Hyperpolarized Xenon-129 MRI: Narrative Review of Clinical Studies, Testing, and Implementation of Advanced Pulmonary...

Hyperpolarized xenon-129 MRI (¹²⁹XeMRI) has emerged as a powerful tool in the identification, evaluation, and assessment of disease endotyping and in response to interventions for a myriad of pulmonary diseases. Growing investigative efforts ranging from basic science to application in translational research have employed ¹²⁹XeMRI in the evaluation of pulmonary conditions such as chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), asthma, and cystic fibrosis (CF). The novel feature of ¹²⁹XeMRI is its ability to generate anatomic and physiologic readouts of the lung with resolution from the whole lung down to the lobar level. Additional advantages include being non-invasive and non-radioactive, and utilizing an inexpensive and ubiquitous noble gas as an inhalation contrast agent: xenon-129. In this review, we outline the clinical advances provided by ¹²⁹XeMRI among common pulmonary diseases with high healthcare burdens in recent decades.