0000000000170548

AUTHOR

K. K. Gast

Flip-angle measurement by magnetization inversion: Calibration of magnetization nutation angle in hyperpolarized 3 He magnetic resonance imaging lung experiments

The aim of this work was to establish a new, fast, and robust method of flip-angle calibration for magnetic resonance imaging of hyperpolarized 3He. The method called flip-angle measurement with magnetization inversion is based on acquiring images from periodically inverted longitudinal magnetization created using the spatial modulation of magnetization technique. By measuring the width of the area where the magnetization was inverted by the spatial modulation of magnetization preparation in phase images, the flip angle can be generated using a simple equation. To validate and establish the limits of the proposed method, flip-angle measurement with magnetization inversion acquisitions were …

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Ein Auswerteprogramm zur quantitativen Untersuchung der Lungenventilation mittels dynamischer MRT von hochpolarisiertem 3He

Purpose: 3 He-MRI is able to visualize the regional distribution of lung ventilation with a temporal and spatial resolution so far unmatched by any other technique. The aim of the study was the development of a new software tool for quantification of dynamic ventilation parameters in absolute physical units. Materials and Methods: During continuous breathing, a bolus of hyperpolarized 3 He (300 ml) was applied at inspiration and a series of 168 coronal projection images simultaneously acquired using a 2D FLASH-sequence. Postprocessing software was developed to analyze the 3 He distribution in the lung. After correction for lung motion, several ventilation parameters (rise time, delay time, …

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Functional Evaluation of Emphysema Using Diffusion-Weighted 3Helium-Magnetic Resonance Imaging, High-Resolution Computed Tomography, and Lung Function Tests

Purpose: To assess the emphysematous enlargement of distal air-spaces and concomitant large and small airway disease using diffusion-weighted 3 Helium-magnetic resonance imaging (MRI), high-resolution computed tomography (HRCT), and lung function tests (LFT). Methods: Seven patients were examined after single lung transplantation (LTx) and 1 before double LTx for various forms of emphysema. Five patients after double LTx served as controls. Patients were assessed by 3 Helium-MRI (apparent diffusion coefficient [ADC]), HRCT (mean lung density [MLD], emphysema index [El]), and LFT. Results: Transplanted lungs: mean ADC = 0.17 cm 2 /s, MLD = -848 H, El = 22%. Emphysematous lungs: mean ADC = 0.…

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Realization of administration unit for3He with gas recycling

Hyperpolarized (HP) noble gases (3He,129Xe) are used for MR-imaging of the lung. In the majority of case the HP gas is filled in Tedlarbags and directly inhaled by the patients. Starting from an earlier pilot device, an administration unit was built respectively to the Medical Devices Law to administer patients HP noble gas boli in defined quantities and at a predefined time during inspiration with high reproducibility and reliability without reducing MR-quality. The patient's airflows are monitored and recorded. It is possible to use gas admixtures, measure the polarization on-line and collect the exhaled gas for later recycling. The first images with healthy volunteers were taken with thi…

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Intrapulmonary 3He Gas Distribution Depending on Bolus Size and Temporal Bolus Placement

OBJECTIVE: Dynamic ventilation (3)He-MRI is a new method to assess pulmonary gas inflow. As differing airway diameters throughout the ventilatory cycle can influence gas inflow this study intends to investigate the influence of volume and timing of a He gas bolus with respect to the beginning of the tidal volume on inspiratory gas distribution. MATERIALS AND METHODS: An ultrafast 2-dimensional spoiled gradient echo sequence (temporal resolution 100 milliseconds) was used for dynamic ventilation (3)He-MRI of 11 anesthetized and mechanically ventilated pigs. The applied (3)He gas bolus was varied in volume between 100 and 200 mL. A 150-mL bolus was varied in its application time after the beg…

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3 He-MRI-based vs. conventional determination of lung volumes in patients after unilateral lung transplantation: a new approach to regional spirometry

