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Nichtinvasive funktionelle Lungenbildgebung mit hyperpolarisiertem Xenon

Durchbruch für die Diagnostik?

Noninvasive functional lung imaging with hyperpolarized xenon

Breakthrough for diagnostics?

  • Leitthema
  • Published:
Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

Hintergrund

Die Magnetresonanztomographie (MRT) ist ein nichtinvasives Verfahren mit hervorragendem Weichteilkontrast. Aufgrund der geringen Protonendichte und vielen Luft-Gewebe-Übergängen ist die Anwendung in der Lunge jedoch eingeschränkt, so dass hier häufig röntgenbasierte Methoden eingesetzt werden (mit den bekannten Nachteilen ionisierender Strahlung).

Fragestellung

In dieser Übersichtsarbeit wird die Lungen-MRT mit hyperpolarisiertem Xenon-129 (Xe-MRT) dargestellt. Die Xe-MRT erlaubt einzigartige wertvolle Einblicke in die Mikrostruktur und Funktion der Lunge, einschließlich des Gasaustauschs mit roten Blutkörperchen – Parameter, die mit klinischen Standardmethoden nicht zugänglich sind.

Material und Methoden

Durch die magnetische Markierung, die Hyperpolarisierung, wird das Signal von Xenon-129 um bis zu 100.000-fach verstärkt. Hierbei werden die Elektronen von Rubidium mittels Laserlicht zunächst auf 100 % polarisiert und dann durch Stöße auf Xenon übertragen. Danach wird das hyperpolarisierte Gas in einem Beutel zum Patienten gebracht und eingeatmet, kurz bevor die MRT-Aufnahmen beginnen.

Ergebnisse

Durch spezielle Programmierungen (Sequenzen) in der MRT kann die Ventilation, Mikrostruktur oder der Gasaustausch der Lunge in 3‑D dargestellt werden. Dies ermöglicht z. B. die quantitative Darstellung von Belüftungsdefekten, der Größe der Alveolen, der Gasaufnahme im Gewebe und des Gastransfers ins Blut.

Schlussfolgerung

Die Xe-MRT liefert einzigartige Informationen über den Zustand der Lunge – nichtinvasiv, in vivo und in weniger als einer Minute.

Abstract

Background

Magnetic resonance imaging (MRI) is a noninvasive technique that provides excellent contrast for soft tissue organs. However, due to the low density of protons and many air–tissue junctions, its application in the lung is limited. Thus, X‑ray-based methods are often used here (with the well-known disadvantages of ionizing radiation).

Objectives

In this review, we discuss pulmonary MRI with hyperpolarized xenon-129 (Xe-MRI). Xe-MRI provides unique valuable insights into lung microstructure and function, including gas exchange with red blood cells—parameters not accessible by any standard clinical methods.

Methods

By magnetic labelling, i.e. hyperpolarization, the signal from xenon-129 is amplified by up to 100,000 times. In this process, electrons from rubidium are first polarized to 100% using laser light and then transferred to xenon by collisions. Then the hyperpolarized gas is brought to the patient in a bag and inhaled shortly before the MRI scan.

Results

Using special programming (sequences) of the MRI, the ventilation, microstructure, or gas exchange of the lungs, can be displayed in 3D. This allows, for example, quantitative visualization of ventilation defects, alveolar size, tissue gas uptake and gas transfer to the blood.

Conclusions

Xe-MRI provides unique information about the state of the lung—noninvasively, in vivo and in less than a minute.

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Danksagung

Diese Arbeit wird durch den Sonderforschungsbereich/Transregio 287 BULK-REACTION, das Graduiertenkolleg „Materialien für das Gehirn“ (GRK 2154/1-2019), das Bundesministerium für Bildung und Forschung (BMBF) im Rahmen des Förderkonzepts (01ZX1915C), das Emmy Noether-Programm „Metabolische und molekulare MR“ (HO 4604/2-2) unterstützt. MOIN CC wurde mit Hilfe eines Zuschusses des Europäischen Fonds für regionale Entwicklung (EFRE) und des Zukunftsprogramms Wirtschaft des Landes Schleswig-Holstein (Projekt Nr. 122-09-053) gegründet.

M. Anikeeva dankt E. Peschke, F. Ellermann, P. Saul, K. Them, J. Kuhn für die Hilfe beim Erstellen des Manuskriptes.

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Authors and Affiliations

  1. Sektion Biomedizinische Bildgebung, Molecular Imaging North Competence Center (MOIN CC), Klinik für Radiologie und Neuroradiologie, Universtätsklinikum Schleswig-Holstein, Christian-Albrechts-Universität zu Kiel, Am Botanischen Garten 14, 24118, Kiel, Deutschland

    Mariia Anikeeva, Josh Peters &  Jan-Bernd Hövener

  2. Klinik für Radiologie und Neuroradiologie, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland

    Mariia Anikeeva, Maaz Zuhayra, Ulf Lützen, Josh Peters, Olav Jansen &  Jan-Bernd Hövener

  3. Abteilung Biomedizinische Magnetresonanz, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland

    Maitreyi Sangal & Oliver Speck

  4. POLARIS, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, Großbritannien

    Graham Norquay

Authors
  1. Mariia Anikeeva
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  2. Maitreyi Sangal
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  3. Oliver Speck
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  4. Graham Norquay
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  5. Maaz Zuhayra
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  6. Ulf Lützen
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  7. Josh Peters
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  9. Jan-Bernd Hövener
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Corresponding authors

Correspondence to Mariia Anikeeva or Jan-Bernd Hövener.

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Interessenkonflikt

G. Norquay ein Co-Autor dieses Beitrags, ist derzeit bei POLARIS (Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK) beschäftigt. M. Anikeeva, M. Sangal, O. Speck, M. Zuhayra, U. Lützen, J. Peters, O. Jansen und J.-B. Hövener geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Erstveröffentlichung in Radiologe (2022)62: 130–139. https://doi.org/10.1007/s00117-021-00955-8

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Anikeeva, M., Sangal, M., Speck, O. et al. Nichtinvasive funktionelle Lungenbildgebung mit hyperpolarisiertem Xenon. Z Pneumologie 21, 38–48 (2024). https://doi.org/10.1007/s10405-024-00544-1

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