Comparison of Hyperpolarized ³He and ¹²⁹Xe MR Imaging in Cystic Fibrosis Patients

In this study, we compared hyperpolarized ³He and ¹²⁹Xe images from patients with cystic fibrosis using two commonly applied magnetic resonance sequences, standard gradient echo (GRE) and balanced steady-state free precession (TrueFISP) to quantify regional similarities and differences in signal distribution and defect analysis.

Ten patients (7M/3F) with cystic fibrosis underwent hyperpolarized gas MR imaging with both ³He and ¹²⁹Xe. Six had MRI with both GRE, and TrueFISP sequences and four patients had only GRE sequence but not TrueFISP. Ventilation defect percentages (VDPs) were calculated as lung voxels with <60% of the whole-lung hyperpolarized gas signal mean and was measured in all datasets. The voxel signal distributions of both ¹²⁹Xe and ³He gases were visualized and compared using violin plots. VDPs of hyperpolarized 3 He and 129 Xe were compared in Bland-Altman plots; Pearson correlation coefficients were used to evaluate the relationships between inter-gas and inter-scan to assess the reproducibility.

A significant correlation was demonstrated between ¹²⁹Xe VDP and ³He VDP for both GRE and TrueFISP sequences (ρ = 0.78, p<0.0004). The correlation between the GRE and TrueFISP VDP for ³He was ρ = 0.98 and was ρ = 0.91 for ¹²⁹Xe. Overall, ¹²⁹Xe (27.2±9.4) VDP was higher than ³He (24.3±6.9) VDP on average on cystic fibrosis patients.

In patients with cystic fibrosis, the selection of hyperpolarized ¹²⁹Xe or ³He gas is most likely inconsequential when it comes to measure the overall lung function by VDP although ¹²⁹Xe may be more sensitive to starker lung defects, particularly when using a TrueFISP sequence.