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Novel Thoracic MRI Approaches for the Assessment of Pulmonary Physiology and Inflammation

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Lung Inflammation in Health and Disease, Volume II

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1304))

Abstract

Excessive pulmonary inflammation can lead to damage of lung tissue, airway remodelling and established structural lung disease. Novel therapeutics that specifically target inflammatory pathways are becoming increasingly common in clinical practice, but there is yet to be a similar stepwise change in pulmonary diagnostic tools. A variety of thoracic magnetic resonance imaging (MRI) tools are currently in development, which may soon fulfil this emerging clinical need for highly sensitive assessments of lung structure and function. Given conventional MRI techniques are poorly suited to lung imaging, alternate strategies have been developed, including the use of inhaled contrast agents, intravenous contrast and specialized lung MR sequences. In this chapter, we discuss technical challenges of performing MRI of the lungs and how they may be overcome. Key thoracic MRI modalities are reviewed, namely, hyperpolarized noble gas MRI, oxygen-enhanced MRI (OE-MRI), ultrashort echo time (UTE) MRI and dynamic contrast-enhanced (DCE) MRI. Finally, we consider potential clinical applications of these techniques including phenotyping of lung disease, evaluation of novel pulmonary therapeutic efficacy and longitudinal assessment of specific patient groups.

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Abbreviations

129Xe:

Xenon-129

3He:

Helium-3

ADC:

Apparent diffusion coefficient

ASL:

Arterial spin labelling

BOS:

Bronchiolitis obliterans syndrome

CF:

Cystic fibrosis

CFTR:

Cystic fibrosis transmembrane receptor

COPD:

Chronic obstructive pulmonary disease

CT:

Computed tomography

CTPA:

CT pulmonary angiography

DCE:

Dynamic contrast enhancement

DLCO:

Diffusion capacity of the lung for carbon dioxide

DPD:

Dynamic proton density

DWI:

Diffusion-weighted imaging

FEV1:

Forced expiratory volume in 1 second

GRE:

Gradient recall echo

ILD:

Interstitial lung disease

IPF:

Idiopathic pulmonary fibrosis

LAM:

Lymphangioleiomyomatosis

LCI:

Lung clearance index

LVR:

Lung volume reduction

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

OE-MRI:

Oxygen-enhanced MRI

OTF:

Oxygen transfer function

PE:

Pulmonary embolism

PET:

Positron emission tomography

PFT:

Pulmonary function test

RBC:

Red blood cell

RER:

Relative enhancement ratio

RF:

Radiofrequency

SS:

Systemic sclerosis

SUVmax:

Maximum standardized uptake value

T:

Tesla

UTE:

Ultrashort echo time

V/Q:

Ventilation-perfusion

VDP:

Ventilation defect percentage

VDV:

Ventilation defect volume

ZTE:

Zero echo time

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  1. Department of Respiratory Medicine, University of Nottingham, Queens Medical Centre, Nottingham, UK

    Jonathan P. Brooke & Ian P. Hall

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    Yong-Xiao Wang

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Brooke, J.P., Hall, I.P. (2021). Novel Thoracic MRI Approaches for the Assessment of Pulmonary Physiology and Inflammation. In: Wang, YX. (eds) Lung Inflammation in Health and Disease, Volume II. Advances in Experimental Medicine and Biology, vol 1304. Springer, Cham. https://doi.org/10.1007/978-3-030-68748-9_8

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