☆ 4.7 Article

Hyperpolarized 3He MR for Sensitive Imaging of Ventilation Function and Treatment Efficiency in Young Cystic Fibrosis Patients with Normal Lung Function

RADIOLOGY (2010)

Journal

RADIOLOGY

Volume 255, Issue 1, Pages 225-232

Publisher

RADIOLOGICAL SOC NORTH AMERICA

DOI: 10.1148/radiol.09090039

Keywords

Funding

Vaincre La Mucoviscidose
Hospices Civils de Lyon
European Union Marie Curie Research Training Network PHeLINet [MRTN-CT-2006-036002]
Centre d'Investigation Clinique de Lyon

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Abstract

Purpose: To assess the sensitivity of hyperpolarized helium 3 (He-3) magnetic resonance (MR) imaging for the detection of peripheral airway obstruction in younger cystic fibrosis (CF) patients showing normal spirometric results (mean forced expiratory volume in 1 second [FEV1], 112% +/- 14.5 [standard deviation]) and to observe the immediate effects of a single chest physical therapy (CPT) session, thereby comparing two image quantification techniques. Materials and Methods: Ten pediatric CF patients (age range, 8-16 years) with normal spirometric results were included in this study after approval from the local research ethics committee. Spirometry followed by proton and hyperpolarized 3 He three-dimensional lung imaging were performed with a 1.5-T MR unit before and after 20 minutes of CPT. The number of ventilation defects per image (VDI) and the ventilated lung fraction (VF), defined as the ratio of ventilated lung volume divided by total lung volume, were quantified. Results: Ventilation defects were found in all patients (mean VDI, 5.1 +/- 1.9; mean global VF, 78.5% +/- 12.3; and mean peripheral VF, 75.5% +/- 17.1) despite normal spirometric results. After CPT, disparate changes in the distribution of ventilation defects were observed but the average VDI and VF did not change significantly (mean VDI, 5.1 +/- 1.1; mean global VF, 83.5% +/- 12.2; and mean peripheral VF, 80.3% +/- 12.2). There was no correlation between FEV1 and VDI (rho = -0.041, P = .863) or global VF (rho = -0.196, P = .408) values but peripheral VF and VDI were correlated (rho = -0.563, P = .011). Conclusion: Although spirometric results indicate normal lung function, the mean VDI in patients (5.1) found in this study is well above the VDI in healthy subjects (1.6) reported in the literature. A single CPT session induces disparate changes in the distribution and extent of ventilation defects. (C) RSNA, 2010

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Comparison of Hyperpolarized 3He and 129Xe MR Imaging in Cystic Fibrosis Patients

Ummul Afia Shammi, Michelle Felicia D'Alessandro, Talissa Altes, F. William Hersman, Iulian C. Ruset, John Mugler, Craig Meyer, Jamie Mata, Kun Qing, Robert Thomen

Summary: This study compared hyperpolarized He-3 and Xe-129 images from patients with cystic fibrosis using different magnetic resonance sequences. The results showed that the choice of hyperpolarized Xe-129 or He-3 gas is inconsequential when it comes to measuring overall lung function by VDP, although Xe-129 may be more sensitive to starker lung defects, particularly when using a TrueFISP sequence.

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