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Myrte Wennen^1,2, Tim J. Marcus³, Annemijn Jonkman¹, Lilian Meijboom³, Marc Kachelriess⁴, Yannick Berker^5,6,7, Gustav J. Strijkers³, Coen A. C. Ottenheijm⁸, Leo M. A. Heunks¹, Aart J. Nederveen³, and Oliver J. Gurney-Champion^3
1Intensive Care, Erasmus Medical Centre, Rotterdam, Netherlands, ²Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Rotterdam, Netherlands, ³Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands, ⁴Division of X-Ray imaging and CT, German Cancer Research Center (DKFZ), Heidelberg, Germany, ⁵Hopp Children's Cencer Center Heidelberg (KiTZ), Heidelberg, Germany, ⁶Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany, ⁷National Center for Tumor Diseases (NCT), Heidelberg, Germany, ⁸Department of Physiology, Amsterdam University Medical Centers, Amsterdam, Netherlands

Keywords: Lung, Motion Correction, Diaphragm

Diaphragm weakness is common in intensive care patients and has a detrimental effect on clinical outcome. Weakness in these patients may be explained by disuse atrophy or injury resulting from systemic inflammation among other factors. MRI can be used to study the motion and tissue characteristics of the diaphragm. We present the design of an MRI protocol for quantifying motion and tissue characteristics of the diaphragm. 4D MRI, relaxometry and dynamic contrast enhanced MRI were successfully applied in healthy volunteers and COVID-19 patients. Our method may aid in finding treatments and prevention strategies for diaphragm weakness in critically ill patients.

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Ding Xia¹, Ye Tian², Thomas Benkert³, and Li Feng^1
1Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, United States, ³MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Lung, Lung

The purpose of this work was to develop a dynamic lung MRI framework, called Spiral-GRASP-UTE, for 4D real-time imaging of the lung with sub-second temporal resolution. Spiral-GRASP-UTE combines continuous ultra-short echo time (UTE) variable-density stack-of-spirals acquisition with a recently developed GRASP-Pro reconstruction technique that is based on a low-rank subspace model. Compared to other state-of-the-art lung MRI methods using 3D radial Kooshball sampling, Spiral-GRASP-UTE enables fast free-breathing dynamic lung imaging (2-3 minutes) and a high temporal resolution of less than one second per volume. This eliminates the need for respiratory motion detection and compensation, which is often challenging in lung MRI.

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Felicia Seemann¹, Ahsan Javed¹, Jaffar M Khan¹, Christopher G Bruce¹, Rachel Chae¹, Korel Yildirim¹, Amanda Potersnak¹, Haiyan Wang¹, Rajiv Ramasawmy¹, Robert J Lederman¹, and Adrienne E Campbell-Washburn^1
1National Heart, Lung , and Blood Institute, National Institutes of Health, Bethesda, MD, United States

Keywords: Image Reconstruction, Lung, Exercise MRI

Dynamic quantification of lung water during exercise stress is of clinical interest for early diagnosis of heart failure. In this study, we demonstrate a method to derive quantitative time-resolved lung water density maps from a continuous 3D MRI acquisition during supine exercise stress by using a motion corrected sliding-window image reconstruction. An animal model of dynamic lung water accumulation was used to validate the method, and feasibility was demonstrated in healthy subjects imaged in transitions between rest and exercise, measuring a lung water density increase of 23±10% during peak exercise.

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Chaowei Wu^1,2, Hsu-Lei Lee¹, Nan Wang^1,3, Fei Han⁴, Vibhas Deshpande⁵, Andreas Voskrebenzev⁶, Jens Vogel-Claussen⁶, Anthony G Christodoulou^1,2, Yibin Xie¹, and Debiao Li^1,2
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States, ³Radiology Department, Stanford University, Stanford, CA, United States, ⁴Siemens Healthcare, Los Angeles, CA, United States, ⁵Siemens Healthcare, Austin, TX, United States, ⁶Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany

Keywords: Lung, Quantitative Imaging

Pulmonary imaging has taken on greater importance during the COVID-19 pandemic. Regional fractional ventilation (FV) and T1 from MR imaging are potential biomarkers for pulmonary tissue and functional abnormality. However, FV imaging is limited to 2-D acquisition or 3-D with low spatial resolution, and T1 imaging typically requires long breath-holding that is not practical in many scenarios. Furthermore, there is no existing technique for simultaneous acquisition of both pieces of information. To address these limitations, we propose a novel motion-resolved pulmonary imaging technique for simultaneous FV and T1 mapping using MR Multitasking, and demonstrate its feasibility in 7 healthy volunteers.