Background: To use 3Helium (3He)-MRI in patients with unilateral lung grafts to assess the contributions of graft and native lung to total ventilated lung volume, and second to compare conventional measurements of intrapulmonary gas volume (spirometry, body plethysmography) with image-based volumetry of ventilated lung parenchyma visualized by hyperpolarized 3He-MRI. Methods: With Ethics Committee approval, five patients with single lung transplantation (SLTX) for idiopathic pulmonary fibrosis (IPF) underwent both conventional pulmonary function testing (PFT) and 3He-MRI of the lung. Intrapulmonary gas volume (GV) during the inspiratory breathhold for 3He-MRI was calculated from measured fu…

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Reformatierungen als Lösungsansatz für die Problematik der unterschiedlichen Schichtführung beim Vergleich von3He-MRT und HR-CT der Lunge

Purpose: 3 He-MRI of the lung has been shown to be a sensitive method for functional imaging of the lung. A previous study compared 3 He-MRI (coronal planes) with CT (transverse planes) by looking for ventilation defects and their pathomorphologic correlation. Anatomic structures, such as lobar fissures and hilar vessels, were used for orientation, but the reliable assignment of ventilation defects to lung segments is problematic. The present work compares multiplanar reformations of 3 He-MRI and HR-CT, which were generated from planes determined by the respective method, and investigates their suitability as a solution of this problem. Materials and Methods: A total of 16 data sets taken f…

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Dynamische Bildgebung der Nasenhaupthöhle und der Nasennebenhöhlen im MR mittels polarisiertem 3Helium

sinuses with polarized 3 helium MRI. Purpose: Reduced or blocked ventilation of the paranasal sinuses is probably the most important factor in the development of sinusitis. Recently, the use of optically polarized noble gas isotopes has attracted increasing interest for use in a variety of promising MR applications. The aim of this study was to test the feasibility of imaging and visualization ventilation of the nasal cavity and paranasal sinus in MR by inhalation of hyperpolarized 3 helium. The goal was to evaluate ventilation defects of the paranasal sinuses. Volunteers and Methods: Three volunteers were enrolled in the study. 3 Helium was polarized to 40-50% by direct optical pumping. 30…

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Multi-Slice CT (MSCT) in Cardiac Function Imaging: Threshold-Value-Supported 3D Volume Reconstructions to Determine the Left Ventricular Ejection Fraction in Comparison to MRI

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Repräsentiert der HRCT-Emphysemindex die gesamte Lunge?

Purpose: Comparison of emphysema index derived of thin section MD-CT of the entire lung volume and HRCT, simulated by calculation of every twentieth image of the whole data-set. Materials and Methods: Pulmonary emphysema was quantified by semiautomatic, segmentation of lung borders and assessment of lung volume and emphysema volume within these borders. The emphysema index (pixel index) was calculated. Statistical analysis was done by the sign-test and Bland-Altman-analysis. Results: Median lung volume, emphysema volume and emphysema index are significantly higher in simulated HRCT. Median lung volume (emphysema volume) calculated by HRCT is 5118 ml (407 ml) and 5040 ml (367 ml) calculated …

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MRI in lung transplant recipients using hyperpolarized 3He: comparison with CT.

PURPOSE To elucidate the ability of 3He-MRI to detect ventilation defects in lung transplant recipients, 3He-MRI was compared to CT for concordance. MATERIALS AND METHODS We examined 14 lung recipients using 3He-MRI on a 1.5 T MR scanner. CT served as a reference method. Up to four representative ventilation defects were defined for each lung on 3He-MRI and compared to corresponding areas on CT. RESULTS Altogether, 59 representative ventilation defects were defined on 3He-MRI. Plausible CT correlates were found for 29 ventilation defects; less plausible CT correlates were found for eight defects. In 22 defects (37%) no corresponding CT changes were detected. CT demonstrated correlates for v…

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Visualization of alveolar recruitment in a porcine model of unilateral lung lavage using3He-MRI

BACKGROUND: In the acute respiratory distress syndrome potentially recruitable lung volume is currently discussed. (3)He-magnetic resonance imaging ((3)He-MRI) offers the possibility to visualize alveolar recruitment directly. METHODS: With the approval of the state animal care committee, unilateral lung damage was induced in seven anesthetized pigs by saline lavage of the right lungs. The left lung served as an intraindividual control (healthy lung). Unilateral lung damage was confirmed by conventional proton MRI and spiral-CT scanning. The total aerated lung volume was determined both at a positive end-expiratory pressure (PEEP) of 0 and 10 mbar from three-dimensionally reconstructed (3)H…

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Symptomatic atherosclerotic occlusive disease of all supra-aortic arch vessels treated with total aortic arch rerouting.

