ISBE-AstraZeneca Strategic Alliance – Work Plan - Project #38
Oxygen enhanced MR imaging of the lung
Project commencement date: May 2006
Research Project Period: to Dec 2006
Research and Supervisory Staff: Deirdre McGrath, Geoff Parker, Lars Ollson, Tony Lacey
Name of Supervisor: Geoff Parker
Programme of research work (the “Research Project”)
Project Aim
I) To assess oxygen enhanced magnetic resonance imaging as a technique to investigate regional lung function in chronic obstructive pulmonary disease (COPD).
II) To assess the similarities and differences in lung perfusion and oxygenation.
III) To compare results with those from other lung function tests such as spirometry.
Rationale: The principle objective of the research is to assess oxygen enhanced magnetic resonance imaging as a technique to investigate regional lung function in chronic obstructive pulmonary disease (COPD). We will map the time course of oxygen uptake in the lungs of patients suffering from obstructive lung diseases using magnetic resonance imaging to provide quantitative information about regional ventilation in the lung. We will investigate global and regional differences in oxygen uptake between a group of patients and a control group of volunteers. We will evaluate the applicability of these techniques to the patient group and will further develop them as necessary. The secondary objective is to assess the similarities and differences in lung perfusion and oxygenation by carrying out DCE-MRI on the same subjects to obtain lung perfusion measures.
Background and Previous Literature
Chronic obstructive pulmonary disease or COPD is a group of debilitating conditions including emphysema and chronic bronchitis which involve obstruction of the airways. It is the fourth largest cause of death in the US. There is currently no cure for COPD but a number of new treatments are in development. Standard methods of assessment of the disease provide information about whole lung function but evaluating the efficacy of new treatments will require a more regional investigation. Oxygen-enhanced magnetic resonance (MR) imaging visualises the uptake of oxygen in lung tissue and has the potential to provide a minimally invasive regional assessment of disease progression.
Oxygen-enhanced MR imaging uses oxygen as a contrast agent. Oxygen is paramagnetic and when it is dissolved in water it changes the longitudinal MRI relaxation time, T1. This means that the signal intensity in the image is different when dissolved oxygen is present. By comparing images taken with a subject breathing air (21% oxygen) and 100% oxygen we can visualise the uptake of oxygen into the lung parenchyma. The method was first demonstrated in 1996 [1] and has recently been shown to correlate with diffusing capacity of the lung [2]. To date there have been a number of studies of change in relative signal intensity or T1 between breathing air and 100% O2 [1-4] but limited work on dynamic measurements [5,6]. In a pilot study on volunteers we have optimized the acquisition protocol for dynamic measurements and developed an image registration technique that allows improved regional determination of T1 change and oxygen uptake[7].
Lung perfusion may be measured using intravenous contrast agents[8]. Pulmonary function is dependent upon adequate perfusion in addition to adequate ventilation. Examination of the similarities and differences in the regional perfusion and ventilation will provide additional quantitative information for understanding the lung function in individual patients
[1] Edelman R R et al, Nature Medicine, 2, 1236 (1996)
[2] Ohno Y et al, Magn Reson Med, 47, 1139 (2002)
[3] Loffler R et al, Magn Reson, Med, 43, 860 (2000)
[4] Mai Vu M et al, Magn Reson Med, 49, 591 (2003)
[5] Hatabu H et al, Eur J Radiol, 37, 172 (2001)
[6] Muller C J et al, Radiology 222, 499 (2002)
[7] Naish J H et al, Magn Reson Med, 54,464-469 (2005)
[8] Parker G J et al, Proc. Int. Soc. Magn. Reson. Med., 1255 (2003)
Proposed Work Plan
· Finalise OE-MRI protocol on healthy volunteers
· Verify collaborating clinicians (Jurgen Vestbo, David Singh)
· Verify suitable patient group and aged matched normals.
· Apply for ethics approval.
· Scan patients and volunteers.
· Report in publications
Milestones
· Find clinician, verify can recruit patients
· Ethics approval
· Analysis of patient data.
Outputs (1) Information sought for AstraZeneca:
Function measures of lung function, gas transfer and regional ventilation.
Outputs (2) Publication opportunities:
Journals (MRM, JMRI)
Conferences: ISMRM
Project Management
Payment Schedule
Use of University Intellectual Property/third party Intellectual Property
Ethical/Home Office approvals and authorisations
Ethics approval required for patient study.
Signature page overleaf
Signed by Dr. Geoff Parker______
Title: Lecturer
Date: / Signed by Dr Tony Lacey
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Title: Senior Informatician
Date:
Signed by Chris Taylor
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Title: Professor
Date: / Signed by Dr John Waterton
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Title: Director of Imaging
Date:
Signed by
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Title:
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