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Ahsan Javed¹, Rajiv Ramasawmy¹, Pan Su², Thomas Benkert³, Waqas Majeed², Kelvin Chow², and Adrienne E Campbell-Washburn^1
1National Institutes of Health, Bethesda, MD, United States, ²Siemens Medical Solutions USA Inc, Malvern, PA, United States, ³MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Lung, Lung

We determined the feasibility of diagnostic high resolution pulmonary imaging on a commercial 0.55T scanner and compared the image quality to a ramped down prototype 0.55T scanner. 0.55T scanners can improve accessibility of MRI, due to their lower cost, ease of installation, and wider bore geometry. Previously, we showed robust pulmonary imaging at 0.55T using a prototype scanner with high performance gradients. In this work, we leverage our robust self-gated, concomitant and motion corrected reconstruction pipeline to enable diagnostic pulmonary imaging on a commercial 0.55T scanner with lower gradient performance.

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Alexander M Matheson¹, Marrissa J McIntosh¹, Narinder Paul², Anurag Bhalla³, Cory Yamashita³, and Grace Parraga^1,2,3
1Medical Biophysics, Robarts Research Institute, Western University, London, ON, Canada, ²Department of Medical Imaging, Western University, London, ON, Canada, ³Division of Respirology, Department of Medicine, Western University, London, ON, Canada

Keywords: Lung, Hyperpolarized MR (Gas)

Large and small airway-wall and lumen abnormalities and occlusion are hallmark findings in asthma, but pathologic abnormalities have also been reported in the pulmonary vasculature. ¹²⁹Xe MR-spectroscopy provides a way to quantify ¹²⁹Xe gas in the airways and as it diffuses through the alveolar tissue-membrane and binds to red-blood-cells in the pulmonary capillaries. Static and dynamic ¹²⁹Xe MR-spectroscopy were undertaken in participants with poorly controlled asthma in whom there was significantly different ¹²⁹Xe MR RBC:membrane ratio compared to healthy-volunteers. Cardiopulmonary oscillations were observed in all ¹²⁹Xe compartments; the oscillation amplitude in the gas-compartment was related to oscillometry airways impedance measurements.   

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Zachary Peggs^1,2, Jonathan Brooke², Jan Paul¹, Christopher Bradley¹, Andrew Cooper¹, Charlotte E Bolton², Ian P Hall², Susan Francis^1,2, and Penny Gowland^1,2
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²NIHR Nottingham Biomedical Research Centre (BRC), Respiratory Medicine, School of Medicine, University of Nottingham, Nottingham, United Kingdom

Keywords: Lung, Data Analysis, COPD

The relationship between lung volume and lung MR signal is key to quantifying ventilation using ¹H MRI. This relationship was probed using a highly accelerated 3D FFE acquisition at 3T. Linear regression between the percentage change in lung-diaphragm navigator signal and lung volume showed that the relationship between these parameters was not always linear, especially in patient groups. Polynomial regression was used to assess the extent of the hysteresis between inspiration and expiration, with more hysteresis observed in chronic obstructive pulmonary disease (COPD) patients.

