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Diverse Cardiopulmonary Diseases are Associated with Distinct Xenon MRI Signatures.

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Date
2019-10-16
Authors
Wang, Ziyi
Bier, Elianna A
Swaminathan, Aparna
Parikh, Kishan
Nouls, John
He, Mu
Mammarappallil, Joseph G
Luo, Sheng
Driehuys, Bastiaan
Rajagopal, Sudarshan
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Abstract
BACKGROUND:As an increasing number of patients exhibit concomitant cardiac and pulmonary disease, limitations of standard diagnostic criteria are more frequently encountered. Here, we apply noninvasive 129Xenon MR imaging and spectroscopy to identify patterns of regional gas transfer impairment and hemodynamics that are uniquely associated with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), left heart failure (LHF), and pulmonary arterial hypertension (PAH). METHODS:Healthy volunteers (n=23) and patients with COPD (n=8), IPF (n=12), LHF (n=6), and PAH (n=10) underwent 129Xe gas transfer imaging and dynamic spectroscopy. For each patient, 3D maps were generated to depict ventilation, barrier uptake (129Xe dissolved in interstitial tissue), and red blood cell (RBC) transfer (129Xe dissolved in RBCs). Dynamic 129Xe spectroscopy was used to quantify cardiogenic oscillations in the RBC signal amplitude and frequency shift. RESULTS:Compared to healthy volunteers, all patient groups exhibited decreased ventilation and RBC transfer (p≤0.01, p≤0.01). Patients with COPD demonstrated more ventilation and barrier defects compared to all other groups (p≤0.02, p≤0.02). In contrast, IPF patients demonstrated elevated barrier uptake compared to all other groups (p≤0.007) and increased RBC amplitude and shift oscillations compared to healthy volunteers (p=0.007, p≤0.01). Patients with COPD and PAH both exhibited decreased RBC amplitude oscillations (p=0.02, p=0.005) compared to healthy volunteers. LHF was distinguishable from PAH by enhanced RBC amplitude oscillations (p=0.01). CONCLUSION:COPD, IPF, LHF, and PAH each exhibit unique 129Xe MR imaging and dynamic spectroscopy signatures. These metrics may help with diagnostic challenges in cardiopulmonary disease and increase understanding of regional lung function and hemodynamics at the alveolar-capillary level.
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Journal article
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https://hdl.handle.net/10161/19451
Published Version (Please cite this version)
10.1183/13993003.00831-2019
Publication Info
Wang, Ziyi; Bier, Elianna A; Swaminathan, Aparna; Parikh, Kishan; Nouls, John; He, Mu; ... Rajagopal, Sudarshan (2019). Diverse Cardiopulmonary Diseases are Associated with Distinct Xenon MRI Signatures. The European respiratory journal. pp. 1900831-1900831. 10.1183/13993003.00831-2019. Retrieved from https://hdl.handle.net/10161/19451.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Driehuys

Bastiaan Driehuys

Professor of Radiology
My research program is focused on developing and applying hyperpolarized gases to enable fundamentally new applications in MRI. Currently we use this technology to non-invasively image pulmonary function in 3D. Hyperpolarization involves aligning nuclei to a high degree to enhance their MRI signal by 5-6 orders of magnitude. Thus, despite the low density of gases relative to water (the ordinary signal source in MRI), they can be imaged at high-resolution in a single breath. This technology leads
Luo

Sheng Luo

Professor of Biostatistics & Bioinformatics
Mammarappallil

Joseph George Mammarappallil

Assistant Professor of Radiology

John Claude Nouls

Assistant Professor of Radiology
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Parikh

Kishan S Parikh

Assistant Professor of Medicine
Duke University Medical CenterDuke Clinical Research Institute
Rajagopal

Sudarshan Rajagopal

Associate Professor of Medicine
I am a physician-scientist with a research focus on G protein-coupled receptor signaling in inflammation and vascular disease and a clinical focus on pulmonary vascular disease. I serve as Co-Director of the Duke Pulmonary Vascular Disease Center.
Swaminathan

Aparna Swaminathan

Assistant Professor of Medicine
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