Imaging biomarkers of lung ventilation in interstitial lung disease from 129Xe and oxygen enhanced 1H MRI
Open accessAbstract
To compare imaging biomarkers from hyperpolarised 129Xe ventilation MRI and dynamic oxygen-enhanced MRI (OE-MRI) with standard pulmonary function tests (PFT) in interstitial lung disease (ILD) patients. To evaluate if biomarkers can separate ILD subtypes and detect early signs of disease resolution or progression. Prospective longitudinal. Forty-one ILD (fourteen idiopathic pulmonary fibrosis (IPF), eleven hypersensitivity pneumonitis (HP), eleven drug-induced ILD (DI-ILD), five connective tissue disease related-ILD (CTD-ILD)) patients and ten healthy volunteers imaged at visit 1. Thirty-four ILD patients completed visit 2 (eleven IPF, eight HP, ten DIILD, five CTD-ILD) after 6 or 26 weeks. MRI was performed at 1.5 T, including inversion recovery T1 mapping, dynamic MRI acquisition with varying oxygen levels, and hyperpolarised 129Xe ventilation MRI. Subjects underwent standard spirometry and gas transfer testing. Five 1H MRI and two 129Xe MRI ventilation metrics were compared with spirometry and gas transfer measurements. To evaluate differences at visit 1 among subgroups: ANOVA or Kruskal-Wallis rank tests with correction for multiple comparisons. To assess the relationships between imaging biomarkers, PFT, age and gender, at visit 1 and for the change between visit 1 and 2: Pearson correlations and multilinear regression models. The global PFT tests could not distinguish ILD subtypes. Percentage ventilated volumes were lower in ILD patients than in HVs when measured with 129Xe MRI (HV 97.4 ± 2.6, CTD-ILD: 91.0 ± 4.8 p = 0.017, DI-ILD 90.1 ± 7.4 p = 0.003, HP 92.6 ± 4.0 p = 0.013, IPF 88.1 ± 6.5 p < 0.001), but not with OE-MRI. 129Xe reported more heterogeneous ventilation in DI-ILD and IPF than in HV, and OE-MRI reported more heterogeneous ventilation in DI-ILD and IPF than in HP or CTD-ILD. The longitudinal changes reported by the imaging biomarkers did not correlate with the PFT changes between visits. Neither 129Xe ventilation nor OE-MRI biomarkers investigated in this study were able to differentiate between ILD subtypes, suggesting that ventilation-only biomarkers are not indicated for this task. Limited but progressive loss of ventilated volume as measured by 129Xe-MRI may be present as the biomarker of focal disease progresses. OE-MRI biomarkers are feasible in ILD patients and do not correlate strongly with PFT. Both OE-MRI and 129Xe MRI revealed more spatially heterogeneous ventilation in DI-ILD and IPF.
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In another study, ventilation or oxygen enhanced-MRI biomarkers were not able to discriminate between different types of interstitial lung disease.
“However, in another study, ventilation or oxygen enhanced-MRI biomarkers were not able to discriminate between the different types of interstitial lung disease (ILD) (Tibiletti et al., 2023).”
From Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies (2023) · cites this paper as Tibiletti et al., 2023
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- Authors
- Tibiletti, M., Eaden, J. A., Naish, J. H., Hughes, P. J. C., Waterton, J. C., Heaton, M. J., Chaudhuri, N., Skeoch, S., Bruce, I. N., Bianchi, S., Wild, J. M., & Parker, G. J. M.
- Affiliations
- University of Sheffield (GB)
- Manchester University NHS Foundation Trust (GB)
- University of Manchester (GB)
- Manchester Academic Health Science Centre (GB)
- Royal National Hospital for Rheumatic Diseases (GB)
- Sheffield Teaching Hospitals NHS Foundation Trust (GB)
- Insigneo (GB)
- University College London (GB)
- Corresponding author
- Parker, Geoff J.M.
- ORCID
- Venue
- Magnetic Resonance Imaging
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 95
- Pages
- 39-49
- ISSN
- 0730-725X (ISSN-L)
- OpenAlex
- W4306319281
- Cited by
- 13
- References
- 47
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 1 · 2023: 4
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Magnetic Resonance Imaging (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- Ulster University Research Portal (Ulster University) (submittedVersion, cc-by)
- Funders
- Innovative Medicines Initiative (116106)
- NIH
- GlaxoSmithKline (BIDS3000032592)
- Medical Research Council (MR/M008894/1)
- National Institute for Health and Care Research
- Department of Health and Social Care
- European Federation of Pharmaceutical Industries and Associations
- European Commission
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Physical Sciences › Physics and Astronomy › Atomic and Molecular Physics, and Optics › Atomic and Subatomic Physics Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- interstitial lung disease, pulmonary ventilation, imaging biomarkers, oxygen-enhanced MRI, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, drug-induced interstitial lung disease, connective tissue disease-associated interstitial lung disease, pulmonary function tests, gas transfer, ventilation heterogeneity, disease progression, disease resolution, ILD subtypes
- MeSH terms
- Humans, Lung, Magnetic Resonance Imaging, Oxygen, Prospective Studies, Biomarkers, Lung Diseases, Interstitial, Idiopathic Pulmonary Fibrosis
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