Sarah H. Needleman¹, Mina Kim¹, Jamie R. McClelland¹, Marta Tibiletti², Josephine H. Naish^2,3, James P. B. O'Connor⁴, and Geoff J. M. Parker^1,2
1Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom, ²Bioxydyn Limited, Manchester, United Kingdom, ³MCMR, Manchester University NHS Foundation Trust, Manchester, United Kingdom, ⁴Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom

Analysis of dynamic lung OE-MRI is challenging due to the presence of substantial artefacts and poor SNR, particularly at 3 T. We propose a cyclical oxygen delivery scheme and ICA to separate the oxygen-enhancement signal from these confounding factors at 3 T. The proposed method extracts a well-defined oxygen-enhancement signal that removes confounds due to proton density changes, blood flow and motion. We also demonstrate the ability to resolve the opposite enhancement effects of the parenchymal and vascular OE-MRI signals to provide information on pulmonary vasculature and gas distribution. The method is shown to be sensitive to smoking status.

Neil J Stewart^1,2, Nara Higano^2,3,4,5, Shanmukha Sai Mukthapuram^3,6, Matthew M Willmering^2,3, Anita Arnsperger⁷, Ronald Pratt⁴, Wolfgang Loew⁴, Madhwesha R Rao¹, Rolf F Schulte⁸, Jim M Wild¹, and Jason C Woods^2,3,4,5
1POLARIS, Imaging Sciences, Department of Infection, Immunity & Cardiovascular Disease, The University of Sheffield, Sheffield, United Kingdom, ²Center for Pulmonary Imaging Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States, ³Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States, ⁴Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States, ⁵Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States, ⁶The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States, ⁷Division of Respiratory Care, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States, ⁸GE Healthcare, Munich, Germany

Julius Heidenreich¹, Philipp Josef Kuhl¹, Corona Metz¹, Andreas Max Weng¹, Jan-Peter Grunz¹, Thomas Benkert², Helge Hebestreit³, Thorsten Alexander Bley¹, Herbert Köstler¹, and Simon Veldhoen^1
1Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany, ²Siemens Healthineers GmbH, Erlangen, Germany, ³Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany

Single breath-hold 3D-UTE-MRI was proposed for simultaneous evaluation of lung morphology and function. Sixteen patients with cystic fibrosis (CF) underwent initial and follow-up 3D-UTE-MRI in 2019 and 2021. In line with a previous study, referenced voxelwise fractional ventilation (FV) provided a marker that correlates strongly with the lung clearance index (LCI), reflecting ventilation inhomogeneity. Seven patients received a new drug-combination (ivacaftor/elexacaftor/tezacaftor) with significantly improved lung function during clinical follow-up. Similarly, significantly decreased ventilation inhomogeneity was derived from functional MRI. Thus, single breath-hold 3D-UTE MRI is a valuable tool for monitoring ventilation inhomogeneity in patients with CF during drug treatment. 

Qing Zou¹, Luis A. Torres², Sean B. Fain¹, and Mathews Jacob^1
1University of Iowa, Iowa City, IA, United States, ²University of Wisconsin–Madison, Madison, WI, United States

UTE radial MRI methods are powerful tools for probing lung structure and function. However, the challenge in directly using this scheme for high-resolution lung imaging applications is the long breath-hold needed. While self-gating approaches that bin the data to different respiratory phases are promising, they do not allow the functional imaging of the lung and are often sensitive to bulk motion. The main focus of this work is to introduce a novel motion compensated manifold learning framework for functional and structural lung imaging. The proposed scheme is robust to bulk motion and enables high-resolution lung imaging in around 4 minutes.

Björn Wieslander¹, Ahsan Javed², Rajiv Ramasawmy², Ashkan A Malayeri³, Scott Baute², Kendall J O'Brien², Christine Mancini², Amanda Potersnak², Cheryl Warga⁴, Joel Moss¹, Marcus Y Chen², and Adrienne E Campbell-Washburn^2
1Pulmonary Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States, ²Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States, ³Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States, ⁴National Cancer Institute, National Institutes of Health, Bethesda, MD, United States

Lung imaging plays an important role in routine screening for lung nodules and lung cancer. Magnetic resonance imaging (MRI) has recently emerged as an alternative to computed tomography (CT) to image lung nodules. Lower field MRI offers high image quality, due to improved field homogeneity, and lower cost. We imaged 11 patients who had a total of 29 nodules visible on clinically motivated CT scans. T2-weighted images showed good agreement with CT in terms of nodule size and diameters and malignant nodules were more often visible on diffusion weighted images (b = 800).