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Zachary Peggs^1,2, Jonathan Brooke², Jan Paul¹, Christopher Bradley¹, Andrew Cooper¹, Charlotte E Bolton², Ian P Hall², Susan Francis^1,2, and Penny Gowland^1,2
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²NIHR Nottingham Biomedical Research Centre (BRC), Respiratory Medicine, School of Medicine, University of Nottingham, Nottingham, United Kingdom

Keywords: Lung, Quantitative Imaging, COPD

The VOLVE (VOxel-wise Linear fit VEntilation, VOLVE) method, whereby voxel-wise linear fitting between the lung-diaphragm navigator signal and lung parenchyma MR signal is used to assess regional ventilation, was investigated in chronic obstructive pulmonary disease (COPD) and alpha-1 antitrypsin deficiency (A1ATD). Fractional ventilation (FV) maps derived from phase-resolved functional lung imaging (PREFUL) were also determined. Significant differences between the healthy and the lung disease groups were found, indicating the sensitivity of these techniques to emphysematous lung disease.

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Helen Marshall¹, Guilhem J Collier¹, Ho-Fung Chan¹, Laurie J Smith¹, Paul JC Hughes¹, Dave Capener¹, Jody Bray¹, Sinoy Joseph¹, Ryan Munro¹, Olly Rodgers¹, James Ball¹, Neil J Stewart¹, Graham Norquay¹, Martin L Brook¹, Leanne Armstrong¹, Latife Hardaker², Titti Fihn-Wikander³, Rod Hughes⁴, and Jim Wild^1
1University of Sheffield, Sheffield, United Kingdom, ²Priory Medical Group, York, United Kingdom, ³AstraZeneca, Gothenburg, Sweden, ⁴AstraZeneca, Cambridge, United Kingdom

Keywords: Lung, Hyperpolarized MR (Gas)

Longitudinal changes of ¹²⁹Xe MRI metrics in patients with asthma and/or COPD have not yet been reported.  140 patients with asthma and/or COPD were scanned at 2 visits, 1 year apart, using ¹²⁹Xe gas transfer and diffusion MRI.  From visit 1 to visit 2 red blood cell (RBC) / membrane (M) and RBC/gas decreased and the amplitude of red blood cell oscillations (ARBCO) increased when all patients were considered.  RBC/M and RBC/gas decreased in asthma+COPD, and RBC/M decreased and ARBCO increased in asthma from visit 1 to visit 2.  M/gas and acinar microstructure metrics did not change significantly between visits.

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Jaime Mata¹, John Mugler III¹, Bastiaan Driehuys², David Mummy², Laura Bell³, Alexandre Coimbra³, Paula Belloni³, Peter Niedbalski⁴, and Yun Michael Shim^1
1University of Virginia, Charlottesville, VA, United States, ²Duke University, Durham, NC, United States, ³Genentech, San Francisco, CA, United States, ⁴University of Kansas, Lawrence, KS, United States

Keywords: Lung, Hyperpolarized MR (Gas), COPD, clinical trial

Harmonization of imaging methodology among three sites was successfully achieved.

Preliminary results for longitudinal treatment with azithromycin demonstrated the sensitivity of 129Xe MRI in detecting ventilation changes, presumably caused by Sars-Cov2 infection or termination of azithromycin treatment at week 24 due to hearing loss. This preliminary data supports that 129Xe MRI is a sensitive tool for detecting subtle changes in COPD early and may potentially reduce the length of clinical trials that aim to visualize therapeutic responses.  

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Simon Michael Florian Triphan^1,2, Marilisa Konietzke^1,2,3, Jürgen Biederer^1,2,4,5, Hans-Ulrich Kauczor^1,2, Claus Peter Heußel^1,6, and Mark Oliver Wielpütz^1,2
1Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany, ²Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany, ³Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany, ⁴Faculty of Medicine, University of Latvia, Riga, Latvia, ⁵Christian-Albrechts-Universität zu Kiel, Kiel, Germany, ⁶Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany

Keywords: Lung, Quantitative Imaging, T1 mapping, perfusion quantification, UTE

Observed TE-dependent T1 has been shown to correlate with MRI perfusion scores. Here, 22 patients with COPD were examined using DCE MRI and 2D UTE. Perfusion and T1(TE) was quantified based on these, respectively. Correlations of T1(TE) with perfusion measures were examined, with the strongest inter-patient correlation at TE₂=500μs but stronger local correlations at TE₁=70μs and TE₃=1200μs than at TE₂. The average T1 in defect areas according to DCE was shorter than in normal areas, with the smallest difference at TE₂. This implies that the local TE-dependence in defect voxels is further away from previously published behaviour in healthy volunteers.

