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Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma: A Prospective Comparison Between Semiautomated Ventilation Defect Percentage Calculation and Pulmonary Function Tests.

Publication ,  Journal Article
Ebner, L; He, M; Virgincar, RS; Heacock, T; Kaushik, SS; Freemann, MS; McAdams, HP; Kraft, M; Driehuys, B
Published in: Invest Radiol
February 2017

OBJECTIVES: The aim of this study was to investigate ventilation in mild to moderate asthmatic patients and age-matched controls using hyperpolarized (HP) Xenon magnetic resonance imaging (MRI) and correlate findings with pulmonary function tests (PFTs). MATERIALS AND METHODS: This single-center, Health Insurance Portability and Accountability Act-compliant prospective study was approved by our institutional review board. Thirty subjects (10 young asthmatic patients, 26 ± 6 years; 3 males, 7 females; 10 older asthmatic patients, 64 ± 6 years; 3 males, 7 females; 10 healthy controls) were enrolled. After repeated PFTs 1 week apart, the subjects underwent 2 MRI scans within 10 minutes, inhaling 1-L volumes containing 0.5 to 1 L of Xe. Xe ventilation signal was quantified by linear binning, from which the ventilation defect percentage (VDP) was derived. Differences in VDP among subgroups and variability with age were evaluated using 1-tailed t tests. Correlation of VDP with PFTs was tested using Pearson correlation coefficient. Reproducibility of VDP was assessed using Bland-Altman plots, linear regression (R), intraclass correlation coefficient, and concordance correlation coefficient. RESULTS: Ventilation defect percentage was significantly higher in young asthmatic patients versus young healthy subjects (8.4% ± 3.2% vs 5.6% ± 1.7%, P = 0.031), but not in older asthmatic patients versus age-matched controls (16.8% ± 10.3% vs 11.6% ± 6.6%, P = 0.13). Ventilation defect percentage was found to increase significantly with age (healthy, P = 0.05; asthmatic patients, P = 0.033). Ventilation defect percentage was highly reproducible (R = 0.976; intraclass correlation coefficient, 0.977; concordance correlation coefficient, 0.976) and significantly correlated with FEV1% (r = -0.42, P = 0.025), FEF25%-75% (r = -0.45, P = 0.019), FEV1/FVC (r = -0.71, P < 0.0001), FeNO (r = 0.69, P < 0.0001), and RV/TLC (r = 0.51, P = 0.0067). Bland-Altman analysis showed a bias for VDP of -0.88 ± 1.52 (FEV1%, -0.33 ± 7.18). CONCLUSIONS: Xenon MRI is able to depict airway obstructions in mild to moderate asthma and significantly correlates with PFTs.

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Published In

Invest Radiol

DOI

EISSN

1536-0210

Publication Date

February 2017

Volume

52

Issue

2

Start / End Page

120 / 127

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Severity of Illness Index
  • Respiratory Function Tests
  • Reproducibility of Results
  • Pulmonary Ventilation
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
 

Citation

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Ebner, L., He, M., Virgincar, R. S., Heacock, T., Kaushik, S. S., Freemann, M. S., … Driehuys, B. (2017). Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma: A Prospective Comparison Between Semiautomated Ventilation Defect Percentage Calculation and Pulmonary Function Tests. Invest Radiol, 52(2), 120–127. https://doi.org/10.1097/RLI.0000000000000322
Ebner, Lukas, Mu He, Rohan S. Virgincar, Timothy Heacock, Suryanarayanan S. Kaushik, Matthew S. Freemann, H Page McAdams, Monica Kraft, and Bastiaan Driehuys. “Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma: A Prospective Comparison Between Semiautomated Ventilation Defect Percentage Calculation and Pulmonary Function Tests.Invest Radiol 52, no. 2 (February 2017): 120–27. https://doi.org/10.1097/RLI.0000000000000322.

Published In

Invest Radiol

DOI

EISSN

1536-0210

Publication Date

February 2017

Volume

52

Issue

2

Start / End Page

120 / 127

Location

United States

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Severity of Illness Index
  • Respiratory Function Tests
  • Reproducibility of Results
  • Pulmonary Ventilation
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male