Hyperpolarized 129Xe MR Spectroscopy in the Lung Shows 1-year Reduced Function in Idiopathic Pulmonary Fibrosis
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Background Idiopathic pulmonary fibrosis (IPF) is a temporally and spatially heterogeneous lung disease. Identifying whether IPF in a patient is progressive or stable is crucial for treatment regimens. Purpose To assess the role of hyperpolarized (HP) xenon 129 (129Xe) MRI measures of ventilation and gas transfer in IPF generally and as an early signature of future IPF progression. Materials and Methods In a prospective study, healthy volunteers and participants with IPF were consecutively recruited between December 2015 and August 2019 and underwent baseline HP 129Xe MRI and chest CT. Participants with IPF were followed up with forced vital capacity percent predicted (FVC%p), diffusing capacity of the lungs for carbon monoxide percent predicted (DLco%p), and clinical outcome at 1 year. IPF progression was defined as reduction in FVC%p by at least 10%, reduction in DLco%p by at least 15%, or admission to hospice care. CT and MRI were spatially coregistered and a measure of pulmonary gas transfer (red blood cell [RBC]-to-barrier ratio) and high-ventilation percentage of lung volume were compared across groups and across fibrotic versus normal-appearing regions at CT by using Wilcoxon signed rank tests. Results Sixteen healthy volunteers (mean age, 57 years ± 14 [SD]; 10 women) and 22 participants with IPF (mean age, 71 years ± 9; 15 men) were evaluated, as follows: nine IPF progressors (mean age, 72 years ± 7; five women) and 13 nonprogressors (mean age, 70 years ± 10; 11 men). Reduction of high-ventilation percent (13% ± 6.1 vs 8.2% ± 5.9; P = .03) and RBC-to-barrier ratio (0.26 ± 0.06 vs 0.20 ± 0.06; P = .03) at baseline were associated with progression of IPF. Participants with progressive disease had reduced RBC-to-barrier ratio in structurally normal-appearing lung at CT (0.21 ± 0.07 vs 0.28 ± 0.05; P = .01) but not in fibrotic regions of the lung (0.15 ± 0.09 vs 0.14 ± 0.04; P = .62) relative to the nonprogressive group. Conclusion In this preliminary study, functional measures of gas transfer and ventilation measured with xenon 129 MRI and the extent of fibrotic structure at CT were associated with idiopathic pulmonary fibrosis disease progression. Differences in gas transfer were found in regions of nonfibrotic lung. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gleeson and Fraser in this issue.
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A recent preliminary study showed that HP 129Xe-MRI could evaluate functional measures of gas transfer and ventilation to accurately identify patients with progressive PF, and could identify differences in gas transfer in regions of non-fibrotic lung in patients with progressive fibrosis compared with those with stable fibrosis.
“A recent preliminary study showed that HP 129 Xe-MRI could evaluate functional measures of gas transfer and ventilation to accurately identify patients with progressive PF. This novel imaging approach was also able to identify differences in gas transfer in regions of nonfibrotic lung in patients with progressive fibrosis compared with those with stable fibrosis (Hahn et al., 2022).”
From Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies (2023) · cites this paper as Hahn et al., 2022
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Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies
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- Authors
- Hahn, A. D., Carey, K. J., Barton, G. P., Torres, L. A., Kammerman, J., Cadman, R. V., Lee, K. E., Schiebler, M. L., Sandbo, N., & Fain, S. B.
- Affiliations
- University of Iowa (US)
- ORCID
- Venue
- Radiology
- Published
- 2022-12
- Volume
- 305
- Issue
- 3
- Pages
- 688-696
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- PMC
- PMC9713448
- OpenAlex
- W4288010166
- Cited by
- 33
- References
- 35
- Citations by year
- 2026: 12 · 2025: 8 · 2024: 5 · 2023: 8
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Radiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health/Office of Research Infrastructure Programs (S10 OD016394)
- National Institutes of Health/National Heart, Lung, and Blood Institute (R01HL126771, R01HL146689)
- 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 › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- idiopathic pulmonary fibrosis, hyperpolarized 129Xe MRI, pulmonary ventilation, pulmonary gas transfer, disease progression, forced vital capacity, diffusing capacity for carbon monoxide, pulmonary fibrosis, lung heterogeneity, lung perfusion imaging
- MeSH terms
- Aged, Female, Humans, Lung, Male, Middle Aged, Magnetic Resonance Spectroscopy, Prospective Studies, Respiratory Function Tests, Idiopathic Pulmonary Fibrosis
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