Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis
Purpose: The existing tools to quantify lung function in interstitial lung diseases have significant limitations. Lung MRI imaging using inhaled hyperpolarized xenon-129 gas (<sup>129</sup>Xe) as a contrast agent is a new technology for measuring regional lung physiology. We sought to as...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/11/6/1533 |
| _version_ | 1797595974291423232 |
|---|---|
| author | Kun Qing Talissa A. Altes John P. Mugler Jaime F. Mata Nicholas J. Tustison Kai Ruppert Juliana Bueno Lucia Flors Yun M. Shim Li Zhao Joanne Cassani William G. Teague John S. Kim Zhixing Wang Iulian C. Ruset F. William Hersman Borna Mehrad |
| author_facet | Kun Qing Talissa A. Altes John P. Mugler Jaime F. Mata Nicholas J. Tustison Kai Ruppert Juliana Bueno Lucia Flors Yun M. Shim Li Zhao Joanne Cassani William G. Teague John S. Kim Zhixing Wang Iulian C. Ruset F. William Hersman Borna Mehrad |
| author_sort | Kun Qing |
| collection | DOAJ |
| description | Purpose: The existing tools to quantify lung function in interstitial lung diseases have significant limitations. Lung MRI imaging using inhaled hyperpolarized xenon-129 gas (<sup>129</sup>Xe) as a contrast agent is a new technology for measuring regional lung physiology. We sought to assess the utility of the <sup>129</sup>Xe MRI in detecting impaired lung physiology in usual interstitial pneumonia (UIP). Materials and methods: After institutional review board approval and informed consent and in compliance with HIPAA regulations, we performed chest CT, pulmonary function tests (PFTs), and <sup>129</sup>Xe MRI in 10 UIP subjects and 10 healthy controls. Results: The <sup>129</sup>Xe MRI detected highly heterogeneous abnormalities within individual UIP subjects as compared to controls. Subjects with UIP had markedly impaired ventilation (ventilation defect fraction: UIP: 30 ± 9%; healthy: 21 ± 9%; <i>p</i> = 0.026), a greater amount of <sup>129</sup>Xe dissolved in the lung interstitium (tissue-to-gas ratio: UIP: 1.45 ± 0.35%; healthy: 1.10 ± 0.17%; <i>p</i> = 0.014), and impaired <sup>129</sup>Xe diffusion into the blood (RBC-to-tissue ratio: UIP: 0.20 ± 0.06; healthy: 0.28 ± 0.05; <i>p</i> = 0.004). Most MRI variables had no correlation with the CT and PFT measurements. The elevated level of <sup>129</sup>Xe dissolved in the lung interstitium, in particular, was detectable even in subjects with normal or mildly impaired PFTs, suggesting that this measurement may represent a new method for detecting early fibrosis. Conclusion: The hyperpolarized <sup>129</sup>Xe MRI was highly sensitive to regional functional changes in subjects with UIP and may represent a new tool for understanding the pathophysiology, monitoring the progression, and assessing the effectiveness of treatment in UIP. |
| first_indexed | 2024-03-11T02:44:57Z |
| format | Article |
| id | doaj.art-9d5d7da228274bd6884a18a09daa3ba2 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T02:44:57Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-9d5d7da228274bd6884a18a09daa3ba22023-11-18T09:24:40ZengMDPI AGBiomedicines2227-90592023-05-01116153310.3390/biomedicines11061533Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary FibrosisKun Qing0Talissa A. Altes1John P. Mugler2Jaime F. Mata3Nicholas J. Tustison4Kai Ruppert5Juliana Bueno6Lucia Flors7Yun M. Shim8Li Zhao9Joanne Cassani10William G. Teague11John S. Kim12Zhixing Wang13Iulian C. Ruset14F. William Hersman15Borna Mehrad16Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA 91010, USADepartment of Radiology, University of Missouri, Columbia, MO 65211, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Radiology, University of Pennsylvania, Cincinnati, PA 19104, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Radiology, Keck Medical Center, University of Southern California, Los Angeles, CA 90089, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Biomedical Engineering, Zhejiang University, Hangzhou 310027, ChinaDepartment of Radiology, University of Missouri, Columbia, MO 65211, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA 22903, USADepartment of Radiation Oncology, City of Hope National Medical Center, Duarte, CA 91010, USAXemed LLC, Durham, NH 03824, USAXemed LLC, Durham, NH 