PMID- 30846475 OWN - NLM STAT- MEDLINE DCOM- 20201028 LR - 20240327 IS - 1399-3003 (Electronic) IS - 0903-1936 (Print) IS - 0903-1936 (Linking) VI - 53 IP - 5 DP - 2019 May TI - Xenon-129 MRI detects ventilation deficits in paediatric stem cell transplant patients unable to perform spirometry. LID - 10.1183/13993003.01779-2018 [doi] LID - 1801779 AB - BACKGROUND: Early detection of pulmonary morbidity following haematopoietic stem cell transplantation (HSCT) remains an important challenge for intervention, primarily due to the insensitivity of spirometry to early change, and in paediatrics, patient compliance provides additional challenges. Regional lung ventilation abnormalities in paediatric HSCT patients were quantified using hyperpolarised xenon-129 ((129)Xe) magnetic resonance imaging (MRI) and compared to spirometry. METHODS: Medically stable, paediatric allogeneic HSCT patients (n=23, ages 6-16 years) underwent an outpatient MRI scan where regional ventilation was quantified with a breath-hold of hyperpolarised (129)Xe gas. Ventilation deficits, regions of the lung that ventilate poorly due to obstruction, were quantified as a ventilation defect percentage (VDP) and compared to forced expiratory volume in 1 s (FEV(1)), FEV(1)/forced vital capacity (FVC) ratio, and forced expiratory flow at 25-75% of FVC (FEF(25-75%)) from spirometry using linear regression. RESULTS: The mean+/-sd (129)Xe VDP was 10.5+/-9.4% (range 2.6-41.4%). (129)Xe VDP correlated with FEV(1), FEV(1)/FVC ratio and FEF(25-75%) (p80%), supporting the sensitivity of (129)Xe MRI to early obstruction reported in other pulmonary conditions. Seven (30%) patients could not perform spirometry, yet ventilation deficits were observed in five of these patients, detecting abnormalities that otherwise may have gone undetected and untreated until advanced. CONCLUSION: Lung ventilation deficits were detected using hyperpolarised (129)Xe gas MRI in asymptomatic paediatric HSCT patients and in a subgroup who were unable to perform reliable spirometry. (129)Xe MRI provides a reliable imaging-based assessment of pulmonary involvement in this potentially difficult to diagnose paediatric population. CI - Copyright (c)ERS 2019. FAU - Walkup, Laura L AU - Walkup LL AUID- ORCID: 0000-0002-5060-6401 AD - Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Dept of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - Myers, Kasiani AU - Myers K AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - El-Bietar, Javier AU - El-Bietar J AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. AD - Deceased 19 December 2017. FAU - Nelson, Adam AU - Nelson A AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - Willmering, Matthew M AU - Willmering MM AUID- ORCID: 0000-0002-4356-9622 AD - Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Dept of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - Grimley, Michael AU - Grimley M AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - Davies, Stella M AU - Davies SM AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - Towe, Christopher AU - Towe C AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. FAU - Woods, Jason C AU - Woods JC AD - Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Dept of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA Jason.woods@cchmc.org. AD - Dept of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. AD - Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. LA - eng GR - K99 HL138255/HL/NHLBI NIH HHS/United States GR - T32 HL007752/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20190502 PL - England TA - Eur Respir J JT - The European respiratory journal JID - 8803460 RN - 0 (Xenon Isotopes) RN - 0 (Xenon-129) SB - IM MH - Adolescent MH - Child MH - Female MH - Forced Expiratory Volume MH - *Hematopoietic Stem Cell Transplantation MH - Humans MH - Linear Models MH - Lung/*diagnostic imaging/*physiopathology MH - Magnetic Resonance Imaging/*methods MH - Male MH - Pulmonary Ventilation MH - Respiratory Function Tests MH - Spirometry MH - Vital Capacity MH - *Xenon Isotopes PMC - PMC6945824 MID - NIHMS1065902 COIS- Conflict of interest: L.L. Walkup has nothing to disclose. Conflict of interest: K. Myers reports personal fees from Novartis and Bellicum, outside the submitted work. Conflict of interest: A. Nelson has nothing to disclose. Conflict of interest: M.M. Willmering has nothing to disclose. Conflict of interest: M. Grimley has nothing to disclose. Conflict of interest: S.M. Davies has nothing to disclose. Conflict of interest: C. Towe has nothing to disclose. Conflict of interest: J.C. Woods reports grants from and consultancy for Vertex Pharmaceuticals, and grants from Grifols, Inc., outside the submitted work. EDAT- 2019/03/09 06:00 MHDA- 2020/10/29 06:00 PMCR- 2020/01/07 CRDT- 2019/03/09 06:00 PHST- 2018/09/18 00:00 [received] PHST- 2019/02/06 00:00 [accepted] PHST- 2019/03/09 06:00 [pubmed] PHST- 2020/10/29 06:00 [medline] PHST- 2019/03/09 06:00 [entrez] PHST- 2020/01/07 00:00 [pmc-release] AID - 13993003.01779-2018 [pii] AID - 10.1183/13993003.01779-2018 [doi] PST - epublish SO - Eur Respir J. 2019 May 2;53(5):1801779. doi: 10.1183/13993003.01779-2018. Print 2019 May.