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Estimation of pulmonary motion in healthy subjects and patients with intrathoracic tumors using 3D-dynamic MRI: initial results.

Plathow C, Schoebinger M, Herth F, Tuengerthal S, Meinzer HP, Kauczor HU - Korean J Radiol (2009 Nov-Dec)

Bottom Line: Using global spirometry, an improvement could also be shown (vital capacity 2.9 +/- 0.5 versus 3.4 L +/- 0.6, FEV1 0.9 +/- 0.2 versus 1.4 +/- 0.2 L) after CHT, but this improvement was not significant.A 3D-dynamic MRI is able to quantify intraparenchymal lung motion.Local and global parenchymal pathologies can be precisely located and might be a new tool used to quantify even slight changes in lung motion (e.g. in therapy monitoring, follow-up studies or even benign lung diseases).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, German Cancer Research Center Heidelberg, Germany. christian.plathow@uniklinikfreiburg.de

ABSTRACT

Objective: To estimate a new technique for quantifying regional lung motion using 3D-MRI in healthy volunteers and to apply the technique in patients with intra- or extrapulmonary tumors.

Materials and methods: Intraparenchymal lung motion during a whole breathing cycle was quantified in 30 healthy volunteers using 3D-dynamic MRI (FLASH [fast low angle shot] 3D, TRICKS [time-resolved interpolated contrast kinetics]). Qualitative and quantitative vector color maps and cumulative histograms were performed using an introduced semiautomatic algorithm. An analysis of lung motion was performed and correlated with an established 2D-MRI technique for verification. As a proof of concept, the technique was applied in five patients with non-small cell lung cancer (NSCLC) and 5 patients with malignant pleural mesothelioma (MPM).

Results: The correlation between intraparenchymal lung motion of the basal lung parts and the 2D-MRI technique was significant (r = 0.89, p < 0.05). Also, the vector color maps quantitatively illustrated regional lung motion in all healthy volunteers. No differences were observed between both hemithoraces, which was verified by cumulative histograms. The patients with NSCLC showed a local lack of lung motion in the area of the tumor. In the patients with MPM, there was global diminished motion of the tumor bearing hemithorax, which improved significantly after chemotherapy (CHT) (assessed by the 2D- and 3D-techniques) (p < 0.01). Using global spirometry, an improvement could also be shown (vital capacity 2.9 +/- 0.5 versus 3.4 L +/- 0.6, FEV1 0.9 +/- 0.2 versus 1.4 +/- 0.2 L) after CHT, but this improvement was not significant.

Conclusion: A 3D-dynamic MRI is able to quantify intraparenchymal lung motion. Local and global parenchymal pathologies can be precisely located and might be a new tool used to quantify even slight changes in lung motion (e.g. in therapy monitoring, follow-up studies or even benign lung diseases).

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Patient with malignant pleural mesothelioma in left hemithorax before (left) and after (right) chemotherapy. Substantial restriction of left-sided intrapulmonary motion can be observed. After therapy, lung motion increased slightly and in good correlation with improved lung function.
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Figure 4: Patient with malignant pleural mesothelioma in left hemithorax before (left) and after (right) chemotherapy. Substantial restriction of left-sided intrapulmonary motion can be observed. After therapy, lung motion increased slightly and in good correlation with improved lung function.

Mentions: Intraparenchymal lung motion during respiration is shown using the color map technique, before and after therapy (Fig. 4). A substantial restriction of the whole intraparenchymal lung motion in comparison with healthy volunteers (Fig. 1), is shown. A slight improvement of lung mobility can be observed after therapy. In Table 1, absolute data concerning the maximum CC motion indicate a significant improvement of the motion of the MPM-bearing hemithorax. This improvement was also found by clinically performed pulmonary function tests (vital capacity 2.9 ± 0.5 versus 3.4 ± 0.6 L, FEV1 0.9 ± 0.2 versus 1.4 ± 0.2 L), but was not proven to be significant.


