Repeatability of Regional Lung Ventilation Quantification Using Fluorinated (19F) Gas Magnetic Resonance Imaging

Gutberlet, Marcel; Kaireit, Till F.; Voskrebenzev, Andreas; Kern, A.; Obert, Arnd; Wacker, Frank; Hohlfeld, Jens M.; Vogel‐Claussen, Jens

doi:10.1016/j.acra.2018.10.021

Cited by 17 publications

(52 citation statements)

References 37 publications

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“…Further work in other disease states could better inform the clinical utility of the dynamic 19 F approaches. Although we did not perform repeatability scans as a part of this study, others have shown that dynamic 19 F ventilation imaging, albeit with a different scanning protocol, has good repeatability in normal subjects and subjects with chronic obstructive pulmonary diseases 26 …”

Section: Discussionmentioning

confidence: 99%

“…Although we did not perform repeatability scans as a part of this study, others have shown that dynamic 19 F ventilation imaging, albeit with a different scanning protocol, has good repeatability in normal subjects and subjects with chronic obstructive pulmonary diseases. 26 Several technical factors impacted our data, including challenges related to co-registration of 19 F, 129 Xe, and 1 H images. Proton images of the thoracic cavity and gas ventilation images were obtained during separate maximal inhalation breath-holds, making it likely that the same inspiratory capacity might not be reached consistently.…”

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confidence: 99%

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Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

McCallister

Chung

Antonacci

et al. 2020

Magnetic Resonance in Med

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Purpose To quantitatively compare dynamic 19F and single breath hyperpolarized 129Xe MRI for the detection of ventilation abnormalities in subjects with mild cystic fibrosis (CF) lung disease. Methods Ten participants with stable CF and a baseline FEV1 > 70% completed a single imaging session where dynamic 19F and single breath 129Xe lung ventilation images were acquired on a 3T MRI scanner. Ventilation defect percentages (VDP) values between 19F early‐breath, 19F maximum‐ventilation, 129Xe low‐resolution, and 129Xe high‐resolution images were compared. Dynamic 19F images were used to determine gas wash‐in/out rates in regions of ventilation congruency and mismatch between 129Xe and 19F. Results VDP values from high‐resolution 129Xe images were greater than from low‐resolution images (P = .001), although these values were significantly correlated (r = 0.68, P = .03). Early‐breath 19F VDP and max‐vent 19F VDP also showed significant correlation (r = 0.75, P = .012), with early‐breath 19F VDP values being significantly greater (P < .001). No correlation in VDP values were detected between either 19F method or high‐res 129Xe images. In addition, the location and volume of ventilation defects were often different when comparing 129Xe and 19F images from the same subject. Areas of ventilation congruence displayed the expected ventilation kinetics, while areas of ventilation mismatch displayed abnormally slow gas wash‐in and wash‐out. Conclusion In CF subjects, ventilation abnormalities are identified by both 19F and HP 129Xe imaging. However, these ventilation abnormalities are not entirely congruent. 19F and HP 129Xe imaging provide complementary information that enable differentiation of normally ventilated, slowly ventilated, and non‐ventilated regions in the lungs.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

McCallister

Chung

Antonacci

et al. 2020

Magnetic Resonance in Med

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“…An ideal RF coil should have full lung coverage and good B 1 homogeneity, but the coil should also be as small as patient comfort allows in order to minimize the RF power requirements and maximize receive sensitivity. Both single channel 19,20 and phased array 19 F RF coils 26 have been described for human lung imaging. Single channel flexible vest transmit/ receive RF coils typically provide a good image quality, while maintaining patient comfort and compliance.…”

Section: Gas Propertiesmentioning

confidence: 99%

“…19,20 Other designs use a rigid elliptical birdcage transmit and a flexible receive array with up to 16 channels. 26 The rigid transmit coil should have a superior B 1 homogeneity, at the expense of requiring more RF power for the larger transmit element compared to the flexible vest. The use of a phased array receive coil allows for accelerated image acquisitions with parallel imaging reconstruction (ie, GRAPPA).…”

Section: Gas Propertiesmentioning

confidence: 99%

¹⁹F MRI of the Lungs Using Inert Fluorinated Gases: Challenges and New Developments

