XeBox-E10 Gas Polarizer for Functional MRI of Pediatric Lung Disease

描述（由申请人提供）：本提案支持在儿科患者群体中创建稳健和安全的肺部磁共振成像（MRI）所需的基础设施。儿科肺部疾病的评估和治疗具有挑战性，因为现有的测量疾病严重程度的工具是不够的。包括婴儿肺功能测试（PFTs）在内的肺量测定法已被证明不足以评估轻度肺部疾病，特别是在囊性纤维化（CF）中，尽管使用电离辐射，x射线CT和胸部x线摄影仍发挥着越来越大的作用。支气管肺发育不良（BPD）是一种早产儿疾病，也是根据异常影像学表现诊断的，至少30%的32周前出生的婴儿出生体重<1000g。在BPD的动物模型中，肺的肺泡化和血管化被阻止，导致气体交换单位组织不良。然而，如果不使用灵敏度和空间分辨率有限的x射线或基于放射性核素的成像方法，很难对BPD和其他早期肺部疾病的潜在结构和功能变化进行无创评估。儿童哮喘是另一种更为普遍的疾病，由于儿童难以进行必要的呼吸运动和对早期疾病进展不敏感，常规肺功能检查对其不敏感。肺部MRI的最新进展使得在单次给药超极化3He气体（一种供应有限的惰性惰性气体）期间，使用新型快速MRI方法对儿童哮喘通气进行功能成像成为可能。使用129Xe（大气中的一种微量气体）的类似进展已被应用于成人哮喘和慢性阻塞性肺病的肺部MRI，有望成为3He的更广泛替代品。此外，放射MRI的进步显著改善了以前未检测到的肺结构的水质子信号，以显示实质和气道结构和组织灌注。因此，第一次临床可行的MRI方案能够成像肺结构和功能。本提案的总体目标是将该方案转化为儿科肺部疾病的临床研究和验证。本建议书的具体目的是：1.拟定建议书。为威斯康星大学放射科开发儿科肺部MRI的临床基础设施，包括升级硬件的新型MR750w，用于8个接收通道的多核光谱，成本和时间效率高的商用129Xe气体偏振器，以确保气体的安全生产和管理，以及设计用于在自由呼吸条件下成像水质子和129Xe气体的儿科胸部rf线圈，以进行结构功能比较；将通气/灌注MRI应用于哮喘、CF和BPD早期疾病的临床研究，同时支持正在进行的成人肺部疾病研究并扩展到新的机会。

DESCRIPTION (provided by applicant): This proposal supports the creation of the infrastructure required for robust and safe pulmonary magnetic resonance imaging (MRI) in the pediatric patient population. Pediatric lung disease is challenging to evaluate and treat because existing tools for measuring disease severity are inadequate. Spirometry, including infant pulmonary function tests (PFTs), has been shown to be inadequate for the assessment of mild lung disease, especially in cystic fibrosis (CF) where X-ray CT and chest radiography have played an increasing role despite their use of ionizing radiation. Bronchopulmonary dysplasia (BPD), also diagnosed based on abnormal radiographic findings is a disease of prematurity, affecting at least 30% of babies born before 32 weeks with birth weights <1000g. In animal models of BPD, alveolarization and vascularization of the lung is arrested, resulting in poorly organized gas exchange units. However, non-invasive assessment of underlying structural and functional changes in BPD and other early lung diseases is not easily performed without using X-ray or radionuclide-based imaging methods that have limited sensitivity and spatial resolution. Childhood asthma is another, more prevalent disease, for which conventional lung function tests are insensitive due to the child's difficulty performing the necessary respiratory maneuvers and their insensitivity to early disease progression. Recent advances in pulmonary MRI have enabled functional imaging of ventilation in childhood asthma using novel fast MRI methods during single bolus delivery of hyperpolarized 3He gas, an inert noble gas of limited supply. Similar advances using 129Xe, a trace gas in the atmosphere, have been applied to lung MRI in adult asthma and COPD and promise a more widely available alternative to 3He. In addition, advances in radial MRI have markedly improved water proton signal from lung structures not previously detected to visualize parenchymal and airway structures and tissue perfusion. Thus, for the first time a clinically viable MRI protocol capable of imaging lung structure and function s available. The overall goal of this proposal is to translate this protocol into the clinic for reserch and validation in pediatric lung diseases. The Specific Aims of the proposal are: 1. To develop the clinical infrastructure for pediatric lung MRI in the University of Wisconsin Department of Radiology inclusive of upgraded hardware on a new MR750w for multi- nuclear spectroscopy with 8 receiver channels, a cost and time-efficient commercial 129Xe gas polarizer to enable safe production and administration of gas, and a pediatric chest RF-coil designed for imaging both water protons and 129Xe gas under free breathing conditions for structure-function comparison, and 2. To apply ventilation/perfusion MRI to clinical research investigations of early disease in asthma, CF, and BPD, while supporting ongoing studies of adult lung disease and expansion to new opportunities.