ID: 63: RAPID 3D PRECLINICAL QUANTITATIVE LUNG IMAGING WITH ULTRASHORT-ECHO TIME (UTE) MRI IN A MOUSE MODEL OF CYSTIC FIBROSIS LUNG DISEASE

2016 ◽  
Vol 64 (4) ◽  
pp. 975.1-975
Author(s):  
C Anderson ◽  
C Flask

Currently, the life expectancy for cystic fibrosis (CF) lung disease is less than 40 years due to decreasing lung function despite significant advances in the care and treatment of these patients. As patients live longer, the preservation of healthy lung tissue becomes of paramount importance to improve patient quality of life and increase life span. To do this, an understanding of the early disease processes is needed as is an ability to monitor the efficacy of therapeutic interventions early in life. CF lung disease, similar to other lung diseases, is a regional disease causing local dysfunction in the lung tissue and changes in lung anatomy. It is important for any monitoring or diagnostic tool to be sensitive to early regional disease which current methods (spirometry) are not. This lack of sensitivity to regional disease limits the ability of physicians and researchers to track the earliest stages of disease and assess treatment efficacy in these initial disease stages, ideally in infants and young children. Three dimensional imaging presents a unique solution to this problem by providing a non-invasive, volumetric investigation of the lung tissue. Computed tomography has long been the first choice in clinical lung imaging offering excellent resolution and fast imaging times but results in repeated exposure to ionizing radiation. Because the patient populations of interest are infants and children, avoidance of unnecessary, repeated radiation exposure during longitudinal monitoring is desirable. This combination of clinical and research need has led us to the exploration of rapid MRI techniques for lung imaging. We are interested in developing a novel, robust quantitative Magnetic Resonance Imaging technique that allows for 3D investigation of the lung tissue and is sensitive to early disease changes. Our hypothesis is that quantitative imaging will be able to detect changes in regional lung anatomy as an indication of early disease before disease is detected by standard methods. To accomplish this goal, we are proposing the implementation of multiple advanced quantitative MRI techniques including T1-mapping using Saturation-Recovery Look-Locker mapping and simultaneous multiple parameter mapping (combinations of T1, T2, T2*) using the recently developed Magnetic Resonance Fingerprinting method. An ultra-short echo time acquisition will be used to ensure imaging of the rapidly decaying MRI signal in the lung is possible. Using a radial acquisition, we plan to include an undersampled acquisition to reduce imaging time and generate an imaging method that is rapid and insensitive to patient motion. Our goal is to initially apply these quantitative measures in a mouse model of cystic fibrosis to establish the ability of the imaging methods to be sensitive to regional disease in CF mice. We expect to see changes in the quantitative parameters in areas that correspond to diseased areas of the lung upon histological investigation. These quantitative measurements should give unambiguous indications of disease and allow identification of changes in lung anatomy early in the disease process. This work will lay the foundation for translation of clinical CF monitoring in a pediatric population. Translational studies such as these will hopefully provide a measurement of disease progression and provide a new opportunity to evaluate early disease therapeutics offering insight into the earliest manifestations of CF lung disease.

2019 ◽  
Vol 26 (3) ◽  
pp. 344-354 ◽  
Author(s):  
Giles Santyr ◽  
Nikhil Kanhere ◽  
Felipe Morgado ◽  
Jonathan H. Rayment ◽  
Felix Ratjen ◽  
...  

2019 ◽  
Vol 53 (5) ◽  
pp. 1802188 ◽  
Author(s):  
Jonathan H. Rayment ◽  
Marcus J. Couch ◽  
Nancy McDonald ◽  
Nikhil Kanhere ◽  
David Manson ◽  
...  

Pulmonary magnetic resonance imaging using hyperpolarised 129Xe gas (XeMRI) can quantify ventilation inhomogeneity by measuring the percentage of unventilated lung volume (ventilation defect per cent (VDP)). While previous studies have demonstrated its sensitivity for detecting early cystic fibrosis (CF) lung disease, the utility of XeMRI to monitor response to therapy in CF is unknown. The aim of this study was to assess the ability of XeMRI to capture treatment response in paediatric CF patients undergoing inpatient antibiotic treatment for a pulmonary exacerbation.15 CF patients aged 8–18 years underwent XeMRI, spirometry, plethysmography and multiple-breath nitrogen washout at the beginning and end of inpatient treatment of a pulmonary exacerbation. VDP was calculated from XeMRI images obtained during a static breath hold using semi-automated k-means clustering and linear binning approaches.XeMRI was well tolerated. VDP, lung clearance index and the forced expiratory volume in 1 s all improved with treatment; however, response was not uniform in individual patients. Of all outcome measures, VDP showed the largest relative improvement (−42.1%, 95% CI −52.1–−31.9%, p<0.0001).These data support further investigation of XeMRI as a tool to capture treatment response in CF lung disease.


2019 ◽  
Vol 53 (5) ◽  
pp. 1702020 ◽  
Author(s):  
Francesca Pennati ◽  
Caterina Salito ◽  
Irene Borzani ◽  
Giulia Cervellin ◽  
Simone Gambazza ◽  
...  

This cross-sectional study aims to verify the relationship between quantitative multivolume proton-magnetic resonance imaging (1H-MRI) and clinical indicators of ventilatory abnormalities in cystic fibrosis (CF) lung disease.Non-enhanced chest MRI, spirometry and multiple breath washout was performed by 28 patients (10–27 years) with CF lung disease. Images acquired at end-inspiration and end-expiration were registered by optical flow to estimate expiratory–inspiratory proton-density change (Δ1H-MRI) as a measure of regional ventilation. Magnetic resonance images were also evaluated using a CF-specific scoring system.Biomarkers of CF ventilation impairment were defined from the Δ1H-MRI as follows: Δ1H-MRI median, Δ1H-MRI quartile coefficient of variation (QCV) and percentage of low-ventilation volume (%LVV). Imaging biomarkers correlated to all the clinical measures of ventilation abnormality, with the strongest correlation between Δ1H-MRI median and forced expiratory volume in 1 s (r2=0.44, p<0.001), Δ1H-MRI QCV and lung clearance index (LCI) (r2=0.51, p<0.001) and %LVV and LCI (r2=0.66, p<0.001). Correlations were also found between imaging biomarkers of ventilation and morphological scoring.The study showed a significant correlation between quantitative multivolume MRI and clinical indicators of CF lung disease. MRI, as a non-ionising imaging technique, may be particularly attractive in CF care for longitudinal evaluation, providing a new imaging biomarker to detect early ventilatory abnormalities.


Respirology ◽  
2011 ◽  
Vol 17 (1) ◽  
pp. 87-91 ◽  
Author(s):  
SILVIA MONTELLA ◽  
MARCO MAGLIONE ◽  
DARIO BRUZZESE ◽  
CARMINE MOLLICA ◽  
CLAUDIO PIGNATA ◽  
...  

mSystems ◽  
2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Stephen C. Watts ◽  
Louise M. Judd ◽  
Rosemary Carzino ◽  
Sarath Ranganathan ◽  
Kathryn E. Holt

Cystic fibrosis (CF) lung disease begins during infancy, and acute respiratory infections increase the risk of early disease development and progression. Microbes involved in advanced stages of CF are well characterized, but less is known about early respiratory colonizers.


PLoS ONE ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. e0157177 ◽  
Author(s):  
Rebecca J. Theilmann ◽  
Chantal Darquenne ◽  
Ann R. Elliott ◽  
Barbara A. Bailey ◽  
Douglas J. Conrad

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