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Robin Aaron Müller^1,2, Filip Klimeš^1,2, Andreas Voskrebenzev^1,2, Lea Behrendt^1,2, Till Frederik Kaireit^1,2, Julian Magnus Wilhelm Glandorf^1,2, Maximilian Zubke^1,2, Marius Wernz^1,2, Agilo Luitger Kern^1,2, Martin R. Prince^3,4, Christopher B. Cooper⁵, R. Graham Barr⁶, Jens M. Hohlfeld^2,7,8, and Jens Vogel-Claussen^1,2
1Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, ³Department of Radiology, Weill Cornell Medical College, New York, NY, United States, ⁴Department of Radiology, Columbia College of Physicians and Surgeons, New York, NY, United States, ⁵Departments of Medicine and Physiology, David Geffen School of Medicine, Los Angeles, CA, United States, ⁶Department of Medicine, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States, ⁷Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany, ⁸Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany

Keywords: Lung, Lung, COPD

Metronome-paced tachypnea (MPT) is a technique where a patient breathes rapidly with a fixed frequency (40 breaths / minute). MPT induces dynamic hyperinflation and allows investigation of potential stress-driven effects on ventilation parameters. Fifteen patients with chronic obstructive pulmonary disease (COPD) and thirty healthy subjects underwent MRI with a 2D coronal lung MR image acquired repeatedly with a temporal resolution of 200 ms during resting tidal breathing (RTB) and MPT. The decrease of fractional ventilation (FV) and the increase of end-expiratory lung area (EELA) during MPT was significantly higher in COPD patients compared to respective healthy subjects.

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Xuzhe Zhang¹, Martin R. Prince¹, Christopher B. Cooper², Michael C. Backman¹, Stephen M. Dashnaw¹, Eric A. Hoffman³, Bharath Ambale-Venkatesh⁴, Joao A. C. Lima⁴, Prachi Agarwal⁵, Joyce D. Schroeder⁶, Jens Vogel-Claussen⁷, David A. Bluemke⁸, John P. Finn², R. Graham Barr¹, and Wei Shen^1
1Columbia University, New York, NY, United States, ²University of California, Los Angeles, Los Angeles, CA, United States, ³University of Iowa, Iowa City, IA, United States, ⁴Johns Hopkins University, Baltimore, MD, United States, ⁵University of Michigan, Ann Arbor, MI, United States, ⁶University of Utah, Salt Lake City, UT, United States, ⁷Hannover Medical School, Hanover, Germany, ⁸University of Wisconsin, Madison, WI, United States

Keywords: Lung, Lung, chronic obstructive pulmonary disease, pulmonary cine MRI, metronome-paced tachypnea, dynamic hyperinflation, transfer learning, unsupervised domain adaptation

Metronome-paced tachypnea-induced dynamic hyperinflation of the lungs is typically assessed with spirometry; this method does not measure the dynamic change in lung volume over time. We implemented metronome-paced tachypnea with cardiopulmonary cine MRI. We developed an automated lung area segmentation algorithm using unsupervised domain adaptation (UDA) to measure dynamic hyperinflation in a SubPopulations and Intermediate Outcomes In COPD and Heart Failure Study (SPIROMICS HF) sample (n=65). Preliminary results showed that the integration of metronome-paced tachypnea and pulmonary cine MRI can quantify dynamic hyperinflation; dynamic hyperinflation identified on MRI appears to be associated with COPD severity. 

