![]() ![]() Consequently, there is a pressing need to move beyond form to function in pulmonary imaging. However, these very subtle, interstitial alterations are critical to the early diagnosis of potentially reversible changes in the lungs. Interstitial alterations of the lung parenchyma are less conspicuous on CT and are consequently under-diagnosed. However, CT excels primarily for lung morphology but relies on indirect signs in cases of obstructive or restrictive pulmonary disease. Chest computed tomography (CT) is considered the reference standard for lung imaging due to its superior spatial and temporal resolution compared to magnetic resonance imaging and nuclear imaging techniques. Imaging technologies have improved the sensitivity and specificity for the detection of lung diseases but without quantification of these processes there has been limited impact outside of the Radiology Department. Hence, there is a strong demand for more local measures of lung function capable of depicting regional ventilation patterns that are characteristic of different obstructive and restrictive lung diseases in their early stages. Subtle alterations of the lung parenchyma are generally poorly detected by conventional PFTs for example, a local loss of ventilation in a given pulmonary segment is missed by these global methods of assessment. ![]() More generally, traditional pulmonary function tests (PFTs) insufficiently characterize regional lung function in the early stages of disease. As a global measure FEV 1 is not sensitive to disease heterogeneity and is non-specific for the underlying cause of airway obstruction. Despite its limitations, forced expiratory volume in one second (FEV 1) continues to serve as the main intermediate endpoint in numerous longitudinal studies. In this review article, we aim to (1) provide a brief overview of current ventilation MR imaging techniques, (2) emphasize the role of HP 129Xe MRI within the array of different imaging strategies, (3) discuss the unique imaging possibilities with HP 129Xe MRI, and (4) propose clinical applications.įor more than a century, the assessment of lung function has relied on global measurements derived from spirometry and body plethysmography. HP 129Xe MRI provides not only 3-dimensional ventilation imaging, but also unique capabilities for probing regional lung physiology. Currently, hyperpolarized (HP) noble gas lung MRI is limited to selected academic institutions yet, the promising results from initial clinical trials have drawn the attention of the pulmonary medicine community. With advances in polarizer technology and the current transition towards the widely available 129Xe gas, this method is ready for translation to the clinic. Both helium ( 3 He) and xenon ( 129Xe) gas have been thoroughly investigated for their ability to assess both the global and regional patterns of lung ventilation. In the last two decades, functional imaging of the lungs using hyperpolarized noble gases has entered the clinical stage. ![]()
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