European Radiology

, Volume 16, Issue 11, pp 2483–2490

Hyperpolarized 3helium magnetic resonance ventilation imaging of the lung in cystic fibrosis: comparison with high resolution CT and spirometry

  • Colm J. McMahon
  • Jonathan D. Dodd
  • Catherine Hill
  • Neil Woodhouse
  • Jim M. Wild
  • Stan Fichele
  • Charles G. Gallagher
  • Stephen J. Skehan
  • Edwin J. R. van Beek
  • James B. Masterson
Chest

Abstract

The purpose of this study was to compare hyperpolarized 3helium magnetic resonance imaging (3He MRI) of the lungs in adults with cystic fibrosis (CF) with high-resolution computed tomography (HRCT) and spirometry. Eight patients with stable CF prospectively underwent 3He MRI, HRCT, and spirometry within 1 week. Three-dimensional (3D) gradient-echo sequence was used during an 18-s breath-hold following inhalation of hyperpolarized 3He. Each lung was divided into six zones; 3He MRI was scored as percentage ventilation per lung zone. HRCT was scored using a modified Bhalla scoring system. Univariate (Spearman rank) and multivariate correlations were performed between 3He MRI, HRCT, and spirometry. Results are expressed as mean±SD (range). Spirometry is expressed as percent predicted. There were four men and four women, mean age=31.9±9 (20–46). Mean forced expiratory volume in 1 s (FEV)1=52%±29 (27–93). Mean 3He MRI score=74%±25 (55–100). Mean HRCT score=48.8±24 (13.5–83). The correlation between3He MRI and HRCT was strong (R=±0.89, p<0.001). Bronchiectasis was the only independent predictor of 3He MRI; 3He MRI correlated better with FEV1 and forced vital capacity (FVC) (R=0.86 and 0.93, p<0.01, respectively) than HRCT (R=±0.72 and ±0.81, p<0.05, respectively). This study showed that 3He MRI correlates strongly with structural HRCT abnormalities and is a stronger correlate of spirometry than HRCT in CF.

Keywords

Cystic fibrosis Helium Lung Magnetic resonance (MR) Contrast enhancement  Nuclei other than H 