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Helen Marshall¹, Guilhem J Collier¹, Laurie J Smith¹, Ho-Fung Chan¹, Paul JC Hughes¹, Dave Capener¹, Jody Bray¹, Sinoy Joseph¹, Ryan Munro¹, Olly Rodgers¹, James Ball¹, Neil J Stewart¹, Graham Norquay¹, Martin L Brook¹, Leanne Armstrong¹, Latife Hardaker², Titti Fihn-Wikander³, Rod Hughes⁴, and Jim M Wild^1
1University of Sheffield, Sheffield, United Kingdom, ²Priory Medical Group, York, United Kingdom, ³AstraZeneca, Gothenburg, Sweden, ⁴AstraZeneca, Cambridge, United Kingdom

Keywords: Lung, Hyperpolarized MR (Gas)

Lung ventilation increases after bronchodilator inhalation in patients with asthma or COPD but there is little MRI data on how bronchodilator inhalation affects gas transfer.  117 patients with asthma and/or COPD were scanned with ¹²⁹Xe gas transfer MRI before and after bronchodilator inhalation.  There were no significant changes in red blood cell (RBC) / membrane (M), RBC/gas or M/gas in response to bronchodilator when all patients were considered, but RBC/gas and M/gas increased post-bronchodilator in a sub-group of patients with asthma+COPD.  The amplitude of RBC oscillations increased post-bronchodilator in patients with asthma or COPD, and when all patients were considered.

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Andreas Voskrebenzev^1,2, Till Frederik Kaireit^1,2, Marcel Gutberlet^1,2, Filip Klimeš^1,2, Lea Behrendt^1,2, Hoen-oh Shin^1,2, Hans-Ulrich Kauczor^3,4, Tobias Welte^2,5, Frank Wacker^1,2, and Jens Vogel-Claussen^1,2
1Institute of Diagnostic and Interventional Radiology, Medical School Hannover, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, ³Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany, ⁴Translational Lung Research Center Heidelberg (TLRC), Member of the German Lung Research Center (DZL), Heidelberg, Germany, ⁵Clinic of Pneumology, Medical School Hannover, Hannover, Germany

Keywords: Lung, Data Processing

Ventilation measurements using signal differences between expiratory and inspiratory respiration states gained popularity as a biomarker for ventilation abnormalities. One method, which incorpartes such measurements is Phase-resolved functional lung imaging (PREFUL). A further classification of abnormalities such as emphysema and air-trapping beyond  the current gas-exchange measurement is desirable. Therefore a MR adaption of CT’s parametric-response mapping (CT_PRM) method is proposed as an additional post-processing method for PREFUL. The analysis of 34 patients with chronic obstructive pulmonary disease (COPD), shows that there is a high regional (Overlap normal 91%) and total lung concordance (r>0.86) for the proposed method PREFUL_PRM and CT_PRM.

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Tao Ouyang¹, Yichen Tang¹, Chen Zhang², Jens Vogel-Claussen³, Andreas Voskrebenzev³, Xiuqin Jia¹, and Qi Yang^1
1Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ²MR Scientific Marketing, Siemens Healthcare, Beijing, China, ³Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany

Keywords: Lung, Perfusion

This study investigated the difference in pulmonary function (including perfusion and ventilation defects) using PREFUL-MRI between pulmonary embolism patients and healthy volunteers. Three coronal slices were acquisitor with MAGNETOM Prisma 3T MR scanner per subject. The results showed that perfusion and ventilation defect percentages derived from PREFUL-MRI in PE patients were higher than in healthy subjects. And the PREFUL-MRI parameters showed a strong correlation with spirometry parameters in PE patients. Our study suggests that PREFUL-MRI allows for the quantification of lung function under free breathing and non-contrast in PE patients, making this a promising tool for future monitoring of patients

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Efe Ilicak^1,2, Safa Ozdemir^1,2, Jascha Zapp^1,2, Lothar R. Schad^1,2, and Frank G. Zöllner^1,2
1Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany, ²Mannheim Institute for Intelligent Systems in Medicine, Heidelberg University, Mannheim, Germany

Keywords: Lung, Data Processing

Fourier Decomposition and related techniques have demonstrated the viability of obtaining regional pulmonary functions. To this end, novel post-processing techniques have been previously proposed to obtain ventilation and perfusion related information from dynamic acquisitions. To improve upon these methods, here we propose the use of an advanced data processing framework based on dynamic mode decomposition (DMD) for functional lung MRI. Phantom and in vivo results indicate that DMD achieves similar performance compared to established techniques and improves robustness in cases with fewer number of measurements.

