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

Lukas Ebner, Mu He, Rohan S. Virgincar, Timothy Heacock, Suryanarayanan S. Kaushik, Matthew S. Freemann, H. Page McAdams, Monica Kraft, Bastiaan Driehuys

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Abstract

Objectives The aim of this study was to investigate ventilation in mild to moderate asthmatic patients and age-matched controls using hyperpolarized (HP) 129Xenon 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 129Xe. 129Xe 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 (R2), 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 (R2 = 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 129Xenon MRI is able to depict airway obstructions in mild to moderate asthma and significantly correlates with PFTs.

Original languageEnglish (US)
Pages (from-to)120-127
Number of pages8
JournalInvestigative Radiology
Volume52
Issue number2
DOIs
Publication statusPublished - Feb 1 2017
Externally publishedYes

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Keywords

  • airway obstruction
  • asthma
  • hyperpolarized xenon gas
  • lung MRI
  • pulmonary function tests

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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. / Ebner, Lukas; He, Mu; Virgincar, Rohan S.; Heacock, Timothy; Kaushik, Suryanarayanan S.; Freemann, Matthew S.; McAdams, H. Page; Kraft, Monica; Driehuys, Bastiaan.

In: Investigative Radiology, Vol. 52, No. 2, 01.02.2017, p. 120-127.

Research output: Contribution to journalArticle