Hyperpolarized Helium-3 MRI of exercise-induced bronchoconstriction during challenge and therapy

J Magn Reson Imaging. 2014 May;39(5):1230-7. doi: 10.1002/jmri.24272. Epub 2013 Sep 4.

Abstract

Purpose: To investigate the utility of hyperpolarized He-3 MRI for detecting regional lung ventilated volume (VV) changes in response to exercise challenge and leukotriene inhibitor montelukast, human subjects with exercise induced bronchoconstriction (EIB) were recruited. This condition is described by airway constriction following exercise leading to reduced forced expiratory volume in 1 second (FEV1) coinciding with ventilation defects on hyperpolarized He-3 MRI.

Materials and methods: Thirteen EIB subjects underwent spirometry and He-3 MRI at baseline, postexercise, and postrecovery at multiple visits. On one visit montelukast was given and on two visits placebo was given. Regional VV was calculated in the apical/basilar dimension, in the anterior/posterior dimension, and for the entire lung volume. The whole lung VV was used as an end-point and compared with spirometry.

Results: Postchallenge FEV1 dropped with placebo but not with treatment, while postchallenge VV dropped more with placebo than treatment. Sources of variability for VV included region (anterior/posterior), scan, and treatment. VV correlated with FEV1/ forced vital capacity (FVC) and forced expiratory flow between 25 and 75% of FVC and showed gravitational dependence after exercise challenge.

Conclusion: A paradigm testing the response of ventilation to montelukast revealed both a whole-lung and regional response to exercise challenge and therapy in EIB subjects.

Keywords: asthma; exercise; helium; imaging; therapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetates / therapeutic use*
  • Adult
  • Bronchial Diseases / diagnosis*
  • Bronchial Diseases / drug therapy*
  • Bronchodilator Agents / therapeutic use
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / drug therapy
  • Exercise Test*
  • Female
  • Helium*
  • Humans
  • Isotopes
  • Lung Volume Measurements / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Quinolines / therapeutic use*
  • Radiopharmaceuticals
  • Treatment Outcome
  • Young Adult

Substances

  • Acetates
  • Bronchodilator Agents
  • Isotopes
  • Quinolines
  • Radiopharmaceuticals
  • Helium
  • montelukast