03824, USADepartment of Medicine, University of Florida, Gainesville, FL 32611, USAPurpose: The existing tools to quantify lung function in interstitial lung diseases have significant limitations. Lung MRI imaging using inhaled hyperpolarized xenon-129 gas (<sup>129</sup>Xe) as a contrast agent is a new technology for measuring regional lung physiology. We sought to assess the utility of the <sup>129</sup>Xe MRI in detecting impaired lung physiology in usual interstitial pneumonia (UIP). Materials and methods: After institutional review board approval and informed consent and in compliance with HIPAA regulations, we performed chest CT, pulmonary function tests (PFTs), and <sup>129</sup>Xe MRI in 10 UIP subjects and 10 healthy controls. Results: The <sup>129</sup>Xe MRI detected highly heterogeneous abnormalities within individual UIP subjects as compared to controls. Subjects with UIP had markedly impaired ventilation (ventilation defect fraction: UIP: 30 ± 9%; healthy: 21 ± 9%; <i>p</i> = 0.026), a greater amount of <sup>129</sup>Xe dissolved in the lung interstitium (tissue-to-gas ratio: UIP: 1.45 ± 0.35%; healthy: 1.10 ± 0.17%; <i>p</i> = 0.014), and impaired <sup>129</sup>Xe diffusion into the blood (RBC-to-tissue ratio: UIP: 0.20 ± 0.06; healthy: 0.28 ± 0.05; <i>p</i> = 0.004). Most MRI variables had no correlation with the CT and PFT measurements. The elevated level of <sup>129</sup>Xe dissolved in the lung interstitium, in particular, was detectable even in subjects with normal or mildly impaired PFTs, suggesting that this measurement may represent a new method for detecting early fibrosis. Conclusion: The hyperpolarized <sup>129</sup>Xe MRI was highly sensitive to regional functional changes in subjects with UIP and may represent a new tool for understanding the pathophysiology, monitoring the progression, and assessing the effectiveness of treatment in UIP.https://www.mdpi.com/2227-9059/11/6/1533hyperpolarized xenon-129 MRIpulmonary fibrosisusual interstitial pneumonia |
| spellingShingle | Kun Qing Talissa A. Altes John P. Mugler Jaime F. Mata Nicholas J. Tustison Kai Ruppert Juliana Bueno Lucia Flors Yun M. Shim Li Zhao Joanne Cassani William G. Teague John S. Kim Zhixing Wang Iulian C. Ruset F. William Hersman Borna Mehrad Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis Biomedicines hyperpolarized xenon-129 MRI pulmonary fibrosis usual interstitial pneumonia |
| title | Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis |
| title_full | Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis |
| title_fullStr | Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis |
| title_full_unstemmed | Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis |
| title_short | Hyperpolarized Xenon-129: A New Tool to Assess Pulmonary Physiology in Patients with Pulmonary Fibrosis |
| title_sort | hyperpolarized xenon 129 a new tool to assess pulmonary physiology in patients with pulmonary fibrosis |
| topic | hyperpolarized xenon-129 MRI pulmonary fibrosis usual interstitial pneumonia |
| url | https://www.mdpi.com/2227-9059/11/6/1533 |
| work_keys_str_mv | AT kunqing hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT talissaaaltes hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT johnpmugler hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT jaimefmata hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT nicholasjtustison hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT kairuppert hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT julianabueno hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT luciaflors hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT yunmshim hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT lizhao hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT joannecassani hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT williamgteague hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT johnskim hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT zhixingwang hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT iuliancruset hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT fwilliamhersman hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis AT bornamehrad hyperpolarizedxenon129anewtooltoassesspulmonaryphysiologyinpatientswithpulmonaryfibrosis |