Couch

Ball²,

et al. 2018

Magnetic Resonance Imaging

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Fluorine‐19 (19F) MRI using inhaled inert fluorinated gases is an emerging technique that can provide functional images of the lungs. Inert fluorinated gases are nontoxic, abundant, relatively inexpensive, and the technique can be performed on any MRI scanner with broadband multinuclear imaging capabilities. Pulmonary 19F MRI has been performed in animals, healthy human volunteers, and in patients with lung disease. In this review, the technical requirements of 19F MRI are discussed, along with various imaging approaches used to optimize the image quality. Lung imaging is typically performed in humans using a gas mixture containing 79% perfluoropropane (PFP) or sulphur hexafluoride (SF6) and 21% oxygen. In lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF), ventilation defects are apparent in regions that the inhaled gas cannot access. 19F lung images are typically acquired in a single breath‐hold, or in a time‐resolved, multiple breath fashion. The former provides measurements of the ventilation defect percent (VDP), while the latter provides measurements of gas replacement (ie, fractional ventilation). Finally, preliminary comparisons with other functional lung imaging techniques are discussed, such as Fourier decomposition MRI and hyperpolarized gas MRI. Overall, functional 19F lung MRI is expected to complement existing proton‐based structural imaging techniques, and the combination of structural and functional lung MRI will provide useful outcome measures in the future management of pulmonary diseases in the clinic. Level of Evidence: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:343–354.

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“…Assessment of regional lung ventilation using 19 F gas MRI has been successfully compared with other imaging methods [22][23][24] and has shown a good repeatability. 25 The main drawback of this technique is the lower SNR in comparison to hyperpolarized gas MRI. Because the first breath after gas administration is of most clinical relevance and most sensitive for detection of hypoventilated lung segments, 26 the low SNR especially after only one breath of gas is a major limiting factor for clinical translation of 19 F MRI.…”

Section: Introductionmentioning

confidence: 99%

¹H‐guided reconstruction of ¹⁹F gas MRI in COPD patients

Obert

Gutberlet

Kern

et al. 2020

Magnetic Resonance in Med

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Purpose:To reduce acquisition time and improve image quality and robustness of ventilation assessment in a single breath-hold using 1 H-guided reconstruction of fluorinated gas ( 19 F) MRI. Methods: Reconstructions constraining total variation in the image domain, L1 norm in the wavelet domain, and directional total variation between 19 F and 1 H images were compared in order to accelerate 19 F ventilation imaging using retrospectively undersampled data from a healthy volunteer. Using the optimal constrained reconstruction in 8 patients with chronic obstructive pulmonary disease (16-seconds breath-hold), ventilation maps of various acceleration factors (2-fold to 13-fold) were compared with maps of the full data set using the Dice coefficient, difference in volume defect percentage and overlap percentage, as well as hyperpolarized 129 Xe gas MRI. Results: The reconstruction constraining total variation and directional total variation simultaneously performed best in the healthy volunteer (RMS error = 0.07, structural similarity index = 0.77) for a measurement time of 2 seconds. Using the same reconstruction in the patients with chronic obstructive pulmonary disease, the Dice coefficient of defect volumes was 0.86 ± 0.05, the mean difference in volume defect percentage was −1.0 ± 1.7 percentage points, and the overlap percentage was 87% ± 2% for a measurement time of 6 seconds. Between volume defect percentage of 19 F and 129 Xe, a linear correlation (r = 0.75; P = .03) was found, with 19 F volume defect percentage being significantly higher (mean difference = 11%; P = .04). Conclusion: 1 H-guided reconstruction of pulmonary 19 F gas MRI enables reduction of acquisition time while maintaining image quality and robustness of functional parameters.

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Repeatability of Regional Lung Ventilation Quantification Using Fluorinated (19F) Gas Magnetic Resonance Imaging

Cited by 17 publications

References 37 publications

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

¹⁹F MRI of the Lungs Using Inert Fluorinated Gases: Challenges and New Developments

¹H‐guided reconstruction of ¹⁹F gas MRI in COPD patients

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Repeatability of Regional Lung Ventilation Quantification Using Fluorinated (19F) Gas Magnetic Resonance Imaging

Cited by 17 publications

References 37 publications

Comparison of single breath hyperpolarized 129Xe MRI with dynamic 19F MRI in cystic fibrosis lung disease

Comparison of single breath hyperpolarized 129Xe MRI with dynamic 19F MRI in cystic fibrosis lung disease

19F MRI of the Lungs Using Inert Fluorinated Gases: Challenges and New Developments

1H‐guided reconstruction of 19F gas MRI in COPD patients

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Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

Comparison of single breath hyperpolarized ¹²⁹Xe MRI with dynamic ¹⁹F MRI in cystic fibrosis lung disease

¹⁹F MRI of the Lungs Using Inert Fluorinated Gases: Challenges and New Developments

¹H‐guided reconstruction of ¹⁹F gas MRI in COPD patients