Evaluating Bronchodilator Effects in Chronic Obstructive Pulmonary Disease using Diffusion-Weighted Hyperpolarized Helium-3 Magnetic Resonance Imaging.
The objective of this study was to evaluate the regional effects of bronchodilator administration in chronic obstructive pulmonary disease (COPD) using hyperpolarized helium-3 ((3)He) magnetic resonance imaging (MRI) apparent diffusion coefficients (ADC). Ten COPD ex-smokers provided written informed consent and underwent diffusion-weighted hyperpolarized (3)He MRI, spirometry and plethysmography before and 25±2 minutes after bronchodilator administration. Pre-and post-salbutamol whole lung (WL) ADC maps were generated and registered together to identify the lung regions containing (3)He signal at both time-points, and mean ADC within those regions of interest (ROI) was determined for previously ventilated ROI ADC (ADC(P)). Lung ROI with (3)He signal at both time-points was used as a binary mask on post-salbutamol WL ADC maps to obtain an ADC measurement for newly ventilated ROI (ADC(N)). Post-salbutamol, no significant differences were detected in WL ADC (p=.516). There were no significant differences between ADC(N) and ADC(P) post-salbutamol (p=1.00), suggesting that the newly ventilated lung regions were not more emphysematous than the lung ROI participating in ventilation before bronchodilator administration. Post-salbutamol, a statistically significant decrease in ADC(P) (p=.01) was detected and there were significant differences between ADC(P) in the most anterior and most posterior image slices (p=.02), suggesting a reduction in regional gas trapping following bronchodilator administration. Regional evaluation of tissue microstructure using hyperpolarized (3)He MRI ADC provides insights into lung alterations that accompany improvements in regional (3)He gas distribution after bronchodilator administration.[1]References
- Evaluating Bronchodilator Effects in Chronic Obstructive Pulmonary Disease using Diffusion-Weighted Hyperpolarized Helium-3 Magnetic Resonance Imaging. Kirby, M., Heydarian, M., Wheatley, A., McCormack, D.G., Parraga, G. J. Applied Physiology (bethesda, Md. : 1985) (2011) [Pubmed]
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