title: What makes a good pediatric transplant lung: Insights from in vivo lung morphometry with hyperpolarized3He magnetic resonance imaging.
abstract: Obtaining information on transplanted lung microstructure is an important part of the current care for monitoring transplant recipients. However, until now this information was only available from invasive lung biopsy. The objective of this study was to evaluate the use of an innovative non-invasive technique, in vivo lung morphometry with hyperpolarized ³He MRI-to characterize lung microstructure in the pediatric lung transplant population. This technique yields quantitative measurements of acinar airways' (alveolar ducts and sacs) parameters, such as acinar airway radii and alveolar depth. Six pediatric lung transplant recipients with cystic fibrosis underwent in vivo lung morphometry MRI, pulmonary function testing, and quantitative CT. We found a strong correlation between lung lifespan and alveolar depth-patients with more shallow alveoli were likely to have a negative outcome sooner than those with larger alveolar depth. Combining morphometric results with CT, we also determined mean alveolar wall thickness and found substantial increases in this parameter in some patients that negatively correlated with DLCO. In vivo lung morphometry uniquely provides previously unavailable information on lung microstructure that may be predictive of a negative outcome and has a potential to aid in lung selection for transplantation.
authors.affiliation: Department of Pediatrics, Washington University, St. Louis, MO, USA.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Fishman
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Quirk
authors.affiliation: Department of Pediatrics, Washington University, St. Louis, MO, USA.
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Sweet
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Department of Physics, Washington University, St. Louis, MO, USA.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Woods
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Gierada
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.|Department of Physics, Washington University, St. Louis, MO, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Conradi
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Siegel
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
authors.forename: Dmitriy A
authors.initials: DA
authors.lastname: Yablonskiy
mesh_terms: D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006371:Helium / Q000737:chemistry; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000502:physiology*; D016040:Lung Transplantation; D008297:Male; D010539:Permeability; D011446:Prospective Studies; D011650:Pulmonary Alveoli / Q000473:pathology; D012129:Respiratory Function Tests; D059629:Signal-To-Noise Ratio; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D006371:Helium
keywords: acinar airways; alveoli; diffusion magnetic resonance imaging; hyperpolarized gas magnetic resonance imaging; in vivo lung morphometry; lung transplantation; pediatrics