We present an uncommon case of symptomatic atherosclerotic occlusive disease of all supra-aortic arch vessels and its surgical treatment by total aortic arch rerouting after endarteriectomy of all target vessels.

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Ein Auswerteprogramm zur quantitativen Analyse von Messungen des alveolären Sauerstoffpartialdrucks (pAO2) mit der sauerstoffsensitiven 3He-MR-Tomographie

Purpose: To develop a software tool for quantitative analysis of alveolar oxygen partial pressure (p A O 2 ) as well as its time course during apnea. Material and Methods: T 1 -relaxation times of hyperpolarized 3 He are reduced by paramagnetic oxygen rendering 3 He-MRI sensitive to oxygen and thus allowing the assessment of the local oxygen partial pressure in the pulmonary airspaces. Oxygen-related relaxation and loss of polarization by RF-excitation can be discriminated by acquiring two image series with varying interscan delay and/or flip angles. Software was developed to calculate the p A O 2 and the decay rate in user-defined regions of interest (ROIs) automatically. Moreover, paramet…

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Structural and Functional Characterization of Chronic Obstructive Lung Disease and Emphysema Using 3He- MRI: Comparison with CT and Pulmonary Function Tests

mor types. For these reasons, Matrigel impregnated with angiogenic hormone, basic-Fibroblast Growth Factor (bFGF), in a mouse model has been extensively used in fundamental angiogenesis research to induce endothelial cell differentiation and successfully allow the study of different phases of the angiogenesis process. The objective of this study was to evaluate the ability of functional ultrasound imaging (fUSI) to provide data allowing the quantification of the angiogenic process, using the Matrigel model.

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Application unit for the administration of contrast gases for pulmonary magnetic resonance imaging: optimization of ventilation distribution for3He-MRI

Purpose MRI of lung airspaces using gases with MR-active nuclei (3He, 129Xe, and 19F) is an important area of research in pulmonary imaging. The volume-controlled administration of gas mixtures is important for obtaining quantitative information from MR images. State-of-the-art gas administration using plastic bags (PBs) does not allow for a precise determination of both the volume and timing of a 3He bolus. Methods A novel application unit (AU) was built according to the requirements of the German medical devices law. Integrated spirometers enable the monitoring of the inhaled gas flow. The device is particularly suited for hyperpolarized (HP) gases (e.g., storage and administration with m…

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Funktionelle Bildgebung der Lunge mit gasförmigem Kontrastmittel: ³Helium-Magnetresonanztomographie

Current imaging methods of the lung concentrate on morphology as well as on the depiction of the pulmonary parenchyma. The need of an advanced and more subtle imaging technology compared to conventional radiography is met by computed topography as the method of choice. Nevertheless, computed tomography yields very limited functional information. This is to be derived from arterial blood gas analysis, spirometry and body plethysmography. These methods, however, lack the scope for regional allocation of any pathology. Magnetic resonance imaging of the lung has been advanced by the use of hyperpolarised (3)Helium as an inhaled gaseous contrast agent. The inhalation of the gas provides function…

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Clinical aspects of the apparent diffusion coefficient in 3He MRI: results in healthy volunteers and patients after lung transplantation.

Purpose To measure the apparent diffusion coefficient (ADC) after inhalation of hyperpolarized 3He in healthy volunteers and lung transplant recipients, and demonstrate the gravity dependence of ADC values. Materials and Methods Six healthy volunteers, 10 patients after single-lung transplantation, and six patients after double-lung transplantation were examined at 1.5T during inspiration and expiration. The inhalation of 300 mL of hyperpolarized 3He was performed with a computer-controlled delivery device. A two-dimensional fast low-angle shot (FLASH) sequence measured the 3He diffusive gas movement. From these data the ADC was calculated. Results The mean ADC was 0.143 cm2/second in healt…

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Three-dimensional mapping of the B 1 field using an optimized phase-based method: Application to hyperpolarized 3 He in lungs