References

  1. 1.
    Devaney J, Glennon M, Farrell G, Ruttledge M, Smith T, Houghton JA, Maher M (2003) Cystic fibrosis mutation frequencies in an Irish population. Clin Genet 63:121–125PubMedCrossRefGoogle Scholar
  2. 2.
    Jaffe A, Bush A (2001) Cystic fibrosis: review of the decade. Monaldi Arch Chest Dis 56:240–247PubMedGoogle Scholar
  3. 3.
    Bhalla M, Turcios N, Aponte V, Jenkins M, Leitman BS, McCauley DI, Naidich DP (1991) Cystic fibrosis: scoring system with thin-section CT. Radiology 179:783–788PubMedGoogle Scholar
  4. 4.
    Hansell DM, Strickland B (1989) High-resolution computed tomography in pulmonary cystic fibrosis. Br J Radiol 62:1–5PubMedCrossRefGoogle Scholar
  5. 5.
    Demirkazik FB, Ariyurek OM, Ozcelik U, Gocmen A, Hassanabad HK, Kiper N (2001) High resolution CT in children with cystic fibrosis: correlation with pulmonary functions and radiographic scores. Eur J Radiol 37:54–59PubMedCrossRefGoogle Scholar
  6. 6.
    Lynch DA, Brasch RC, Hardy KA, Webb WR (1990) Pediatric pulmonary disease: assessment with high-resolution ultrafast CT. Radiology 176:243–248PubMedGoogle Scholar
  7. 7.
    Mayo JR, Aldrich J, Muller NL (2003) Radiation exposure at chest CT: a statement of the Fleischner Society. Radiology 228:15–21PubMedGoogle Scholar
  8. 8.
    Kalra MK, Maher MM, Toth TL, Hamberg LM, Blake MA, Shepard JA, Saini S (2004) Strategies for CT radiation dose optimization. Radiology 230:619–628PubMedGoogle Scholar
  9. 9.
    de Jong PA, Mayo JR, Golmohammadi K, Nakano Y, Lequin MH, Tiddens HA, Aldrich J, Coxson HO, Sin DD (2006) Estimation of cancer mortality associated with repetitive computed tomography scanning. Am J Respir Crit Care Med 173:199–203PubMedCrossRefGoogle Scholar
  10. 10.
    Donnelly LF, Gelfand MJ, Brody AS, Wilmott RW (1997) Comparison between morphologic changes seen on high-resolution CT and regional pulmonary perfusion seen on SPECT in patients with cystic fibrosis. Pediatr Radiol 27:920–925PubMedCrossRefGoogle Scholar
  11. 11.
    Kotloff RM, Zuckerman JB (1996) Lung transplantation for cystic fibrosis: special considerations. Chest 109:787–798PubMedGoogle Scholar
  12. 12.
    Vizza CD, Yusen RD, Lynch JP, Fedele F, Alexander Patterson G, Trulock EP (2000) Outcome of patients with cystic fibrosis awaiting lung transplantation. Am J Respir Crit Care Med 162:819–825PubMedGoogle Scholar
  13. 13.
    Marom EM, McAdams HP, Palmer SM, Erasmus JJ, Sporn TA, Tapson VF, Davis RD, Goodman PC (1999) Cystic fibrosis: usefulness of thoracic CT in the examination of patients before lung transplantation. Radiology 213:283–288PubMedGoogle Scholar
  14. 14.
    Altes TA, Powers PL, Knight-Scott J, Rakes G, Platts-Mills TA, de Lange EE, Alford BA, Mugler JP, 3rd, Brookeman JR (2001) Hyperpolarized 3He MR lung ventilation imaging in asthmatics: preliminary findings. J Magn Reson Imaging 13:378–384PubMedCrossRefGoogle Scholar
  15. 15.
    Donnelly LF, MacFall JR, McAdams HP, Majure JM, Smith J, Frush DP, Bogonad P, Charles HC, Ravin CE (1999) Cystic fibrosis: combined hyperpolarized 3He-enhanced and conventional proton MR imaging in the lung–preliminary observations. Radiology 212:885–889PubMedGoogle Scholar
  16. 16.
    Stavngaard T, Sogaard LV, Mortensen J, Hanson LG, Schmiedeskamp J, Berthelsen AK, Dirksen A (2005) Hyperpolarized 3He MRI and 81mKr SPECT in chronic obstructive pulmonary disease. Eur J Nucl Med Mol Imaging 32:448–457PubMedCrossRefGoogle Scholar
  17. 17.
    Gast KK, Zaporozhan J, Ley S, Biedermann A, Knitz F, Eberle B, Schmiedeskamp J, Heussel CP, Mayer E, Schreiber WG, Thelen M, Kauczor HU (2004) (3)He-MRI in follow-up of lung transplant recipients. Eur Radiol 14:78–85PubMedCrossRefGoogle Scholar
  18. 18.
    Wild JM, Paley MN, Kasuboski L, Swift A, Fichele S, Woodhouse N, Griffiths PD, van Beek EJ (2003) Dynamic radial projection MRI of inhaled hyperpolarized 3He gas. Magn Reson Med 49:991–997PubMedCrossRefGoogle Scholar
  19. 19.
    Deninger AJ, Eberle B, Ebert M, Grossmann T, Heil W, Kauczor H, Lauer L, Markstaller K, Otten E, Schmiedeskamp J, Schreiber W, Surkau R, Thelen M, Weiler N (1999) Quantification of regional intrapulmonary oxygen partial pressure evolution during apnea by (3)He MRI. J Magn Reson 141:207–216PubMedCrossRefADSGoogle Scholar
