Hyperpolarized 129Xe MRI, 99mTc scintigraphy, and SPECT in lung ventilation imaging: a quantitative comparison

J D Peiffer; Talissa Altes; Iulian C Ruset; F W Hersman; John P Mugler 3rd; Craig H Meyer; Jamie Mata; Kun Qing; Robert Thomen

doi:10.1016/j.acra.2023.10.038

Hyperpolarized ¹²⁹Xe MRI, ^99mTc scintigraphy, and SPECT in lung ventilation imaging: a quantitative comparison

Acad Radiol. 2024 Apr;31(4):1666-1675. doi: 10.1016/j.acra.2023.10.038. Epub 2023 Nov 17.

Authors

J D Peiffer¹, Talissa Altes², Iulian C Ruset³, F W Hersman³, John P Mugler 3rd⁴, Craig H Meyer⁴, Jamie Mata⁵, Kun Qing⁵, Robert Thomen⁶

Affiliations

¹ Department of Chemical and Biomedical Engineering, University of Missouri, Columbia, Missouri 65201, USA (J.D.P., R.T.).
² Department of Radiology, University of Missouri, Columbia, Missouri 65201, USA (T.A., R.T.).
³ Xemed LLC, Durham, New Hampshire 03833, USA (I.C.R., F.W.H.).
⁴ Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M., J.M., K.Q.); Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M.).
⁵ Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia 22908, USA (J.P.M., C.H.M., J.M., K.Q.).
⁶ Department of Chemical and Biomedical Engineering, University of Missouri, Columbia, Missouri 65201, USA (J.D.P., R.T.); Department of Radiology, University of Missouri, Columbia, Missouri 65201, USA (T.A., R.T.). Electronic address: thomenr@health.missouri.edu.

PMID: 37977888
PMCID: PMC11015986 (available on 2025-04-01)
DOI: 10.1016/j.acra.2023.10.038

Abstract

Rationale and objectives: The current clinical standard for functional imaging of patients with lung ailments is nuclear medicine scintigraphy and Single Photon Emission Computed Tomography (SPECT) which detect the gamma decay of inhaled radioactive tracers. Hyperpolarized (HP) Xenon-129 MRI (XeMRI) of the lungs has recently been FDA approved and provides similar functional images of the lungs with higher spatial resolution than scintigraphy and SPECT. Here we compare Technetium-99m (^99mTc) diethylene-triamine-pentaacetate scintigraphy and SPECT with HP XeMRI in healthy controls, asthma, and chronic obstructive pulmonary disorder (COPD) patients.

Materials and methods: 59 subjects, healthy, with asthma, and with COPD, underwent ^99mTc scintigraphy/SPECT, standard spirometry, and HP XeMRI. XeMRI and SPECT images were registered for direct voxel-wise signal comparisons. Images were also compared using ventilation defect percentage (VDP), and a standard 6-compartment method. VDP calculated from XeMRI and SPECT images was compared to spirometry.

Results: Median Pearson correlation coefficient for voxel-wise signal comparison was 0.698 (0.613-0.782) between scintigraphy and XeMRI and 0.398 (0.286-0.502) between SPECT and XeMRI. Correlation between VDP measures was r = 0.853, p < 0.05. VDP separated asthma and COPD from the control group and was significantly correlated with FEV1, FEV1/FVC, and FEF 25-75.

Conclusion: HP XeMRI provides equivalent information to ^99mTc SPECT and standard spirometry measures. Additionally, XeMRI is non-invasive, hence it could be used for longitudinal studies for evaluating emerging treatment for lung ailments.

Keywords: Hyperpolarized; Lungs; MRI; SPECT; Xenon.

MeSH terms

Asthma* / diagnostic imaging
Humans
Lung / diagnostic imaging
Magnetic Resonance Imaging / methods
Pulmonary Disease, Chronic Obstructive*
Respiratory Function Tests
Tomography, Emission-Computed, Single-Photon
Xenon Isotopes*

Substances

Xenon-129
Xenon Isotopes

Grants and funding

R44 HL087550/HL/NHLBI NIH HHS/United States