This study is designed to compare the capabilities of two novel imaging techniques: polarized perfluorinated gas mixed with oxygen, and hyperpolarized xenon mixed with N2 to detect changes in lung ventilation using MRI.
The goal of this study is to compare the capabilities of two novel imaging techniques: conventional 'thermally' polarized perfluorinated gases (perfluoropropane, or PFP) mixed with oxygen, and hyperpolarized xenon (129Xe) mixed with N2 to detect changes in lung ventilation using magnetic resonance imaging (MRI). Although considerable work has been done internationally with hyperpolarized xenon MRI, the low availability and high cost of this technique is limiting. Perfluorinated gas MRI is an alternative that may in fact be a suitable, simpler alternative. PFP is commercially availability in large quantities, which allows multiple breath studies and thus provides the ability to analyze gas wash-in and wash-out kinetics. These endpoints may improve the investigators ability to detect ventilation abnormalities beyond the traditional "ventilation defect percentage" parameter obtained with 129Xe MRI. The commercial availability of PFP and lack of need for onsite hyperpolarization may also facilitate the transfer of this technology to other centers for the conduct of multicenter studies. The investigators hypothesize that 19F MRI will not be inferior to hyperpolarized xenon MRI in detection of ventilation defect percentages (VDP).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
11
Hyperpolarized Xenon gas * Hyperpolarized mixture (750ml HP 129Xe and 250ml nitrogen) * Administration: By mouthpiece attached to a single use Tedlar bag. * Dosage: 750 mL of the 129Xe mixture up to, but not exceeding, four doses of the 129Xe. * Frequency: 10-minute interval between doses.
* Inhaled PFP, a gaseous contrast agent (79% PFP; 21% O2, pre-mixed, medical grade gas) * Administration: Full-face disposable ventilation mask and a standard Douglas Bag system. * Dosage: Two controlled breaths of the contrast gas followed by a full breath and a 12-second breath-hold and scan for image acquisition. * Frequency: Repeated 5 times followed by an identical five cycles with room air to ensure PFP gas wash-out has occurred.
The University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Volume of unventilated lung area after a single 129Xe inhalation and after each inhalation cycle with PFP
Primary comparison will be the VDP with Xenon (single breath) and after first PFP inhalation cycle (3 breaths of PFP)
Time frame: 1 hour
Signal-to-noise (SNR) of each modality
Assessment of the quality of signal achieved with each modality
Time frame: 20 minutes
Rate constant describing wash-in and wash-out of PFP
change in ventilated areas of the lung over time when administered PFP
Time frame: 15 minutes
Correlation between VDP identified by each modality and spirometry and Lung Clearance Index (LCI)
Comparison of VDP to two standard metrics of lung function, spirometry and LCI
Time frame: 2 hours
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