preparation of mri scanner room and subject positioning for 129xe mri of lung ventilation

폐 기능을 연구하기 위한 과분극 129Xe MRI를 위한 표준화된 워크플로우

Hyperpolarized 129Xe MRI is an exciting tool for non-invasive, spatially-resolved characterization and quantification of specific aspects of pulmonary function1,2,3. Acquisition and reconstruction approaches similar to those used in anatomical proton MRI yield images of inhaled 129Xe in the lungs, permitting visualization of non-ventilated lung regions and region-resolved quantification of ventilation distribution4,5,6,7,8. More advanced pulse sequence and analysis techniques yield further complementary information, including quantification of gas-exchange efficacy between alveoli and pulmonary capillaries via spectroscopic MRI9,10,11,12,13 and characterization of alveolar microstructure integrity via diffusion-weighted MRI14,15,16.
Inhaled 129Xe has been proven safe and tolerable in adult and pediatric subjects, including those with pulmonary disease17,18. Measurements of lung function derived from 129Xe MRI have shown sensitivity to structural and functional alterations in many pulmonary disease contexts, including chronic obstructive pulmonary disease6,10,19, cystic fibrosis20,21,22, idiopathic pulmonary fibrosis23,24,25, and asthma7,10,26. Given the high safety and tolerability of 129Xe MRI, the lack of ionizing radiation in MRI compared with other common imaging approaches, and the high reproducibility of 129Xe MRI results27,28, 129Xe MRI holds significant promise, in particular for precise serial monitoring of individuals receiving a time course of therapy for chronic pulmonary disease.
The safety and clinical promise of 129Xe MRI have led to its FDA approval in December 2022 for lung ventilation imaging in persons aged 12 years and older29. Given this, it is anticipated that the number of research and clinical sites capable of performing 129Xe MRI (currently ~20 worldwide) will increase significantly over the coming years. As 129Xe MRI spreads to new institutions, it is important that robust methodological resources exist to allow sites to build out clinically relevant 129Xe MRI techniques quickly and to perform scans and generate results that are closely comparable with those of existing sites.
In this work, we will outline the current best practices for human hyperpolarized 129Xe MRI of lung ventilation, as agreed upon by member institutions of the 129Xe MRI Clinical Trials Consortium (Xe MRI CTC) and summarized in a recent position paper30. Topics will include the preparation of tailored pulse sequences ideal for a complete 129Xe MRI workflow, preparation, and administration of hyperpolarized 129Xe gas, an optimized workflow for human 129Xe MRI sessions, and best practices for monitoring subject safety and comfort during MRI sessions.

저자 스포트라이트: 129Xe MRI를 사용한 폐 영상 발전을 위한 표준화 및 모범 사례

폐 환기의 과분극 129Xe 자기 공명 이미지 획득

Our research seeks to establish Xenon MRI as a clinical tool for characterizing lung function. Xenon MRI allows us to directly visualize ventilation defects in patients with obstructive lung diseases like COPD, asthma, and cystic fibrosis. It offers information that can't be obtained from standard MRI and pulmonary function test.Xenon MRI was recently approved by the FDA for clinical evaluation of lung ventilation. This represents a culmination of a huge amount of effort by the people in our field and it's an exciting opportunity to show how Xenon MRI can improve patient care and outcomes in pulmonary disease. Xenon MRI is still a relatively new family of techniques, and standardization is still an ongoing process.This protocol distills the existing standards for Xenon ventilation MRI into a form that we hope will be useful to research in clinical sites who are trying to perform these scans for the first time. Common clinical readouts of lung function, like pulmonary function tests, only give a single number for the entire lung with no spatial information included. Xenon MRI can make regional assessments of several aspects of lung health and function, which we believe will be very useful in the clinic.Only a few institutions are currently performing Xenon MRI, but we expect there will be many more sites soon considering the recent FDA approval. We hope that this Xenon ventilation MRI protocol will serve as a blueprint for new sites and help em to ramp up their Xenon MRI operations more quickly.

폐 환기의 129Xe MRI를 위한 MRI 스캐너 룸 및 피험자 위치 지정 준비

시작하려면 MRI 스캐너실에 들어가는 모든 사람이 몸이나 주머니에서 모든 금속 및 전자 물체를 제거했는지 확인하십시오. Xenon 129 조끼 코일을 스캐너에 연결하고 MRI 스캐너 환자 테이블에 놓아 준비합니다. 피험자에게 스캐너실의 배치에 따라 발을 먼저 눕히거나 머리를 먼저 누운 자세로 환자 테이블에 눕도록 지시합니다.시술 중 편안함을 보장하기 위해 필요에 따라 피험자의 머리, 무릎 등 아래에 베개를 놓습니다. 제논 129 조끼 코일을 피험자의 가슴에 고정하고, 피험자가 편안한 팽창 수준에 있을 때 코일 정중선을 머리-발 방향으로 피험자 폐의 예상 정중선에 최대한 가깝게 유지한다. 코일을 피사체에 낮게 놓으면 폐 주변에서 바람직하지 않은 신호 감소가 발생할 수 있습니다.MRI 스캐너실의 환자 테이블 옆에 MRI 안전 맥박 산소 측정기를 설치하고 맥박 산소 측정기 프로브를 피험자에게 연결합니다. 맥박 산소 측정기가 올바르게 판독되고 있는지 확인하십시오. 비강 캐뉼라를 피험자의 코에 넣고 필요한 경우 용량 흡입 후 사용할 산소 공급원에 연결합니다.산소 탱크와 조절기를 도달 가능한 거리 내에 있는 현지 안전 정책에 따라 MRI 안전한 방식으로 배치하십시오. 환자 테이블을 MRI 스캐너로 전진시켜 코일의 정중선 또는 피험자의 폐를 스캐너의 등중심에 맞춥니다. 여기에 표시된 이미지는 케이블이 손상된 Xenon 129 조끼 코일을 사용하여 무의식적으로 수행된 연구의 환기 이미지를 나타냅니다.오른쪽 폐는 왼쪽 폐보다 신호 대 잡음비가 낮습니다. Xenon 129 조끼 코일을 피험자의 발 쪽으로 너무 멀리 배치하여 수행한 연구의 환기 이미지가 여기에 나와 있습니다. 인위적으로 낮은 크세논 129 신호는 수신기 감도의 부족으로 인해 양쪽 폐 정점에서 관찰됩니다.

Research

JoVE Journal

Medicine

Preparation of MRI Scanner Room and Subject Positioning for 129Xe MRI of Lung Ventilation

Acquiring Hyperpolarized 129Xe Magnetic Resonance Images of Lung Ventilation

Hyperpolarized 129Xe MRI comprises a unique array of structural and functional lung imaging techniques. Technique standardization across sites is ...

연구

의학

Pre-Scan Preparation and Coaching of Subject for 129Xe MRI of Lung Ventilation

폐 환기의 129Xe MRI를 위한 피험자의 사전 스캔 준비 및 코칭

Performing 129Xe MRI Scan of Lung Ventilation to Assess Pulmonary Function

폐 기능을 평가하기 위해 폐 환기의 129Xe MRI 스캔 수행