Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function

Rachel  L Eddy; George H Xu; Jonathon A Leipsic; Janice M Leung; Don D Sin; Chase S Hall; Roger C Tam

doi:10.3791/66257

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Method Article

Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized ¹²⁹Xe MRI to Evaluate Lung Structure-Function

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DOI:

10.3791/66257

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April 12th, 2024

Rachel L Eddy¹^,² , George H Xu³ , Jonathon A Leipsic¹^,⁴ , Janice M Leung¹^,² , Don D Sin¹^,² , Chase S Hall⁵ , Roger C Tam³^,⁴

¹UBC Centre for Heart Lung Innovation, St. Paul’s Hospital, ²Division of Respiratory Medicine, Department of Medicine, University of British Columbia, ³School of Biomedical Engineering, University of British Columbia, ⁴Department of Radiology, University of British Columbia, ⁵Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center

Summary

CT and ¹²⁹Xe MRI provide complementary lung structure-function information that can be exploited for regional analysis using image registration. Here, we provide a protocol that builds from the existing literature for ¹²⁹Xe MR to CT image registration using open-source platforms.

Abstract

Hyperpolarized ¹²⁹Xe gas MRI is an emerging technique to evaluate and measure regional lung function including pulmonary gas distribution and gas exchange. Chest computed tomography (CT) still remains the clinical gold standard for imaging of the lungs, though, in part due to the rapid CT protocols that acquire high-resolution images in seconds and the widespread availability of CT scanners. Quantitative approaches have enabled the extraction of structural lung parenchymal, airway and vascular measurements from chest CT that have been evaluated in many clinical research studies. Together, CT and ¹²⁹Xe MRI provide complementary information that can be used to evaluate regional lung structure and function, resulting in new insights into lung health and disease. ¹²⁹Xe MR-CT image registration can be performed to measure regional lung structure-function to better understand lung disease pathophysiology, and to perform image-guided pulmonary interventions. Here, a method for ¹²⁹Xe MRI-CT registration is outlined to support implementation in research or clinical settings. Registration methods and applications that have been employed to date in the literature are also summarized, and suggestions are provided for future directions that may further overcome technical challenges related to ¹²⁹Xe MR-CT image registration and facilitate broader implementation of regional lung structure-function evaluation.

Introduction

Hyperpolarized gas magnetic resonance imaging (MRI) first emerged as a novel functional pulmonary imaging modality to evaluate pulmonary ventilation distribution nearly three decades ago¹. Since then, research studies using hyperpolarized gas MRI have revealed numerous insights into the nature of lung function in patients with chronic lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis²^,³^,⁴^,⁵^,⁶. Both hyperpolarized ³He and ^1....