A novel method is presented for the three-dimensional mapping of the B1-field of a transmit radio-frequency MR coil. The method is based on the acquisition of phase images, where the effective flip angle is encoded in the phase of the nonselective hard pulse excitation. The method involves the application of a rectangular composite pulse as excitation in a three-dimensional gradient recall echo to produce measurable phase angle variation. However, such a pulse may significantly increase the radio-frequency power deposition in excess of the standard acceptable SAR limits, imposing extremely long TRs (>100 msec), which would result in acquisition times significantly greater than a single brea…

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Assessment of lung microstructure with magnetic resonance imaging of hyperpolarized Helium-3

Magnetic resonance imaging of the apparent diffusion coefficient (ADC) of hyperpolarized Helium-3 is a new technique for probing pulmonary microstructure in vivo. The aim of this study was the assessment of potential sources of systematic errors of the ADC measurement. The influence of macroscopic motion was determined by measurements at two different delays after initiating the breath-hold, and before and after cardiac arrest. An intercentre comparison was performed in two age- and lung function-matched groups of lung-healthy volunteers at two research sites. Moreover, measurements of diffusion anisotropy were performed. We found no dependency of the ADC as a function of the delay after st…

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Visuelle Abschätzung der funktionellen Lungenanteile in der HRCT und 3He-MRT bei Patienten nach Einzel-Lungentransplantation: Vergleich mit der absoluten Volumetrie

Purpose: Visual assessment of the ventilation using HRCT and 3 He-MRI in patients after single lung transplantation (SLTX). Analysis of specific ventilation defects found with 3 He-MRI and morphological changes found with HRCT. Materials and Methods: We evaluated 8male patients (54 ′ 6 years) suffering from emphysema and six patients (3males and 3 females, 58 ′ 9.5 years) suffering from idiopathic pulmonary fibrosis (IPF) after SLTX. The morphological changes at HRCT were classified and localized. In 3 He-MRI (2D FLASH), 10 to 14 slices (slice thickness 10 mm, gap 5 mm) were acquired in coronal orientation to cover the whole lung. Ventilation defects were localized and characterized. The vi…

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Functional Analysis in Single-Lung Transplant Recipients

Objective To develop and evaluate a postprocessing tool to quantify ventilated split-lung volumes on the basis of 3 He-MRI and to apply it in patients after single-lung transplantation (SLTX). High-resolution CT (HRCT) was employed as a reference modality providing split air-filled lung volumes. Lung volumes derived from pulmonary function test results served as clinical parameters and were used as the “gold standard.” Material and methods Eight patients (mean age, 54 years) with emphysema and six patients (mean age, 58 years) with idiopathic pulmonary fibrosis. All patients were evaluated following SLTX. HRCT was performed during inspiration (slice thickness, 1 mm; increment, 10 mm). For c…

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Diffusion-weighted MRI of the lung with hyperpolarized helium-3: A study of reproducibility

Purpose To determine the reproducibility of several parameters of the ADC measurement by calculating the scan-to-scan intrasubject variability. Materials and Methods Measurements were performed using a gradient-echo sequence with a bipolar gradient for diffusion weighting (b = 3.89 sec/cm2). Five patients with pulmonary emphysema, and six healthy-lung volunteers were included in the study. Images were acquired after inspiration of 3He during a single inspiratory breath-hold. To assess the reproducibility, the measurement was performed twice (time between measurements = 20 minutes) without repositioning the subjects. Analysis was performed on the basis of region-of-interest (ROI) analysis an…

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Mikrostruktur der Lunge: Untersuchung mittels Diffusionsmessung von hochpolarisiertem 3Helium

Imaging methods to study the lung are traditionally based on x-ray or on radioactive contrast agents. Conventional magnetic resonance imaging (MRI) has only limited applications for lung imaging because of the low tissue density of protons concentration of hydrogen atoms, which are usually the basis for the imaging. The introduction of hyperpolarized noble gases as a contrast agent in MRI has opened new possibilities for lung diagnosis. The present paper describes this new technique. Diffusion-weighted MRI for assessment of the lung microstructure is presented here as an example of the new possibilities of functional imaging. Studies to determine the sensitivity of the diffusion measurement…

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