Kai Ruppert1, Yi Xin1, Faraz Amzajerdian1, Hooman Hamedani1, Luis Loza1, Tahmina Achekzai1, Ryan J. Baron1, Ian F. Duncan1, Harrilla Profka1, Sarmad Siddiqui1, Mehrdad Pourfathi1, Federico Sertic1, Maurizio F. Cereda2, and Rahim R. Rizi1
1Radiology, University of Pennsylvania, Philadelphia, PA, United States, 2Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, United States
Synopsis
Septal
wall thickness measurements using hyperpolarized xenon-129 MRI are sensitive to
inflammatory or fibrotic pathologies but currently require multi-second
breath-holds. We investigated the feasibility of sampling the recovery of the
xenon dissolved-phase magnetization in the lung parenchyma in real time using a rapid 1D acquisition technique combined with
periodic saturation of the xenon dissolved-phase magnetization, allowing us to
extract the septal wall thickness during short breath holds or even in free-breathing
rabbits. Our measurements indicate that the correlation between the derived
septal wall thickness and the respiratory cycle are low enough to obtain
consistent wall-thickness measurements in free-breathing, non-cooperative
subjects.
Purpose
Septal
wall thickness measurements obtained using hyperpolarized xenon-129 (HXe) Chemical Shift Saturation Recovery (CSSR) MR
spectroscopy1-4
and imaging5-8 are sensitive to inflammatory or fibrotic pathologies
in the lung parenchyma. However, these assessments currently require
multi-second breath holds, making them unsuitable for use in uncooperative or
severely diseased subjects. In addition, physiological variations throughout
the breath hold, which may impact the resulting measurements, cannot be
accounted for. Kern et al7 already proposed to sample the xenon
dissolved-phase magnetization throughout recovery subsequent to saturation9.
In this work, we advanced this approach by investigating the use of a rapid 1D HXe
MRI technique that allows for real-time monitoring of xenon gas uptake, making
it feasible to characterize septal wall thickness in free-breathing subjects.
We evaluated the feasibility of this method in a rabbit model.Methods
Imaging
experiments were performed in sedated New Zealand rabbits (approx. 4 kg).
Animals were ventilated with room air until imaging began, at which point the
gas mix was switched to 20% oxygen and 80% HXe, either for 3 breaths (6 ml/kg
tidal volume) followed by a 4-s breath-hold or for 8 breaths without
breath-hold. All studies were approved by the Institutional Animal Care and Use
Committee.
MR imaging was conducted using a 1D-projection gradient-echo sequence with
left-to-right frequency encoding that employed a non-selective 700-ms Gaussian RF excitation pulse centered 3,530 Hz
downfield from the gas-phase resonance. Taking advantage of the large frequency
difference between the two phases combined with a sufficiently small
acquisition bandwidth, HXe in the pulmonary air spaces and dissolved in the
lung tissue were imaged simultaneously, side-by-side10. The
following sequence parameters were used: matrix size 28×80; TE 2.6 ms; FOV 230
mm; receiver bandwidth 110 Hz/pixel; breath hold studies: flip angle 11°, TR 20
ms (TR90°,equiv 1.10 s)11; free
breathing studies: flip angle 7°, TR 10 ms (TR90°,equiv 1.34 s)11. For
the breath hold studies, the dissolved-phase magnetization was saturated every
25 TRs (0.5 s) with 2-ms frequency-selective Gaussian RF pulses centered at the
dissolved-phase resonance. A more rapid saturation rate of every 20 TRs (0.2 s)
was used for the free-breathing studies. Septal wall thickness was calculated using
the analytical uptake model of Patz et al12 for each pixel in a left-right
direction based on the recovery of the dissolved-phase signal following each
saturation pulse. All MR studies were
performed at 1.5T (Avanto; Siemens) using a custom xenon-129 transmit/receive
birdcage coil (Stark Contrast, Erlangen, Germany). Enriched xenon gas (87% xenon-129)
was polarized using a prototype commercial system (XeBox-E10, Xemed LLC,
Durham, NH).
Results and Discussion
Figure 1 illustrates the temporal dynamics of
the 1D signal projection during a breath hold study (unlike humans, only a
single, broad dissolved-phase resonance is discernible in rabbits). The dark,
equidistantly-spaced bands running across the dissolved-phase signal reflect
the periodic saturation of the dissolved-phase magnetization. Figure 2 depicts
the spatially-averaged dissolved-phase magnetization as a function of time. The
magnetization drops rapidly at around 0.6 s when the first saturation pulse is
applied, and recovers over the course of the next 0.5 s as fresh magnetization
enters the parenchyma from the alveolar gas pool. Similarly, Fig. 3 shows the
whole-lung dissolved-phase signal as a function of time in a free-breathing
rabbit with the whole-lung gas-phase signal superimposed in red. The
corresponding septal wall thickness for the left and right lung throughout the
respiratory cycle are displayed in Fig. 4. While the wall thickness fluctuates
throughout the measurement, it does not appear to be strongly correlated with
respiration. However, the average wall thickness in the left lung in this
animal was approximately 1.5 μm higher than in the right lung (12.9 ± 1.6 μm vs. 11.3 ± 0.8 μm). This difference seems to correspond to the
lower gas-phase and dissolved-phase signal amplitudes in the left lung relative
to the right lung, and was likely caused by a reduced inflation of the left
lung. If the latter assessment is correct, some degree of correlation between
wall thickness and the respiratory cycle would be expected. Future studies with
wall measurements during extended xenon ventilation periods will address this
question.Conclusion
We demonstrated the implementation of a rapid 1D
acquisition technique combined with periodic saturation of the xenon
dissolved-phase magnetization within the lung parenchyma to conduct CSSR
measurements in real time. The correlation between the derived septal wall
thickness and the respiratory cycle appeared to be low enough to obtain
consistent measurement values even in a free-breathing rabbit. Hence, septal
wall thickness measurements seem feasible even in non-cooperative subjects.Acknowledgements
Supported by NIH grants
R01 EB015767, R01 HL129805, S10 OD018203 and R01 CA193050.References
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