Ward Erika R, Hedlund Laurence W, Kurylo William C, Wheeler Charles T, Cofer Gary P, Dewhirst Mark W, Marks Lawrence B, Vujaskovic Zeljko
Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA.
Int J Radiat Oncol Biol Phys. 2004 Apr 1;58(5):1562-9. doi: 10.1016/j.ijrobp.2003.12.010.
To assess the usefulness of hyperpolarized helium (3He) MRI, including apparent diffusion coefficient measurements, in the detection and evaluation of radiation-induced lung injury in rats.
Female Fischer-344 rats were treated to the right lung with fractionated dose of 40 Gy (5 x 8 Gy) using 4-MV photons. Conventional proton (1H) and hyperpolarized (3He) MRI were used to image the lungs 3-6 months after radiation treatment. Apparent diffusion coefficient (ADC) maps of hyperpolarized 3He in the lungs were calculated using a nonlinear, least-squares fitting routine on a pixel-by-pixel basis. After imaging, lungs were processed for histologic assessment of damage.
The effect of radiation was time dependent with progressive right lung damage ranging from mild to moderate at 3 months to severe fibrosis with structural deformation at 6 months after radiation. There was a significant decrease in the apparent diffusion coefficient of hyperpolarized 3He gas in radiation-treated lungs. Areas of decreased ADC in the lungs correlated with fibrosis shown by histology.
This is the first study to show that hyperpolarized 3He MRI can detect radiation-induced lung injury noninvasively. Reduced hyperpolarized 3He ADC values postradiation likely reflect reduced alveolar volumes associated with fibrosis of the interstitium. Future studies at earlier time points may determine whether this noninvasive imaging technique can detect lung damage before clinical symptoms. Development of this new approach of magnetic resonance lung imaging in the rat model of radiation-induced lung injury will increase the ability to develop appropriate algorithms and more accurate models of the normal tissue complication probability.
评估超极化氦(³He)磁共振成像(MRI),包括表观扩散系数测量,在大鼠放射性肺损伤检测和评估中的作用。
雌性Fischer-344大鼠右肺接受4-MV光子的分次剂量40 Gy(5×8 Gy)照射。在放射治疗后3至6个月,使用传统质子(¹H)和超极化(³He)MRI对肺部进行成像。基于逐像素的非线性最小二乘拟合程序计算肺部超极化³He的表观扩散系数(ADC)图。成像后,对肺部进行处理以进行损伤的组织学评估。
放射效应具有时间依赖性,放射后3个月时右肺损伤逐渐加重,从轻度到中度,至6个月时出现严重纤维化并伴有结构变形。放射治疗的肺部中,超极化³He气体的表观扩散系数显著降低。肺部ADC降低的区域与组织学显示的纤维化相关。
这是第一项表明超极化³He MRI可无创检测放射性肺损伤的研究。放射后超极化³He的ADC值降低可能反映了与间质纤维化相关的肺泡体积减小。未来在更早时间点的研究可能会确定这种无创成像技术是否能在出现临床症状之前检测到肺部损伤。在放射性肺损伤大鼠模型中开发这种新的磁共振肺部成像方法将提高开发合适算法和更准确的正常组织并发症概率模型的能力。