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Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia.

Publication ,  Journal Article
Mummy, DG; Bier, EA; Wang, Z; Korzekwinski, J; Morrison, L; Barkauskas, C; McAdams, HP; Tighe, RM; Driehuys, B; Mammarappallil, JG
Published in: Radiology
October 2021

Background Recent studies demonstrate that antifibrotic drugs previously reserved for idiopathic pulmonary fibrosis (IPF) may slow progression in other interstitial lung diseases (ILDs), creating an urgent need for tools that can sensitively assess disease activity, progression, and therapy response across ILDs. Hyperpolarized xenon 129 (129Xe) MRI and spectroscopy have provided noninvasive measurements of regional gas-exchange abnormalities in IPF. Purpose To assess gas exchange function using 129Xe MRI in a group of study participants with nonspecific interstitial pneumonia (NSIP) compared with healthy control participants. Materials and Methods In this prospective study, participants with NSIP and healthy control participants were enrolled between November 2017 and February 2020 and underwent 129Xe MRI and spectroscopy. Quantitative imaging provided three-dimensional maps of ventilation, interstitial barrier uptake, and transfer into the red blood cell (RBC) compartment. Spectroscopy provided parameters of the static RBC and barrier uptake compartments, as well as cardiogenic oscillations in RBC signal amplitude and chemical shift. Differences between NSIP and healthy control participants were assessed using the Wilcoxon rank-sum test. Results Thirty-six participants with NSIP (mean age, 57 years ± 11 [standard deviation]; 27 women) and 15 healthy control participants (mean age, 39 years ± 18; two women) were evaluated. Participants with NSIP had no difference in ventilation compared with healthy control participants (median, 4.4% [first quartile, 1.5%; third quartile, 8.7%] vs 6.0% [first quartile, 2.8%; third quartile, 6.9%]; P = .91), but they had a higher barrier uptake (median, 6.2% [first quartile, 1.8%; third quartile, 23.9%] vs 0.53% [first quartile, 0.33%; third quartile, 2.9%]; P = .003) and an increased RBC transfer defect (median, 20.6% [first quartile, 11.6%; third quartile, 27.8%] vs 2.8% [first quartile, 2.3%; third quartile, 4.9%]; P < .001). NSIP participants also had a reduced ratio of RBC-to-barrier peaks (median, 0.24 [first quartile, 0.19; third quartile, 0.31] vs 0.57 [first quartile, 0.52; third quartile, 0.67]; P < .001) and a reduced RBC chemical shift (median, 217.5 ppm [first quartile, 217.0 ppm; third quartile, 218.0 ppm] vs 218.2 ppm [first quartile, 217.9 ppm; third quartile, 218.6 ppm]; P = .001). Conclusion Participants with nonspecific interstitial pneumonia had increased barrier uptake and decreased red blood cell (RBC) transfer compared with healthy controls measured using xenon 129 gas-exchange MRI and reduced RBC-to-barrier ratio and RBC chemical shift measured using spectroscopy. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Wild in this issue.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

October 2021

Volume

301

Issue

1

Start / End Page

211 / 220

Location

United States

Related Subject Headings

  • Xenon Isotopes
  • Spectrum Analysis
  • Pulmonary Gas Exchange
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Lung Diseases, Interstitial
  • Lung
 

Citation

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ICMJE
MLA
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Mummy, D. G., Bier, E. A., Wang, Z., Korzekwinski, J., Morrison, L., Barkauskas, C., … Mammarappallil, J. G. (2021). Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia. Radiology, 301(1), 211–220. https://doi.org/10.1148/radiol.2021204149
Mummy, David G., Elianna A. Bier, Ziyi Wang, Jennifer Korzekwinski, Lake Morrison, Christina Barkauskas, H Page McAdams, Robert M. Tighe, Bastiaan Driehuys, and Joseph G. Mammarappallil. “Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia.Radiology 301, no. 1 (October 2021): 211–20. https://doi.org/10.1148/radiol.2021204149.
Mummy DG, Bier EA, Wang Z, Korzekwinski J, Morrison L, Barkauskas C, et al. Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia. Radiology. 2021 Oct;301(1):211–20.
Mummy, David G., et al. “Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia.Radiology, vol. 301, no. 1, Oct. 2021, pp. 211–20. Pubmed, doi:10.1148/radiol.2021204149.
Mummy DG, Bier EA, Wang Z, Korzekwinski J, Morrison L, Barkauskas C, McAdams HP, Tighe RM, Driehuys B, Mammarappallil JG. Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia. Radiology. 2021 Oct;301(1):211–220.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

October 2021

Volume

301

Issue

1

Start / End Page

211 / 220

Location

United States

Related Subject Headings

  • Xenon Isotopes
  • Spectrum Analysis
  • Pulmonary Gas Exchange
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Lung Diseases, Interstitial
  • Lung