patient preparation and subject training for hyperpolarized xenon mri

過分極キセノン-129 MRIによる肺機能の評価

Hyperpolarized Xenon-129 (HXe) magnetic resonance imaging (MRI)1 is a technique that offers unique insights into lung structure, function, and gas exchange processes. By dramatically amplifying the magnetization of Xenon gas through spin-exchange optical pumping, HXe MRI achieves an order-of-magnitude improvement in signal-to-noise ratio compared to thermally polarized Xenon MRI2,3,4,5,6. This hyperpolarization enables the direct visualization and quantification of Xenon gas uptake into lung tissue and blood, which would otherwise be undetectable with conventional thermally polarized MRI7.
Chemical shift saturation recovery (CSSR) MR spectroscopy8,9,10,11,12,13 has proven to be one of the most valuable HXe MRI techniques. CSSR involves selectively saturating the magnetization of Xenon dissolved in lung tissue and blood using frequency-specific radiofrequency (RF) pulses. The subsequent recovery of the dissolved-phase (DP) signal as it exchanges with fresh hyperpolarized Xenon gas in the airspaces on a timescale of ms offers important functional information about the lung parenchyma.
Since its development in the early 2000s, the techniques behind CSSR spectroscopy have been progressively refined14,15,16,17,18,19,20,21,22,23. Further, advances in modeling Xenon uptake curves have enabled the extraction of specific physiological parameters, such as alveolar wall thickness and pulmonary transit times10,24,25,26. Studies have shown CSSR&#39;s sensitivity to subtle changes in lung microstructure and gas exchange efficiency in the form of pulmonary abnormalities found in clinically healthy smokers27, as well as in a range of lung diseases, including chronic obstructive pulmonary disease (COPD)18,27,28, fibrosis29, and radiation-induced lung injury30,31. CSSR spectroscopy has also been demonstrated to be sensitive to detect oscillations in the DP signal corresponding to pulsatile blood flow during the cardiac cycle32.
While significant progress has been made, practical challenges remain in implementing CSSR spectroscopy on clinical MRI systems. Scan times requiring single-dose breath holds approaching 10 s may be too long for pediatric subjects33,34 or patients with severe lung disease35,36. Additionally, the technique is susceptible to measurement biases if acquisition parameters such as the order of the saturation delay times or the efficacy of the dissolved-phase saturation are not properly optimized21. To address these limitations and make CSSR more accessible to the broader research community, clear, step-by-step protocols for both conventional breath hold and free-breathing acquisitions, currently under development, are needed.
The objective of this paper is to present a detailed methodology for performing optimized CSSR MR spectroscopy using HXe gas. The protocol will cover polarization and delivery of the Xenon gas, RF pulse calibration, sequence parameter selection, subject preparation, data acquisition, and key steps in data analysis. Examples of experimental results will be provided. It is hoped that this comprehensive guide will serve as a foundation for CSSR implementations across sites and help realize the full potential of this technique for quantifying lung microstructural changes in a range of pulmonary diseases.

著者スポットライト:自由呼吸過分極Xenon-129 MRIによる肺疾患研究の進歩

過分極キセノン分光法による肺の構造と機能の定量的測定

Our research focuses on using hyperpolarizing on 129 MRI technology to assess pulmonary function and to investigate lung diseases. The main objective is to see how this imaging technique can lead to better detection, understanding, and tracking of different lung conditions. Most hyperpolarized lung MR imaging is performed during a breath hold.We believe that pulmonary function quantified under such an artificial condition, may not fully reflect gas exchange during regular respiration, and we are testing new free breathing measurements that do not require any breath hold. Current challenges include the optimization of the CSSR acquisition technique for consistency and accuracy in the face of physiological variation and patient compliance. Severely ill or pediatric patients struggle with maintaining lengthy breath holds.The CSSR heart technique appears particularly sensitive to changes in alveolar septal wall thickness. As we and others in the field of demonstrated, alveolar wall thickening can indicate the presence of interstitial edema, inflammation, or pulmonary fibrosis. All metrics derived from CSSR spectroscopy acquisitions are currently based on the temporal dynamics of the signal amplitudes.In the future though, we hope to include changes in peak shape and center frequency in the analysis to obtain a more complete picture of the ongoing gas exchange processes.

過分極キセノンMRIのための患者準備と被験者トレーニング

まず、イメージング中の呼吸曲線とリアルタイムのガス分析を記録するための生理学的モニタリングシステムを設定します。MRIルームのヘッドフォンを、吸い込みと呼気の音声録音を使用して被験者をガイドするオーディオ信号に接続してテストします。オーディオトラックの再生速度を調整します。息を吸う。各被験者の通常の呼吸数に基づいています。次に、スキャナーベッドに清潔なヘッドレスト、レッグサポートピロー、ブランケットを用意します。緩めたXenon 129チェストベストコイルをMRIスキャナーのテーブルに置き、コイルのコネクタプラグを挿入します。自由呼吸の研究では、イメージング中に同期呼吸を行うための吸気と呼気の音声録音を被験者に紹介します。被験者をMRI室に導き、スキャナーベッドの上に置き、開いたキセノンベストコイルの上に横たわります。被験者が配置されたら、ベストコイルが閉じられるようにベルクロストラップを固定しますが、被験者の胸を収縮させないようにします。自由呼吸法では、患者の顔にニューマタックを塗布したフェイスマスクを装着します。ストラップを締めて、マスクがきつすぎず鼻と口にぴったりとフィットするようにします。装着後、マスクを取り外して後で使用するために脇に置いて、ストラップを被験者の頭の後ろに残します。次に、2つのパルスオキシメータを両人差し指に装着して、研究中の心拍数と血中酸素飽和度を継続的に監視します。MRI対応ヘッドホンを被験者の耳に当てます。MRIスキャナーテーブルをマグネットボアに移動し、被験者の肺が視野の中央に配置されるようにします。

Research

JoVE Journal

Medicine

Patient Preparation and Subject Training for Hyperpolarized Xenon MRI

Quantitative Measure of Lung Structure and Function Obtained from Hyperpolarized Xenon Spectroscopy

Hyperpolarized Xenon-129 (HXe) magnetic resonance imaging (MRI) provides tools for obtaining 2- or 3-dimensional maps of lung ventilation patterns, gas ...

医学

Polarizing Xenon-129 for Hyperpolarized Xenon Spectroscopy

超分極キセノン分光のための偏光キセノン-129

Performing Hyperpolarized Xenon-129 Inhalation for Chemical Shift Saturation Recovery (CSSR) Measurement

化学シフト飽和回復(CSSR)測定のための過分極キセノン-129吸入の実施