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Measuring diffusion limitation with a perfusion-limited gas--hyperpolarized 129Xe gas-transfer spectroscopy in patients with idiopathic pulmonary fibrosis.

Publication ,  Journal Article
Kaushik, SS; Freeman, MS; Yoon, SW; Liljeroth, MG; Stiles, JV; Roos, JE; Foster, WM; Rackley, CR; McAdams, HP; Driehuys, B
Published in: J Appl Physiol (1985)
September 15, 2014

Although xenon is classically taught to be a "perfusion-limited" gas, (129)Xe in its hyperpolarized (HP) form, when detected by magnetic resonance (MR), can probe diffusion limitation. Inhaled HP (129)Xe diffuses across the pulmonary blood-gas barrier, and, depending on its tissue environment, shifts its resonant frequency relative to the gas-phase reference (0 ppm) by 198 ppm in tissue/plasma barrier and 217 ppm in red blood cells (RBCs). In this work, we hypothesized that in patients with idiopathic pulmonary fibrosis (IPF), the ratio of (129)Xe spectroscopic signal in the RBCs vs. barrier would diminish as diffusion-limitation delayed replenishment of (129)Xe magnetization in RBCs. To test this hypothesis, (129)Xe spectra were acquired in 6 IPF subjects as well as 11 healthy volunteers to establish a normal range. The RBC:barrier ratio was 0.55 ± 0.13 in healthy volunteers but was 3.3-fold lower in IPF subjects (0.16 ± 0.03, P = 0.0002). This was caused by a 52% reduction in the RBC signal (P = 0.02) and a 58% increase in the barrier signal (P = 0.01). Furthermore, the RBC:barrier ratio strongly correlated with lung diffusing capacity for carbon monoxide (DLCO) (r = 0.89, P < 0.0001). It exhibited a moderate interscan variability (8.25%), and in healthy volunteers it decreased with greater lung inflation (r = -0.78, P = 0.005). This spectroscopic technique provides a noninvasive, global probe of diffusion limitation and gas-transfer impairment and forms the basis for developing 3D MR imaging of gas exchange.

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Published In

J Appl Physiol (1985)

DOI

EISSN

1522-1601

Publication Date

September 15, 2014

Volume

117

Issue

6

Start / End Page

577 / 585

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Respiratory Function Tests
  • Reproducibility of Results
  • Pulmonary Fibrosis
  • Pulmonary Diffusing Capacity
  • Physiology
  • Perfusion
  • Middle Aged
  • Male
 

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Kaushik, S. S., Freeman, M. S., Yoon, S. W., Liljeroth, M. G., Stiles, J. V., Roos, J. E., … Driehuys, B. (2014). Measuring diffusion limitation with a perfusion-limited gas--hyperpolarized 129Xe gas-transfer spectroscopy in patients with idiopathic pulmonary fibrosis. J Appl Physiol (1985), 117(6), 577–585. https://doi.org/10.1152/japplphysiol.00326.2014
Kaushik, S Sivaram, Matthew S. Freeman, Suk W. Yoon, Maria G. Liljeroth, Jane V. Stiles, Justus E. Roos, W Michael Foster, Craig R. Rackley, H. P. McAdams, and Bastiaan Driehuys. “Measuring diffusion limitation with a perfusion-limited gas--hyperpolarized 129Xe gas-transfer spectroscopy in patients with idiopathic pulmonary fibrosis.J Appl Physiol (1985) 117, no. 6 (September 15, 2014): 577–85. https://doi.org/10.1152/japplphysiol.00326.2014.
Kaushik SS, Freeman MS, Yoon SW, Liljeroth MG, Stiles JV, Roos JE, et al. Measuring diffusion limitation with a perfusion-limited gas--hyperpolarized 129Xe gas-transfer spectroscopy in patients with idiopathic pulmonary fibrosis. J Appl Physiol (1985). 2014 Sep 15;117(6):577–85.
Kaushik, S. Sivaram, et al. “Measuring diffusion limitation with a perfusion-limited gas--hyperpolarized 129Xe gas-transfer spectroscopy in patients with idiopathic pulmonary fibrosis.J Appl Physiol (1985), vol. 117, no. 6, Sept. 2014, pp. 577–85. Pubmed, doi:10.1152/japplphysiol.00326.2014.
Kaushik SS, Freeman MS, Yoon SW, Liljeroth MG, Stiles JV, Roos JE, Foster WM, Rackley CR, McAdams HP, Driehuys B. Measuring diffusion limitation with a perfusion-limited gas--hyperpolarized 129Xe gas-transfer spectroscopy in patients with idiopathic pulmonary fibrosis. J Appl Physiol (1985). 2014 Sep 15;117(6):577–585.

Published In

J Appl Physiol (1985)

DOI

EISSN

1522-1601

Publication Date

September 15, 2014

Volume

117

Issue

6

Start / End Page

577 / 585

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Respiratory Function Tests
  • Reproducibility of Results
  • Pulmonary Fibrosis
  • Pulmonary Diffusing Capacity
  • Physiology
  • Perfusion
  • Middle Aged
  • Male