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. 2023 Jun:83:100993.
doi: 10.1016/j.resmer.2023.100993. Epub 2023 Jan 9.

Simultaneous multiple breath washout and oxygen-enhanced magnetic resonance imaging in healthy adults

Anne-Christianne Kentgens  1 , Orso Pusterla  2 , Grzegorz Bauman  2 , Francesco Santini  2 , Florian Wyler  3 , Marion S Curdy  3 , C Corin Willers  4 , Oliver Bieri  2 , Philipp Latzin  3 , Kathryn A Ramsey  3
Affiliations
Free article

Simultaneous multiple breath washout and oxygen-enhanced magnetic resonance imaging in healthy adults

Anne-Christianne Kentgens et al. Respir Med Res. 2023 Jun.
Free article

Abstract

Lung function testing and lung imaging are commonly used techniques to monitor respiratory diseases, such as cystic fibrosis (CF). The nitrogen (N2) multiple-breath washout technique (MBW) has been shown to detect ventilation inhomogeneity in CF, but the underlying pathophysiological processes that are altered are often unclear. Dynamic oxygen-enhanced magnetic resonance imaging (OE-MRI) could potentially be performed simultaneously with MBW because both techniques require breathing of 100% oxygen (O2) and may allow for visualisation of alterations underlying impaired MBW outcomes. However, simultaneous MBW and OE-MRI has never been assessed, potentially as it requires a magnetic resonance (MR) compatible MBW equipment. In this pilot study, we assessed whether MBW and OE-MRI can be performed simultaneously using a commercial MBW device that has been modified to be MR-compatible. We performed simultaneous measurements in five healthy volunteers aged 25-35 years. We obtained O2 and N2 concentrations from both techniques, and generated O2 wash-in time constant and N2 washout maps from OE-MRI data. We obtained good quality simultaneous measurements in two healthy volunteers due to technical challenges related to the MBW equipment and poor tolerance. Oxygen and N2 concentrations from both techniques, as well as O2 wash-in time constant maps and N2 washout maps could be obtained, suggesting that simultaneous measurements may have the potential to allow for comparison and visualization of regional differences in ventilation underlying impaired MBW outcomes. Simultaneous MBW and OE-MRI measurements can be performed with a modified MBW device and may help to understand MBW outcomes, but the measurements are challenging and have poor feasibility.

Keywords: Cystic fibrosis; Diagnostics; Lung function; Lung imaging; Ventilation inhomogeneity; oxygen-enhanced MRI.

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Conflict of interest statement

Conflict of interest statement Eco Medics AG (Duernten, Switzerland) produced the customized MBW setup and a research version of their commercial software Spiroware 3.3. A.C. Kentgens is recipient of a Swiss Government Excellence Scholarship from the Swiss Confederation, Federal Department of Economic Affairs, Education and Research (EAER). F. Santini reports research grants from the Swiss National Science Foundation and consulting fees of Hoffmann – La Roche paid to the institution. P. Latzin reports grants from Vertex and OM Pharma paid to the institution; personal payments or honoraria from Vertex, Vifor and OM Pharma; payments or honoraria from Vertex, Vifor and OM Pharma paid to the institution; personal fees for participation on a Data Safety Monitoring Board or Advisory Board from Polyphor, Santhera (DMC), Vertex, OM pharma, Vifor and Sanofi Aventis; and fees for participation on a Data Safety Monitoring Board or Advisory Board from Polyphor, Vertex, OM pharma and Vifor paid to the institution, all outside the submitted work. K.A. Ramsey reports a grant from Vertex paid to the institution. Otherwise, all other authors report no other competing interests.