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Nisarg Radadia¹, Yonni Friedlander^2,3, Norman B Konyer², Mobin Jamal¹, Chynna Huang³, Troy Farncombe ^4,5, Christopher Marriott ^4,5, Christian Finley^3,6,7, John Agzarian^3,6,7, Myrna Dolovich^1,2,3, Michael D Noseworthy ^2,4,8, Parameswaran Nair^1,3, Yaron Shargall^3,6,7, and Sarah Svenningsen^1,2,3
1Department of Medicine, Division of Respirology, McMaster University, Hamilton, ON, Canada, ²Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ³Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁴Department of Radiology, McMaster University, Hamilton, ON, Canada, ⁵Department of Nuclear Medicine, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁶Division of Thoracic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada, ⁷Division of Thoracic Surgery, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada, ⁸Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada

Keywords: Lung, Hyperpolarized MR (Gas)

Previous studies have demonstrated the comparability of ventilation assessed by SPECT and hyperpolarized gas MRI methods; however, these comparisons were qualitative and limited to visual scoring methods based on radiologist reporting. Thus, we quantified the relationship between ventilation-defect-percent (VDP) assessed from same-day Technegas ventilation-SPECT and hyperpolarized ¹²⁹Xe MRI, in patients with early-stage lung cancer. We observed that ventilation defects quantified by Technegas V-SPECT and ¹²⁹Xe MRI VDP were correlated and increased in patients with COPD. A bias towards higher Technegas V-SPECT VDP was detected and may be explained by differences in contrast agent properties, image acquisition conditions,  and/or quantification pipelines.  

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Filip Klimeš^1,2, Andreas Voskrebenzev^1,2, Marcel Gutberlet^1,2, Milan Speth^1,2, Robert Grimm³, Martha Dohna¹, Gesine Hansen^2,4, Frank Wacker^1,2, Diane Renz¹, Anna-Maria Dittrich^2,4, and Jens Vogel-Claussen^1,2
1Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, ³MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ⁴Department for Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany

Keywords: Lung, Lung

Kaftrio therapy was shown to improve global clinical ventilation parameters in cystic fibrosis (CF) patients. 3D phase-resolved functional lung (PREFUL) MRI offers a contrast-free assessment of pulmonary ventilation during free breathing. The aim of this study was to determine whether 3D PREFUL parameters are suitable to measure response to Kaftrio therapy and their association with clinical outcomes in CF patients. All assessed MRI and clinical parameters significantly improved after initiation of Kaftrio. Relative change between baseline and post-treatment scans of 3D PREFUL ventilation defect percentage maps was in agreement with forced expiratory volume in 1 second and lung clearance index. 

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Rachel L Eddy^1,2,3, Vanessa M Diamond², Girija Bhatnagar², Alexandra Schmidt¹, Jonathon A Leipsic^1,4, Don D Sin^1,3, Bradley S Quon^1,3, and Jonathan H Rayment^2,5
1Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada, ²BC Children's Hospital Research Institute, Vancouver, BC, Canada, ³Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada, ⁴Department of Radiology, University of British Columbia, Vancouver, BC, Canada, ⁵Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada

Keywords: Lung, Hyperpolarized MR (Gas)

Hyperpolarized ¹²⁹Xe gas MRI (XeMRI) is gaining traction globally as a primary endpoint in clinical trials, however it is unknown how images and measurements directly compare across different MRI scanner platforms. Here we compared same-day ventilation XeMRI across two MRI manufacturers at two sites in Vancouver Canada in patients with cystic fibrosis and healthy controls, to determine the interoperability across MRI platforms. Between-site ventilation images showed strong spatial overlap, and quantitative ventilation defect percent measurements showed strong agreement across all participants. These results support the use of XeMRI in multi-center studies irrespective of MRI platform.