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Quantitative analysis of hyperpolarized 129Xe ventilation imaging in healthy volunteers and subjects with chronic obstructive pulmonary disease
Authors:Rohan S Virgincar  Zackary I Cleveland  S Sivaram Kaushik  Matthew S Freeman  John Nouls  Gary P Cofer  Santiago Martinez‐Jimenez  Mu He  Monica Kraft  Jan Wolber  H Page McAdams  Bastiaan Driehuys
Institution:1. Center for In Vivo Microscopy, Duke University Medical Center, , Durham, NC, USA;2. Department of Biomedical Engineering, Duke University, , Durham, NC, USA;3. Department of Radiology, Duke University Medical Center, , Durham, NC, USA;4. Medical Physics Graduate Program, Duke University, , Durham, NC, USA;5. Department of Electrical and Computer Engineering, Duke University, , Durham, NC, USA;6. Department of Pulmonary and Critical Care Medicine, Duke University Medical Center, , Durham, NC, USA;7. GE Healthcare, The Grove Center, , Amersham, Buckinghamshire, UK;8. Academic Radiology, University of Sheffield, Royal Hallamshire Hospital, , Sheffield, UK
Abstract:In this study, hyperpolarized 129Xe MR ventilation and 1H anatomical images were obtained from three subject groups: young healthy volunteers (HVs), subjects with chronic obstructive pulmonary disease (COPD) and age‐matched controls (AMCs). Ventilation images were quantified by two methods: an expert reader‐based ventilation defect score percentage (VDS%) and a semi‐automated segmentation‐based ventilation defect percentage (VDP). Reader‐based values were assigned by two experienced radiologists and resolved by consensus. In the semi‐automated analysis, 1H anatomical images and 129Xe ventilation images were both segmented following registration to obtain the thoracic cavity volume and ventilated volume, respectively, which were then expressed as a ratio to obtain the VDP. Ventilation images were also characterized by generating signal intensity histograms from voxels within the thoracic cavity volume, and heterogeneity was analyzed using the coefficient of variation (CV). The reader‐based VDS% correlated strongly with the semi‐automatically generated VDP (r = 0.97, p < 0.0001) and with CV (r = 0.82, p < 0.0001). Both 129Xe ventilation defect scoring metrics readily separated the three groups from one another and correlated significantly with the forced expiratory volume in 1 s (FEV1) (VDS%: r = –0.78, p = 0.0002; VDP: r = –0.79, p = 0.0003; CV: r = –0.66, p = 0.0059) and other pulmonary function tests. In the healthy subject groups (HVs and AMCs), the prevalence of ventilation defects also increased with age (VDS%: r = 0.61, p = 0.0002; VDP: r = 0.63, p = 0.0002). Moreover, ventilation histograms and their associated CVs distinguished between subjects with COPD with similar ventilation defect scores, but visibly different ventilation patterns. Copyright © 2012 John Wiley & Sons, Ltd.
Keywords:hyperpolarized  129Xe  MRI  ventilation  defect  segmentation  COPD  coefficient of variation
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