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Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability.

Publication ,  Journal Article
Willmering, MM; Walkup, LL; Niedbalski, PJ; Wang, H; Wang, Z; Hysinger, EB; Myers, KC; Towe, CT; Driehuys, B; Cleveland, ZI; Woods, JC
Published in: J Magn Reson Imaging
October 2022

BACKGROUND: 129 Xe gas-transfer MRI provides regional measures of pulmonary gas exchange in adults and separates xenon in interstitial lung tissue/plasma (barrier) from xenon in red blood cells (RBCs). The technique has yet to be demonstrated in pediatric populations or conditions. PURPOSE/HYPOTHESIS: To perform an exploratory analysis of 129 Xe gas-transfer MRI in children. STUDY TYPE: Prospective. POPULATION: Seventy-seven human volunteers (38 males, age = 17.7 ± 15.1 years, range 5-68 years, 16 healthy). Four pediatric disease cohorts. FIELD STRENGTH/SEQUENCE: 3-T, three-dimensional-radial one-point Dixon Fast Field Echo (FFE) Ultrashort Echo Time (UTE). ASSESSMENT: Breath hold compliance was assessed by quantitative signal-to-noise and dynamic metrics. Whole-lung means and standard deviations were extracted from gas-transfer maps. Gas-transfer metrics were investigated with respect to age and lung disease. Clinical pulmonary function tests were retrospectively acquired for reference lung disease severity. STATISTICAL TESTS: Wilcoxon rank-sum tests to compare age and disease cohorts, Wilcoxon signed-rank tests to compare pre- and post-breath hold vitals, Pearson correlations between age and gas-transfer metrics, and limits of normal with a binomial exact test to compare fraction of subjects with abnormal gas-transfer. P ≤ 0.05 was considered significant. RESULTS: Eighty percentage of pediatric subjects successfully completed 129 Xe gas-transfer MRI. Gas-transfer parameters differed between healthy children and adults, including ventilation (0.75 and 0.67) and RBC:barrier ratio (0.31 and 0.46) which also correlated with age (ρ = -0.76, 0.57, respectively). Bone marrow transplant subjects had impaired ventilation (90% of reference) and increased dissolved 129 Xe standard deviation (242%). Bronchopulmonary dysplasia subjects had decreased barrier-uptake (69%). Cystic fibrosis subjects had impaired ventilation (91%) and increased RBC-transfer (146%). Lastly, childhood interstitial lung disease subjects had increased ventilation heterogeneity (113%). Limits of normal provided detection of abnormalities in additional gas-transfer parameters. DATA CONCLUSION: Pediatric 129 Xe gas-transfer MRI was adequately successful and gas-transfer metrics correlated with age. Exploratory analysis revealed abnormalities in a variety of pediatric obstructive and restrictive lung diseases. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.

Duke Scholars

Published In

J Magn Reson Imaging

DOI

EISSN

1522-2586

Publication Date

October 2022

Volume

56

Issue

4

Start / End Page

1207 / 1219

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Xenon
  • Retrospective Studies
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Lung Diseases
 

Citation

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MLA
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Willmering, M. M., Walkup, L. L., Niedbalski, P. J., Wang, H., Wang, Z., Hysinger, E. B., … Woods, J. C. (2022). Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability. J Magn Reson Imaging, 56(4), 1207–1219. https://doi.org/10.1002/jmri.28136
Willmering, Matthew M., Laura L. Walkup, Peter J. Niedbalski, Hui Wang, Ziyi Wang, Erik B. Hysinger, Kasiani C. Myers, et al. “Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability.J Magn Reson Imaging 56, no. 4 (October 2022): 1207–19. https://doi.org/10.1002/jmri.28136.
Willmering MM, Walkup LL, Niedbalski PJ, Wang H, Wang Z, Hysinger EB, et al. Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability. J Magn Reson Imaging. 2022 Oct;56(4):1207–19.
Willmering, Matthew M., et al. “Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability.J Magn Reson Imaging, vol. 56, no. 4, Oct. 2022, pp. 1207–19. Pubmed, doi:10.1002/jmri.28136.
Willmering MM, Walkup LL, Niedbalski PJ, Wang H, Wang Z, Hysinger EB, Myers KC, Towe CT, Driehuys B, Cleveland ZI, Woods JC. Pediatric 129 Xe Gas-Transfer MRI-Feasibility and Applicability. J Magn Reson Imaging. 2022 Oct;56(4):1207–1219.
Journal cover image

Published In

J Magn Reson Imaging

DOI

EISSN

1522-2586

Publication Date

October 2022

Volume

56

Issue

4

Start / End Page

1207 / 1219

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Xenon
  • Retrospective Studies
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Lung Diseases