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Optimized quantitative mapping of cardiopulmonary oscillations using hyperpolarized 129 Xe gas exchange MRI: Digital phantoms and clinical evaluation in CTEPH.

Publication ,  Journal Article
Lu, J; Alenezi, F; Bier, E; Leewiwatwong, S; Mummy, D; Kabir, S; Rajagopal, S; Robertson, S; Niedbalski, PJ; Driehuys, B
Published in: Magn Reson Med
April 2024

PURPOSE: The interaction between 129 Xe atoms and pulmonary capillary red blood cells provides cardiogenic signal oscillations that display sensitivity to precapillary and postcapillary pulmonary hypertension. Recently, such oscillations have been spatially mapped, but little is known about optimal reconstruction or sensitivity to artifacts. In this study, we use digital phantom simulations to specifically optimize keyhole reconstruction for oscillation imaging. We then use this optimized method to re-establish healthy reference values and quantitatively evaluate microvascular flow changes in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after pulmonary thromboendarterectomy (PTE). METHODS: A six-zone digital lung phantom was designed to investigate the effects of radial views, key radius, and SNR. One-point Dixon 129 Xe gas exchange MRI images were acquired in a healthy cohort (n = 17) to generate a reference distribution and thresholds for mapping red blood cell oscillations. These thresholds were applied to 10 CTEPH participants, with 6 rescanned following PTE. RESULTS: For undersampled acquisitions, a key radius of 0.14 k max $$ 0.14{k}_{\mathrm{max}} $$ was found to optimally resolve oscillation defects while minimizing excessive heterogeneity. CTEPH participants at baseline showed higher oscillation defect + low (32 ± 14%) compared with healthy volunteers (18 ± 12%, p < 0.001). For those scanned both before and after PTE, oscillation defect + low decreased from 37 ± 13% to 23 ± 14% (p = 0.03). CONCLUSIONS: Digital phantom simulations have informed an optimized keyhole reconstruction technique for gas exchange images acquired with standard 1-point Dixon parameters. Our proposed methodology enables more robust quantitative mapping of cardiogenic oscillations, potentially facilitating effective regional quantification of microvascular flow impairment in patients with pulmonary vascular diseases such as CTEPH.

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Published In

Magn Reson Med

DOI

EISSN

1522-2594

Publication Date

April 2024

Volume

91

Issue

4

Start / End Page

1541 / 1555

Location

United States

Related Subject Headings

  • Xenon Isotopes
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Lung Diseases
  • Lung
  • Hypertension, Pulmonary
  • Humans
  • Erythrocytes
  • 4003 Biomedical engineering
  • 0903 Biomedical Engineering
 

Citation

APA
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ICMJE
MLA
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Lu, J., Alenezi, F., Bier, E., Leewiwatwong, S., Mummy, D., Kabir, S., … Driehuys, B. (2024). Optimized quantitative mapping of cardiopulmonary oscillations using hyperpolarized 129 Xe gas exchange MRI: Digital phantoms and clinical evaluation in CTEPH. Magn Reson Med, 91(4), 1541–1555. https://doi.org/10.1002/mrm.29965
Lu, Junlan, Fawaz Alenezi, Elianna Bier, Suphachart Leewiwatwong, David Mummy, Sakib Kabir, Sudarshan Rajagopal, Scott Robertson, Peter J. Niedbalski, and Bastiaan Driehuys. “Optimized quantitative mapping of cardiopulmonary oscillations using hyperpolarized 129 Xe gas exchange MRI: Digital phantoms and clinical evaluation in CTEPH.Magn Reson Med 91, no. 4 (April 2024): 1541–55. https://doi.org/10.1002/mrm.29965.
Lu J, Alenezi F, Bier E, Leewiwatwong S, Mummy D, Kabir S, et al. Optimized quantitative mapping of cardiopulmonary oscillations using hyperpolarized 129 Xe gas exchange MRI: Digital phantoms and clinical evaluation in CTEPH. Magn Reson Med. 2024 Apr;91(4):1541–55.
Lu, Junlan, et al. “Optimized quantitative mapping of cardiopulmonary oscillations using hyperpolarized 129 Xe gas exchange MRI: Digital phantoms and clinical evaluation in CTEPH.Magn Reson Med, vol. 91, no. 4, Apr. 2024, pp. 1541–55. Pubmed, doi:10.1002/mrm.29965.
Lu J, Alenezi F, Bier E, Leewiwatwong S, Mummy D, Kabir S, Rajagopal S, Robertson S, Niedbalski PJ, Driehuys B. Optimized quantitative mapping of cardiopulmonary oscillations using hyperpolarized 129 Xe gas exchange MRI: Digital phantoms and clinical evaluation in CTEPH. Magn Reson Med. 2024 Apr;91(4):1541–1555.
Journal cover image

Published In

Magn Reson Med

DOI

EISSN

1522-2594

Publication Date

April 2024

Volume

91

Issue

4

Start / End Page

1541 / 1555

Location

United States

Related Subject Headings

  • Xenon Isotopes
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Lung Diseases
  • Lung
  • Hypertension, Pulmonary
  • Humans
  • Erythrocytes
  • 4003 Biomedical engineering
  • 0903 Biomedical Engineering