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Conference Abstract: Longitudinal change in hyperpolarised 129Xe MRS in ILD

Longitudinal change in hyperpolarised 129-xenon MR spectroscopy in interstitial lung disease (Conference Abstract)

James Eaden, Paul Hughes, Guilhem Collier, Graham Norquay, Nicholas Weatherly, Matthew Austin, Laurie Smith, Jim Lithgow, Andrew Swift, Stephen Renshaw, Maya Buch, Colm Leonard, Sarah Skeoch, Nazia Chaudhuri, Geoff Parker, Stephen Bianchi, Jim Wild


European Respiratory Journal 2019 54: PA3158 doi: 10.1183/13993003.congress-2019.PA3158 .

Abstract

Introduction: Hyperpolarised 129-xenon (129Xe) MR spectroscopy (MRS) can be used as a quantitative marker of gas exchange in interstitial lung disease (ILD). The ratio of the uptake of 129Xe in the red blood cells to the tissue/plasma (RBC:TP) has been shown to be reduced by 70% in idiopathic pulmonary fibrosis (IPF) patients when compared with healthy volunteers (Kaushik, S.S. et al. J Appl Physiol 2014; 117:577-585). In IPF, a significant decline in 129Xe RBC:TP over 12 months has been demonstrated but no significant change in DLCO or KCO (Weatherley, N.D. et al. Thorax 2018 [Epub ahead of print]).

Aim: To compare longitudinal changes in 129Xe RBC:TP with changes in FVC and DLCO between ILD subtypes.

Methods: A prospective, multicentre study of ILD patients including drug induced ILD (DI-ILD), hypersensitivity pneumonitis (HP), IPF and connective tissue disease ILD (CTD-ILD). Hyperpolarised 129Xe MRS was performed on a 1.5 T scanner.

Results: To date, 18 patients (5 DI-ILD, 5 HP, 6 IPF, 2 CTD-ILD) have undergone 129Xe MRS on two separate visits (6 weeks apart for DI-ILD/HP and 6 months apart for IPF/CTD-ILD). There was a significant difference in longitudinal change in RBC:TP between the HP and IPF groups (p=0.022). Median change in RBC:TP in the HP and IPF groups was 0.022 and -0.023 respectively. There was no significant difference in longitudinal change in FVC% predicted (p=0.79) or DLCO% predicted (p=0.39) between the ILD subtypes.

Conclusions: Our findings demonstrate that 129Xe RBC:TP has sensitivity to longitudinal change with significant differences between IPF and HP patients, whilst FVC and DLCO showed no change, suggesting that RBC:TP is more sensitive to change than PFTs in ILD.