title: Novel Magnetic Resonance Imaging for Assessment of Bronchial Stenosis in Lung Transplant Recipients.
abstract: Bronchial stenosis in lung transplant recipients is a common disorder that adversely affects clinical outcomes. It is evaluated by spirometry, CT scanning, and bronchoscopy with significant limitations. We hypothesize that MRI using both ultrashort echo time (UTE) scans and hyperpolarized (HP)129Xe gas can offer structural and functional assessment of bronchial stenosis seen after lung transplantation. Six patients with lung transplantation-related bronchial stenosis underwent HP129Xe MRI and UTE MRI in the same session. Three patients subsequently underwent airway stent placement and had repeated MRI at 4-week follow-up. HP129Xe MRI depicted decreased ventilation distal to the stenotic airway. After airway stent placement, MRI showed that low-ventilation regions had decreased (35% vs. 27.6%, p = 0.006) and normal-ventilation regions had increased (17.9% vs. 27.6%, p = 0.04) in the stented lung. Improved gas transfer was also seen on129Xe MRI. There was a good correlation between UTE MRI and independent bronchoscopic airway diameter assessment (Pearson correlation coefficient = 0.92). This pilot study shows that UTE and HP129Xe MRI are feasible in patients with bronchial stenosis related to lung transplantation and may provide structural and functional airway assessment to guide treatment. These conclusions need to be confirmed with larger studies.
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University Medical Center, Durham, NC.
authors.forename: K
authors.initials: K
authors.lastname: Mahmood
authors.affiliation: Center for In Vivo Microscopy (CIVM), Duke University, Durham, NC.|Department of Radiology, Cardiothoracic Imaging, Duke University Medical Center, Durham, NC.
authors.forename: L
authors.initials: L
authors.lastname: Ebner
authors.affiliation: Department of Radiology, Cardiothoracic Imaging, Duke University Medical Center, Durham, NC.|Duke University Department of Computer and Electrical Engineering, Durham, NC.
authors.forename: M
authors.initials: M
authors.lastname: He
authors.affiliation: Department of Radiology, Cardiothoracic Imaging, Duke University Medical Center, Durham, NC.|Duke University Medical Physics Program, Durham, NC.
authors.forename: S H
authors.initials: SH
authors.lastname: Robertson
authors.affiliation: Department of Radiology, Cardiothoracic Imaging, Duke University Medical Center, Durham, NC.|Duke University Department of Biomedical Engineering, Durham, NC.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Radiology, Cardiothoracic Imaging, Duke University Medical Center, Durham, NC.
authors.forename: H P
authors.initials: HP
authors.lastname: McAdams
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University Medical Center, Durham, NC.
authors.forename: M M
authors.initials: MM
authors.lastname: Wahidi
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University Medical Center, Durham, NC.
authors.forename: S L
authors.initials: SL
authors.lastname: Shofer
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University Medical Center, Durham, NC.
authors.forename: Y T
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Center for In Vivo Microscopy (CIVM), Duke University, Durham, NC.|Department of Radiology, Cardiothoracic Imaging, Duke University Medical Center, Durham, NC.
authors.forename: B
authors.initials: B
authors.lastname: Driehuys
mesh_terms: D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000175:diagnosis* / Q000209:etiology; D001999:Bronchoscopy; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis* / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D016040:Lung Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D066027:Transplant Recipients; D055815:Young Adult
keywords: clinical research/practice; lung (allograft) function/dysfunction; lung transplantation/pulmonology; surgical technique