibrosis

Evaluation of high resolution computed tomography findings of cystic fibrosis

Differences in hyperpolarized ³He ventilation imaging after 4 years in adults with cystic fibrosis

Lung clearance index in adult cystic fibrosis patients: the role of convection-dependent lung units

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Quantitative Evaluation of Hyperpolarized Helium-3 Magnetic Resonance Imaging of Lung Function Variability in Cystic Fibrosis

Cited by 53 publications

References 23 publications

Evaluation of high resolution computed tomography findings of cystic fibrosis

Evaluation of high resolution computed tomography findings of cystic fibrosis

Differences in hyperpolarized 3He ventilation imaging after 4 years in adults with cystic fibrosis

Lung clearance index in adult cystic fibrosis patients: the role of convection-dependent lung units

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Differences in hyperpolarized ³He ventilation imaging after 4 years in adults with cystic fibrosis