Estimation of pulmonary motion in healthy subjects and patients with intrathoracic tumors using 3D-dynamic MRI: initial results.

Plathow C, Schoebinger M, Herth F, Tuengerthal S, Meinzer HP, Kauczor HU - Korean J Radiol (2009 Nov-Dec)

Patient with malignant pleural mesothelioma in left hemithorax before (left) and after (right) chemotherapy. Substantial restriction of left-sided intrapulmonary motion can be observed. After therapy, lung motion increased slightly and in good correlation with improved lung function.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2770821&req=5

Figure 4: Patient with malignant pleural mesothelioma in left hemithorax before (left) and after (right) chemotherapy. Substantial restriction of left-sided intrapulmonary motion can be observed. After therapy, lung motion increased slightly and in good correlation with improved lung function.
Mentions: Intraparenchymal lung motion during respiration is shown using the color map technique, before and after therapy (Fig. 4). A substantial restriction of the whole intraparenchymal lung motion in comparison with healthy volunteers (Fig. 1), is shown. A slight improvement of lung mobility can be observed after therapy. In Table 1, absolute data concerning the maximum CC motion indicate a significant improvement of the motion of the MPM-bearing hemithorax. This improvement was also found by clinically performed pulmonary function tests (vital capacity 2.9 ± 0.5 versus 3.4 ± 0.6 L, FEV1 0.9 ± 0.2 versus 1.4 ± 0.2 L), but was not proven to be significant.

Bottom Line: Using global spirometry, an improvement could also be shown (vital capacity 2.9 +/- 0.5 versus 3.4 L +/- 0.6, FEV1 0.9 +/- 0.2 versus 1.4 +/- 0.2 L) after CHT, but this improvement was not significant.A 3D-dynamic MRI is able to quantify intraparenchymal lung motion.Local and global parenchymal pathologies can be precisely located and might be a new tool used to quantify even slight changes in lung motion (e.g. in therapy monitoring, follow-up studies or even benign lung diseases).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, German Cancer Research Center Heidelberg, Germany. christian.plathow@uniklinikfreiburg.de

ABSTRACT

Objective: To estimate a new technique for quantifying regional lung motion using 3D-MRI in healthy volunteers and to apply the technique in patients with intra- or extrapulmonary tumors.

Materials and methods: Intraparenchymal lung motion during a whole breathing cycle was quantified in 30 healthy volunteers using 3D-dynamic MRI (FLASH [fast low angle shot] 3D, TRICKS [time-resolved interpolated contrast kinetics]). Qualitative and quantitative vector color maps and cumulative histograms were performed using an introduced semiautomatic algorithm. An analysis of lung motion was performed and correlated with an established 2D-MRI technique for verification. As a proof of concept, the technique was applied in five patients with non-small cell lung cancer (NSCLC) and 5 patients with malignant pleural mesothelioma (MPM).

Results: The correlation between intraparenchymal lung motion of the basal lung parts and the 2D-MRI technique was significant (r = 0.89, p < 0.05). Also, the vector color maps quantitatively illustrated regional lung motion in all healthy volunteers. No differences were observed between both hemithoraces, which was verified by cumulative histograms. The patients with NSCLC showed a local lack of lung motion in the area of the tumor. In the patients with MPM, there was global diminished motion of the tumor bearing hemithorax, which improved significantly after chemotherapy (CHT) (assessed by the 2D- and 3D-techniques) (p < 0.01). Using global spirometry, an improvement could also be shown (vital capacity 2.9 +/- 0.5 versus 3.4 L +/- 0.6, FEV1 0.9 +/- 0.2 versus 1.4 +/- 0.2 L) after CHT, but this improvement was not significant.

Conclusion: A 3D-dynamic MRI is able to quantify intraparenchymal lung motion. Local and global parenchymal pathologies can be precisely located and might be a new tool used to quantify even slight changes in lung motion (e.g. in therapy monitoring, follow-up studies or even benign lung diseases).

Show MeSH
Related in: MedlinePlus