Project Details

Rapid, multi-functional MRI for infant lung disease

Neil Stewart, PhD

Summary

BACKGROUND: Bronchopulmonary dysplasia (BPD) is the leading cause of mortality in pre-term infants; affecting 10,000—15,000 babies born in the US per year, yet understanding and prognostication is poor. GAP: There is a lack of safe, robust, functional imaging methods for assessment of regional pulmonary functional impairment in infant lung diseases, such as BPD. HYPOTHESIS: Magnetic resonance imaging (MRI) with inhaled xenon-129 gas permits rapid, high quality, functional imaging of regional lung ventilation and microstructure in infants within the neonatal intensive care unit (NICU) environment. Quantitative imaging biomarkers of lung ventilation and microstructural function can be derived from xenon-129 MRI that reveal characteristic phenotypes of pulmonary function impairment in BPD. METHODS: Feasibility of xenon-129 MRI on a unique NICU-based MRI scanner will be assessed in healthy infants and infants with BPD. Recruitment will be led by the national BPD center within Cincinnati Children’s Hospital Medical Center (CCHMC). Xenon-129 MRI will be performed to visualize poorly-ventilated lung regions, map microstructural alveolar-airspace size across the lung, and correlate lung function with macrostructure obtained by optimized proton MRI. RESULTS: Preliminary results indicate that xenon-129 MRI can be performed safely in infants with BPD, with an image quality comparable to that in older children / adults. Initial observations of minor ventilation abnormalities apparently unassociated with structural pathology, and potential differences in the dissolved-phase xenon-129 MR spectroscopy of pulmonary gas-exchange compared with older children and adults, are of particular interest. IMPACT: This study has the potential to improve lung disease assessment in infants, with significant impact on patient care. Preliminary data demonstrating the feasibility of phenotyping early BPD will provide the basis for further multi-site studies to promote xenon-129 MRI as a promising clinical measure of child lung health.