  20. 20.
    Koumellis P, van Beek EJ, Woodhouse N, Fichele S, Swift AJ, Paley MN, Hill C, Taylor CJ, Wild JM (2005) Quantitative analysis of regional airways obstruction using dynamic hyperpolarized 3He MRI-preliminary results in children with cystic fibrosis. J Magn Reson Imaging 22:420–426PubMedCrossRefGoogle Scholar
  21. 21.
    Mentore K, Froh DK, de Lange EE, Brookeman JR, Paget-Brown AO, Altes TA (2005) Hyperpolarized HHe 3 MRI of the lung in cystic fibrosis: assessment at baseline and after bronchodilator and airway clearance treatment. Acad Radiol 12:1423–1429PubMedCrossRefGoogle Scholar
  22. 22.
    Wild JM, Woodhouse N, Paley MN, Fichele S, Said Z, Kasuboski L, van Beek EJ (2004) Comparison between 2D and 3D gradient-echo sequences for MRI of human lung ventilation with hyperpolarized 3He. Magn Reson Med 52:673–678PubMedCrossRefGoogle Scholar
  23. 23.
    Nathanson I, Conboy K, Murphy S, Afshani E, Kuhn JP (1991) Ultrafast computerized tomography of the chest in cystic fibrosis: a new scoring system. Pediatr Pulmonol 11:81–86PubMedGoogle Scholar
  24. 24.
    Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J (2005) Standardisation of spirometry. Eur Respir J 26:319–338PubMedCrossRefGoogle Scholar
  25. 25.
    de Jong PA, Ottink MD, Robben SG, Lequin MH, Hop WC, Hendriks JJ, Pare PD, Tiddens HA (2004) Pulmonary disease assessment in cystic fibrosis: comparison of CT scoring systems and value of bronchial and arterial dimension measurements. Radiology 231:434–439PubMedGoogle Scholar
  26. 26.
    Kauczor HU, Hanke A, Van Beek EJ (2002) Assessment of lung ventilation by MR imaging: current status and future perspectives. Eur Radiol 12:1962–1970PubMedGoogle Scholar
  27. 27.
    Helbich TH, Heinz-Peer G, Eichler I, Wunderbaldinger P, Gotz M, Wojnarowski C, Brasch RC, Herold CJ (1999) Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology 213:537–544PubMedGoogle Scholar
  28. 28.
    Kang EY, Miller RR, Muller NL (1995) Bronchiectasis: comparison of preoperative thin-section CT and pathologic findings in resected specimens. Radiology 195:649–654PubMedGoogle Scholar
  29. 29.
    Oikonomou A, Manavis J, Karagianni P, Tsanakas J, Wells AU, Hansell DM, Papadopoulou F, Efremidis SC (2002) Loss of FEV1 in cystic fibrosis: correlation with HRCT features. Eur Radiol 12:2229–2235PubMedCrossRefGoogle Scholar
  30. 30.
    Jaffe A, Hamutcu R, Dhawan RT, Adler B, Rosenthal M, Bush A (2001) Routine ventilation scans in children with cystic fibrosis: diagnostic usefulness and prognostic value. Eur J Nucl Med 28:1313–1318PubMedCrossRefGoogle Scholar
  31. 31.
    Santamaria F, Grillo G, Guidi G, Rotondo A, Raia V, de Ritis G, Sarnelli P, Caterino M, Greco L (1998) Cystic fibrosis: when should high-resolution computed tomography of the chest Be obtained? Pediatrics 101:908–913PubMedCrossRefGoogle Scholar
  32. 32.
    Gast KK, Viallon M, Eberle B, Lill J, Puderbach MU, Hanke AT, Schmiedeskamp J, Kauczor HU (2002) MRI in lung transplant recipients using hyperpolarized 3He: comparison with CT. J Magn Reson Imaging 15:268–274PubMedCrossRefGoogle Scholar
  33. 33.
    van Beek EJ, Schmiedeskamp J, Wild JM, Paley MN, Filbir F, Fichele S, Knitz F, Mills GH, Woodhouse N, Swift A, Heil W, Wolf M, Otten E (2003) Hyperpolarized 3-helium MR imaging of the lungs: testing the concept of a central production facility. Eur Radiol 13:2583–2586PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Colm J. McMahon
    • 1
  • Jonathan D. Dodd
    • 1
  • Catherine Hill
    • 3
  • Neil Woodhouse
    • 3
  • Jim M. Wild
    • 3
  • Stan Fichele
    • 3
  • Charles G. Gallagher
    • 2
  • Stephen J. Skehan
    • 1
  • Edwin J. R. van Beek
    • 3
    • 4
  • James B. Masterson
    • 1
  1. 1.Department of RadiologySt. Vincent’s University HospitalDublin 4Ireland
  2. 2.Department of National Referral Centre for Adult Cystic FibrosisSt. Vincent’s University HospitalDublin 4Ireland
  3. 3.The Unit of Academic Radiology, University of SheffieldRoyal Hallamshire HospitalSheffieldUK
  4. 4.Department of Radiology, Carver College of MedicineUniversity of IowaIowa CityUSA

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