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Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy.

Publication ,  Conference
Bier, EA; Alenezi, F; Lu, J; Wang, Z; Mammarappallil, JG; O'Sullivan-Murphy, B; Erkanli, A; Driehuys, B; Rajagopal, S
Published in: ERJ Open Res
April 2022

BACKGROUND: The diagnosis of pulmonary hypertension (PH) remains challenging. Pre- and post-capillary PH have different signatures on noninvasive 129Xe gas-exchange magnetic resonance imaging (MRI) and dynamic MR spectroscopy (MRS). We tested the accuracy of 129Xe MRI/MRS to diagnose PH status compared to right heart catheterisation (RHC). METHODS: 129Xe MRI/MRS from 93 subjects was used to develop a diagnostic algorithm, which was tested in 32 patients undergoing RHC on the same day (n=20) or within 5 months (42±40 days) (n=12). Three expert readers, blinded to RHC, used 129Xe MRI/MRS to classify subjects as pre-capillary PH, post-capillary PH, no PH and no interstitial lung disease (ILD), or ILD. RESULTS: For pre-capillary PH, 129Xe MRI/MRS diagnostic accuracy was 75% (95% CI 66-84) with a sensitivity of 67% (95% CI 54-79) and a specificity of 86% (95% CI 75-96); for post-capillary PH accuracy was 69% (95% CI 59-78) with sensitivity of 54% (95% CI 34-74) and specificity of 74% (95% CI 63-84). The model performed well in straightforward cases of pre-capillary PH but was less accurate in its diagnosis in the presence of mixed disease, particularly in the presence of ILD or combined post- and pre-capillary PH. CONCLUSION: This study demonstrates the potential to develop 129Xe MRI/MRS into a modality with good accuracy in detecting pre- and post-capillary PH. Furthermore, the combination of 129Xe dynamic MRS and gas-exchange MRI uniquely provide concurrent, noninvasive assessment of both haemodynamics and gas-exchange impairment that may aid in the detection of PH.

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Published In

ERJ Open Res

DOI

ISSN

2312-0541

Publication Date

April 2022

Volume

8

Issue

2

Location

England

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 3201 Cardiovascular medicine and haematology
 

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APA
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ICMJE
MLA
NLM
Bier, E. A., Alenezi, F., Lu, J., Wang, Z., Mammarappallil, J. G., O’Sullivan-Murphy, B., … Rajagopal, S. (2022). Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy. In ERJ Open Res (Vol. 8). England. https://doi.org/10.1183/23120541.00035-2022
Bier, Elianna A., Fawaz Alenezi, Junlan Lu, Ziyi Wang, Joseph G. Mammarappallil, Bryan O’Sullivan-Murphy, Alaattin Erkanli, Bastiaan Driehuys, and Sudarshan Rajagopal. “Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy.” In ERJ Open Res, Vol. 8, 2022. https://doi.org/10.1183/23120541.00035-2022.
Bier EA, Alenezi F, Lu J, Wang Z, Mammarappallil JG, O’Sullivan-Murphy B, et al. Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy. In: ERJ Open Res. 2022.
Bier, Elianna A., et al. “Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy.ERJ Open Res, vol. 8, no. 2, 2022. Pubmed, doi:10.1183/23120541.00035-2022.
Bier EA, Alenezi F, Lu J, Wang Z, Mammarappallil JG, O’Sullivan-Murphy B, Erkanli A, Driehuys B, Rajagopal S. Noninvasive diagnosis of pulmonary hypertension with hyperpolarised 129Xe magnetic resonance imaging and spectroscopy. ERJ Open Res. 2022.

Published In

ERJ Open Res

DOI

ISSN

2312-0541

Publication Date

April 2022

Volume

8

Issue

2

Location

England

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 3201 Cardiovascular medicine and haematology