Ho-Fung Chan¹, Timothy J Baldwin¹, Harry Barker¹, Neil J Stewart¹, James A Eaden^1,2, Paul J.C Hughes¹, Nicholas D Weatherley¹, Joshua Astley^1,3, Bilal A Tahir^1,3, Kevin M Johnson⁴, Ronald A Karwoski⁵, Brian J Bartholmai⁶, Marta Tibiletti⁷, Colm T Leonard^8,9, Sarah Skeoch^8,10, Nazia Chaudhuri^8,9, Ian N Bruce^8,9, Geoff J.M Parker^7,11, Stephen M Bianchi², and Jim M Wild^1
1Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, ²Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, ³Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom, ⁴Radiology and Medical Physics, University of Wisconsin, Madison, WI, United States, ⁵Biomedical Imaging Resource, Mayo Clinic, Rochester, MN, United States, ⁶Radiology, Mayo Clinic, Rochester, MN, United States, ⁷Bioxydyn Limited, Manchester, United Kingdom, ⁸University of Manchester, Manchester, United Kingdom, ⁹Manchester University NHS Foundation Trust, Manchester, United Kingdom, ¹⁰Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom, ¹¹Centre for Medical Image Computing, University College London, London, United Kingdom

UTE lung MRI approaches the diagnostic quality of CT, opening up the possibility for longitudinal follow-up of interstitial lung disease (ILD) progression. Two quantitative biomarkers of UTE lung signal were developed for monitoring longitudinal change in ILD and benchmarked against quantitative CT CALIPER measurements. Normalized UTE lung signal and UTE high percentage (based on 95% cutoff of healthy UTE lung values) was significantly different between nine healthy volunteers and sixteen ILD patients. Longitudinal change in UTE biomarkers correlated with change in CT CALIPER ILD% in the ILD patients, and most-strongly correlated to CT ground-glass changes in the lung parenchyma.

Andrew D Hahn^1,2, Nara S Higano^3,4,5, Matthew M Willmering^3,4,6, Neil J Stewart^6,7, Jason C Woods^3,4,5,6,8,9, and Sean B Fain^1,2
1Department of Radiology, University of Iowa, Iowa City, IA, United States, ²Department of Medical Physics, University of Wisconsin, Madison, Madison, WI, United States, ³Division of Pulmonary Medicine, Cincinnati Children's Hospital, Cincinnati, OH, United States, ⁴Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, United States, ⁵Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States, ⁶Center for Pulmonary Imaging Research, Cincinnati Children's Hospital, Cincinnati, OH, United States, ⁷POLARIS, Imaging Sciences, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, ⁸Department of Radiology, University of Cincinnati, Cincinnati, OH, United States, ⁹Department of Physics, University of Cincinnati, Cincinnati, OH, United States

State-of-the-art structural pulmonary MRI of neonatal intensive care unit patients has previously been performed using 3D radial UTE.  Performance is high yet scan times can be 15 minutes or more due to the low sampling efficiency of radial trajectories.  Here we explore FLORET UTE in this application and demonstrate comparable image quality to the state-of-the-art in approximately 25% of the scan time.  Lung parenchymal SNR is maintained, and the spiral trajectory provides a higher parenchymal signal relative to muscle.  Shorter scan times reduce the opportunity for bulk motion and risk to this sensitive population.

Felicia Seemann¹, Ahsan Javed¹, Rachel Chae¹, Amanda Potersnak¹, Scott Baute¹, Kendall O’Brien¹, Rajiv Ramasawmy¹, Robert J Lederman¹, and Adrienne E Campbell-Washburn^1
1Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States

Quantification of changes in lung water using MRI may provide clinical value in early diagnosis of heart failure. In this study, we demonstrate the ability of our 3D free-breathing spiral ultrashort-TE sequence to quantify and capture changes in lung water using a high-performance 0.55T MRI system. A phantom containing mixtures of water and deuterium oxide at varying concentrations was used to validate water density quantification. Our proposed approach captured the gravity-induced redistribution of lung water, achieved by imaging subjects in the supine and prone positions.