Mapping of regional lung microstructural parameters using hyperpolarized 129 Xe dissolved-phase MRI in healthy volunteers and patients with chronic obstructive pulmonary disease.

PURPOSE: To develop a novel technique for voxel-based mapping of lung microstructural parameters using hyperpolarized 129 Xe dissolved-phase MR imaging during saturation recovery. METHODS: A pulse sequence using a highly undersampled stack-of-stars trajectory was developed, and low-rank plus sparse matrix decomposition was employed for reconstruction of regional 129 Xe uptake dynamics into lung tissue. In 4 healthy volunteers and 9 patients with chronic obstructive pulmonary disease, the technique was tested and compared to chemical shift saturation recovery spectroscopy in patients. Reproducibility of 129 Xe gas uptake imaging was assessed by computing coefficients of variation, and results were compared with other modalities. RESULTS: Numerical simulations and results from in vivo measurements in patients with chronic obstructive pulmonary disease showed that septal wall thickness and surface-to-volume ratio can be measured with an accuracy close to spectroscopic measurements. The average of the microstructural parameters of the total lung volume showed good reproducibility (coefficient of variation wall thickness: 7.4% coefficient of variation surface-to-volume ratio: 7.5%) and correlated strongly with the findings of global chemical shift saturation recovery spectroscopy. Gravitational gradients of microstructural parameters and increased heterogeneity in chronic obstructive pulmonary disease patients were observed. CONCLUSION: A novel technique for mapping of regional lung microstructural parameters was introduced, and its feasibility was shown in healthy volunteers and chronic obstructive pulmonary disease patients.

Feasibility of quantitative regional ventilation and perfusion mapping with phase-resolved functional lung (PREFUL) MRI in healthy volunteers and COPD, CTEPH, and CF patients.

PURPOSE: In this feasibility study, a phase-resolved functional lung imaging postprocessing method for extraction of dynamic perfusion (Q) and ventilation (V) parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. METHODS: Time series of coronal gradient-echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1.5 T. Using a sine model to estimate cardiac and respiratory phases of each image, all images were sorted to reconstruct full cardiac and respiratory cycles. Time to peak (TTP), V/Q maps, and fractional ventilation flow-volume loops were calculated. RESULTS: For the volunteers, homogenous ventilation and perfusion TTP maps (V-TTP, Q-TTP) were obtained. The chronic thromboembolic hypertension patient showed increased perfusion TTP in hypoperfused regions in visual agreement with dynamic contrast-enhanced MRI, which improved postpulmonary endaterectomy surgery. Cystic fibrosis and chronic obstructive pulmonary disease patients showed a pattern of increased V-TTP and Q-TTP in regions of hypoventilation and decreased perfusion. Fractional ventilation flow-volume loops of the chronic obstructive pulmonary disease patient were smaller in comparison with the healthy volunteer, and showed regional differences in visual agreement with functional small airways disease and emphysema on CT. CONCLUSIONS: This study shows the feasibility of phase-resolved functional lung imaging to gain quantitative information regarding regional lung perfusion and ventilation without the need for ultrafast imaging, which will be advantageous for future clinical translation. Magn Reson Med 79:2306-2314, 2018. © 2017 International Society for Magnetic Resonance in Medicine.