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Quantification of lung microstructure with hyperpolarized ³He diffusion MRI

Department of ¹Radiology, Washington University, St. Louis, Missouri; ; Department of ²Physics, Washington University, St. Louis, Missouri; and ; Department of ³Surgery, Washington University, St. Louis, Missouri; and ; ⁴St. Paul's Hospital, Vancouver, British Columbia, Canada

Submitted 14 April 2009 ; accepted in final form 4 August 2009

The structure and integrity of pulmonary acinar airways and their changes in different diseases are of great importance and interest to a broad range of physiologists and clinicians. The introduction of hyperpolarized gases has opened a door to in vivo studies of lungs with MRI. In this study we demonstrate that MRI-based measurements of hyperpolarized ³He diffusivity in human lungs yield quantitative information on the value and spatial distribution of lung parenchyma surface-to-volume ratio, number of alveoli per unit lung volume, mean linear intercept, and acinar airway radii—parameters that have been used by lung physiologists for decades and are accepted as gold standards for quantifying emphysema. We validated our MRI-based method in six human lung specimens with different levels of emphysema against direct unbiased stereological measurements. We demonstrate for the first time MRI images of these lung microgeometric parameters in healthy lungs and lungs with different levels of emphysema (mild, moderate, and severe). Our data suggest that decreases in lung surface area per volume at the initial stages of emphysema are due to dramatic decreases in the depth of the alveolar sleeves covering the alveolar ducts and sacs, implying dramatic decreases in the lung's gas exchange capacity. Our novel methods are sufficiently sensitive to allow early detection and diagnosis of emphysema, providing an opportunity to improve patient treatment outcomes, and have the potential to provide safe and noninvasive in vivo biomarkers for monitoring drug efficacy in clinical trials.

chronic obstructive pulmonary disease; lung morphometry; alveolar number; emphysema; alveolar size

http://bmr.wustl.edu/dmitriy/