Imaging biomarkers of lung ventilation in interstitial lung disease from 129 Xe and oxygen enhanced 1 H MRI

• Published in: Magnetic resonance imaging 2023-01, Vol.95, p.39
• Main Authors: Tibiletti, Marta, Eaden, James A, Naish, Josephine H, Hughes, Paul J C, Waterton, John C, Heaton, Matthew J, Chaudhuri, Nazia, Skeoch, Sarah, Bruce, Ian N, Bianchi, Stephen, Wild, Jim M, Parker, Geoff J M
• Format: Article
• Language: English
• Subjects: Biomarkers; Humans; Idiopathic Pulmonary Fibrosis - diagnosis; Lung - diagnostic imaging; Lung Diseases, Interstitial - diagnostic imaging; Magnetic Resonance Imaging; Oxygen; Prospective Studies
• ISSN: 1873-5894
• DOI: 10.1016/j.mri.2022.10.005

To compare imaging biomarkers from hyperpolarised Xe ventilation MRI and dynamic oxygen-enhanced MRI (OE-MRI) with standard pulmonary function tests (PFT) in interstitial lung disease (ILD) patients. To evaluate if biomarkers can separate ILD subtypes and detect early signs of disease resolution or progression. Prospective longitudinal. Forty-one ILD (fourteen idiopathic pulmonary fibrosis (IPF), eleven hypersensitivity pneumonitis (HP), eleven drug-induced ILD (DI-ILD), five connective tissue disease related-ILD (CTD-ILD)) patients and ten healthy volunteers imaged at visit 1. Thirty-four ILD patients completed visit 2 (eleven IPF, eight HP, ten DIILD, five CTD-ILD) after 6 or 26 weeks. MRI was performed at 1.5 T, including inversion recovery T mapping, dynamic MRI acquisition with varying oxygen levels, and hyperpolarised Xe ventilation MRI. Subjects underwent standard spirometry and gas transfer testing. Five H MRI and two Xe MRI ventilation metrics were compared with spirometry and gas transfer measurements. To evaluate differences at visit 1 among subgroups: ANOVA or Kruskal-Wallis rank tests with correction for multiple comparisons. To assess the relationships between imaging biomarkers, PFT, age and gender, at visit 1 and for the change between visit 1 and 2: Pearson correlations and multilinear regression models. The global PFT tests could not distinguish ILD subtypes. Percentage ventilated volumes were lower in ILD patients than in HVs when measured with Xe MRI (HV 97.4 ± 2.6, CTD-ILD: 91.0 ± 4.8 p = 0.017, DI-ILD 90.1 ± 7.4 p = 0.003, HP 92.6 ± 4.0 p = 0.013, IPF 88.1 ± 6.5 p