<b>Purpose</b> Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide. The standard method for assessing lung function in COPD is spirometry, which provides global lung function information but is a poor predictor of disability and quality of life. The overall aim of this thesis is to develop utility of hyperpolarised xenon gas magnetic resonance imaging (HP <sup>129</sup>Xe-MRI) as a technique to evaluate regional lung function. <b>Methods</b> Studies were approved by the National Research Ethics Service (NRES). Eleven volunteers and 25 patients with COPD underwent HP <sup>129</sup>Xe-MRI, pulmonary function tests (PFTs) and quantitative computerised tomography (QCT). Gravitational-dependent gradients of HP <sup>129</sup>Xe-MRI were compared between prone and supine postures in healthy volunteers. Lobar quantification of HP <sup>129</sup>Xe-MRI was completed in COPD patients, who also underwent time-resolved HP <sup>129</sup>Xe-MRI and HP <sup>129</sup>Xe-MRI pre- and post-salbutamol to determine feasibility of detecting regional delayed ventilation and post-intervention change. The relationship between study measures was assessed using Pearson's correlation coefficient. <b>Results</b> HP <sup>129</sup>Xe-MR ventilation gradients were more marked in the supine than prone posture in healthy volunteers, whereas diffusion-weighted gradients were more uniform. HP <sup>129</sup>Xe-MRI was successfully quantified according to pulmonary lobes and correlated with lobar lung anatomy (QCT) and global functional transfer capability (TLCO) (r=-0.61, p<0.005). Delayed ventilation was observed with time-resolved breath-hold HP <sup>129</sup>Xe-MRI. Differential regional ventilation change was detected with HP <sup>129</sup>Xe-MRI post-salbutamol. <b>Conclusion</b> These data demonstrate technical optimisation of HP <sup>129</sup>Xe-MRI in healthy volunteers and COPD patients. Successful generation of lobar HP <sup>129</sup>Xe-MRI parameters offers an automated analysis method that can be adopted into the clinical workflow. Finally proof-of-principle data have identified roles for HP <sup>129</sup>Xe-MRI in evaluating regional treatments and assessing therapeutic response. Future work will evaluate the role of HP <sup>129</sup>Xe-MRI in patient selection for lung volume reduction therapy and as a surrogate end-point in drug development studies.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:730001 |
| Date | January 2016 |
| Creators | Matin, Tahreema Nihad Hashmi |
| Contributors | Matin, Tahreema Nihad Hashmi ; Gleeson, Fergus V. |
| Publisher | University of Oxford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://ora.ox.ac.uk/objects/uuid:61e77bfb-67d9-4221-b246-4a5cd66b5144 |
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