Emphysema: Hyperpolarized Helium 3 Diffusion MR Imaging of the Lungs Compared with Spirometric Indexes—Initial Experience
Abstract
PURPOSE: To quantitatively evaluate hyperpolarized helium 3 (3He) diffusion magnetic resonance (MR) images of the lung in patients with emphysema and to determine whether apparent diffusion coefficients (ADCs) measured with MR imaging correlate with spirometric indexes.
MATERIALS AND METHODS: Hyperpolarized 3He diffusion MR imaging was performed in 16 healthy volunteers and 11 patients. Coronal diffusion-sensitized MR images were obtained during suspended respiration after inhalation of laser-polarized 3He gas, and images of the ADC were calculated. Spirometry was performed immediately before imaging. The mean and SD of the ADCs were compared between subject groups and were correlated with spirometric indexes.
RESULTS: ADC images were homogeneous in volunteers, but demonstrated regional variations in patients. The mean and SD of the ADCs for patients were significantly larger (P < .002) than those for volunteers. The mean ADCs for all subjects correlated with the percentage of predicted forced expiratory volume in 1 second, or FEV1, (r = −0.797, P < .001) and the ratio of FEV1 to forced vital capacity, or FVC, (r = −0.930, P < .001). ADC images in patients demonstrated a significant increase (P < .001) in the ADCs in the upper regions compared with the lower regions of the lung.
CONCLUSION: Hyperpolarized 3He diffusion MR imaging demonstrated potential for use in evaluating the global and regional severity of emphysema.
References
- 1 National Center for Health Statistics. Preliminary data for 1998. National Vital Statistics Report 1999; 47:25. Google Scholar
- 2 Adams PF, Hendershot GE, Marano MA. Current estimates from the National Health Interview Survey 1996. National Center for Health Statistics. Vital Health Stat 1996; 10:200. Google Scholar
- 3 Takasugi JE, Godwin JD. Radiology of chronic obstructive pulmonary disease. Radiol Clin North Am 1998; 36:29-55. Crossref, Medline, Google Scholar
- 4 Gurney JW. Pathophysiology of obstructive airways disease. Radiol Clin North Am 1998; 36:15-27. Crossref, Medline, Google Scholar
- 5 Middleton H, Black RD, Saam B, et al. MR imaging with hyperpolarized (3)He gas. Magn Reson Med 1995; 33:271-275. Crossref, Medline, Google Scholar
- 6 Black RD, Middleton HL, Cates GD, et al. In vivo He-3 MR images of guinea pig lungs. Radiology 1996; 199:867-870. Link, Google Scholar
- 7 Kauczor HU, Hofmann D, Kreitner KF, et al. Normal and abnormal pulmonary ventilation: visualization at hyperpolarized He-3 MR imaging. Radiology 1996; 201:564-568. Link, Google Scholar
- 8 MacFall JR, Charles HC, Black RD, et al. Human lung air spaces: potential for MR imaging with hyperpolarized He-3. Radiology 1996; 200:553-558. Link, Google Scholar
- 9 Kauczor HU, Ebert M, Kreitner KF, et al. Imaging of the lungs using (3)He MRI: preliminary clinical experience in 18 patients with and without lung disease. J Magn Reson Imaging 1997; 7:538-543. Crossref, Medline, Google Scholar
- 10 de Lange EE, Mugler JP, III, Brookeman JR, et al. Lung air spaces: MR imaging evaluation with hyperpolarized (3)He gas. Radiology 1999; 210:851-857. Link, Google Scholar
- 11 Altes TA, Powers PL, Knight-Scott J, et al. Hyperpolarized (3)He MR lung ventilation imaging in asthmatics: preliminary findings. J Magn Reson Imaging 2001; 13:378-384. Crossref, Medline, Google Scholar
- 12 Donnelly LF, MacFall JR, McAdams HP, et al. Cystic fibrosis: combined hyperpolarized (3)He-enhanced and conventional proton MR imaging in the lung—preliminary observations. Radiology 1999; 212:885-889. Link, Google Scholar
- 13 Moseley ME, Cohen Y, Mintorovitch J, et al. Early detection of regional cerebral ischemia in cats: comparison of diffusion- and T2-weighted MRI and spectroscopy. Magn Reson Med 1990; 14:330-346. Crossref, Medline, Google Scholar
- 14 Lutsep HL, Albers GW, DeCrespigny A, Kamat GN, Marks MP, Moseley ME. Clinical utility of diffusion-weighted magnetic resonance imaging in the assessment of ischemic stroke. Ann Neurol 1997; 41:574-580. Crossref, Medline, Google Scholar
- 15 Chen XJ, Helund LW, Chawla MS, Moller HE, Johnson GA. Detection of elastase-induced emphysema in rat lungs by measuring diffusion of hyperpolarized 3He (abstr) In: Proceedings of the Seventh Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 1999; 130. Google Scholar
- 16 Mugler JP, III, Brookeman JR, Knight-Scott J, Maier T, de Lange EE, Bogorad PL. Regional measurement of the 3He diffusion coefficient in the human lung (abstr) In: Proceedings of the Sixth Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 1998; 1906. Google Scholar
- 17 Salerno M, Brookeman JR, de Lange EE, Knight-Scott J, Mugler JP, III. Demonstration of an alveolar-size gradient in the healthy human lung: a study of the reproducibility of hyperpolarizd 3He diffusion MRI (abstr) In: Proceedings of the Eighth Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 2000; 2195. Google Scholar
- 18 Saam B, Yablonskiy DA, Gierada DS, Cooper JD, Conradi MS. Measurements of 3He diffusivity in human lung: preliminary results from an emphysema patient (abstr) In: Proceedings of the Seventh Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 1999; 136. Google Scholar
- 19 Salerno M, Brookeman JR, de Lange EE, Knight-Scott J, Mugler JP, III. Detection of regional microstructural changes of the lung in emphysema using hyperpolarized 3He diffusion MRI (abstr) In: Proceedings of the Eighth Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 2000; 9. Google Scholar
- 20 Saam BT, Yablonskiy DA, Kodibagkar VD, et al. MR imaging of diffusion of (3)He gas in healthy and diseased lungs. Magn Reson Med 2000; 44:174-179. Crossref, Medline, Google Scholar
- 21 Henkelman RM. Measurement of signal intensities in the presence of noise in MR images. Med Phys 1985; 12:232-233. Crossref, Medline, Google Scholar
- 22 Knudson RJ, Lebowitz M, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with aging. Am Rev Respir Dis 1983; 127:725-734. Medline, Google Scholar
- 23 Chen XJ, Moller HE, Chawla MS, et al. Spatially resolved measurements of hyperpolarized gas properties in the lung in vivo. I. Diffusion coefficient. Magn Reson Med 1999; 42:721-728. Google Scholar
- 24 Bankier AA, De Maertelaer V, Keyzer C, Gevenois PA. Pulmonary emphysema: subjective visual grading versus objective quantification with macroscopic morphometry and thin-section CT densitometry. Radiology 1999; 211:851-858. Medline, Google Scholar







