Detection of longitudinal lung structural and functional changes after diagnosis of radiation-induced lung injury using hyperpolarized 3He magnetic resonance imaging
Detection of longitudinal lung structural and functional changes after diagnosis of radiation-induced lung injury using hyperpolarized 3He magnetic resonance imaging
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DOI：
10.1118/1.3263616
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发表时间：
2010-01-01
期刊：
影响因子：
3.8
通讯作者：
Parraga, Grace
中科院分区：
文献类型：
--
作者：
Mathew, Lindsay;Gaede, Stewart;Parraga, Grace
目的：胸部肿瘤的治疗剂量受到明显限制，以减少非肿瘤组织损伤的风险，但仍有1/3以上的胸部放射治疗病例发生放射性肺损伤(RILI)。虽然临床上可以使用肺功能测量来监测RILI，但对损伤的局部功能影响还不是很清楚。超极化He-3磁共振成像提供了高空间和时间分辨率的局部肺功能和结构测量；作者首次在临床诊断RILI后对7名受试者进行了纵向测量，以更好地了解RILI后局部肺功能和结构的变化。方法：所有受试者在放疗开始后3.0T35.1+/-12.2周进行肺功能和结构的测量。采集胸部H-1、He-3静态通气量和He-3弥散加权图像，生成He-3表观扩散系数(ADC)和He-3通气量百分比(PVV)。结果：基础状态下，患侧肺活量显著低于健侧(P=0.025)，对侧肺静脉曲张发生率为88+/-5%。在纵向上，仅对侧肺的He-3MRI PVV(16%+/-6%，p=0.012)和He-3MRI ADC(0.02+/-0.01 cm(2)/S，p=0.003)显著增加，而对侧肺无明显变化。对侧肺功能改善，微结构改变，而对侧肺保持稳定，提示对侧肺可能因放射性肺损伤而发生功能代偿性改变。(C)2010年美国医学物理学家协会。[DOI：10.1118/1.3263616]
Purpose: Therapeutic radiation doses for thoracic tumors are significantly restricted to decrease the risk of nontumor tissue damage, yet radiation-induced lung injury (RILI) still occurs in over 1/3 of thoracic radiation treatment cases. Although RILI can be clinically monitored using pulmonary function measurements, the regional functional effects of the injury are not well understood. Hyperpolarized He-3 magnetic resonance imaging provides measurements of regional lung function and structure with high spatial and temporal resolution; the authors use this tool longitudinally for the first time in seven subjects after clinical diagnosis of RILI in order to better understand regional changes in lung function and structure post-RILI.Methods: All subjects underwent spirometry, plethysmography, and MRI at 3.0 T 35.1 +/- 12.2 weeks after radiation therapy commenced. Thoracic H-1, static He-3 ventilation, and He-3 diffusion-weighted images were acquired to generate the He-3 apparent diffusion coefficient (ADC) and He-3 percent ventilated volume (PVV). Four subjects returned 22.0 +/- 0.8 weeks after baseline imaging for follow-up spirometry and He-3 MRI measurements of ADC and PVV.Results: At baseline, PVV was significantly different (p = 0.025) and lower in the ipsilateral diseased lung (55 +/- 29%) compared to the contralateral nondiseased lung (88 +/- 5%). Longitudinally, significant increases were observed for He-3 MRI PVV (16% +/- 6%, p = 0.012) and He-3 MRI ADC (0.02 +/- 0.01 cm(2)/s, p = 0.003) in the contralateral lung only, in the four subjects who returned for follow-up, while no changes in the ipsilateral lung were reported.Conclusions: Hyperpolarized He-3 MRI was well tolerated in all subjects with moderate to severe RILI. Functional improvements and microstructural changes were observed in the contralateral lung, while the ipsilateral lung remained stable, suggesting that functional compensatory changes may have occurred in the contralateral lung due to ipsilateral lung radiation-induced injury. (C) 2010 American Association of Physicists in Medicine. [DOI: 10.1118/1.3263616]