Comparison of MRI and VQ-SPECT as a Screening Test for Patients With Suspected CTEPH: CHANGE-MRI Study Design and Rationale
The diagnostic strategy for chronic thromboembolic pulmonary hypertension (CTEPH) is composed of two components required for a diagnosis of CTEPH: the presence of chronic pulmonary embolism and an elevated pulmonary artery pressure. The current guidelines require that ventilation–perfusion single-photon emission computed tomography (VQ-SPECT) is used for the first step diagnosis of chronic pulmonary embolism. However, VQ-SPECT exposes patients to ionizing radiation in a radiation sensitive population. The prospective, multicenter, comparative phase III diagnostic trial CTEPH diagnosis Europe - MRI (CHANGE-MRI, ClinicalTrials.gov identifier NCT02791282) aims to demonstrate whether functional…
k-Space filtering in 2D gradient-echo breath-hold hyperpolarized3He MRI: Spatial resolution and signal-to-noise ratio considerations
In this work some of the factors that can influence the signal-to-noise ratio (SNR) and spatial resolution in MR images of inhaled hyperpolarized gases are systematically addressed. In particular, the effects of RF depletion of longitudinal polarization and image gradient diffusion dephasing were assessed in terms of their contribution to a k-space filter. By means of theoretical simulations and a novel method of experimental validation using a variable transverse magnetization of the 1H signal, systematic quantitative and qualitative investigations of the effects of k-space filtering intrinsic to imaging of hyperpolarized gas were made. A 2D gradient-echo image is considered for a range of…
Functional MRI of the lung using hyperpolarized 3-helium gas
Lung imaging has traditionally relied on x-ray methods, since proton MRI is limited to some extent by low proton density in the lung parenchyma and static field inhomogeneities in the chest. The relatively recent introduction of MRI of hyperpolarized noble gases has led to a rapidly evolving field of pulmonary MRI, revealing functional information of the lungs, which were hitherto unattainable. This review article briefly describes the physical background of the technology, and subsequently focuses on its clinical applications. Four different techniques that have been used in various human investigations are discussed: ventilation distribution, ventilation dynamics, and small airway evaluat…
MRI of Pulmonary Ventilation
Gas imaging has opened the new field of direct imaging of pulmonary ventilation by MRI. The use of hyperpolarised 3He gas for MRI of the lung has been pioneered by a number of groups worldwide. Due to the enormous progress in the fields of hyperpolarisation technology, administration of hyperpolarised 3He, MR hardware, and MR pulse sequences significant progress has been made and the translation into the clinical arena has been accomplished. This chapter gives an overview of the technical methods for HP 3He MRI for human lung imaging, focusing on gas polarisation methods, background physics, MRI hardware considerations, MRI pulse sequence considerations, safety considerations for imaging in…