Hyperpolarized Xe MRI to Evaluate Lung Function in Patients with History of BPD

Motivation: With improved neonatal care and increased survival of very preterm infants, the incidence of bronchopulmonary dysplasia (BPD, or chronic lung disease of prematurity) has increased. Goal(s): To evaluate Xe gas-exchange MRI by investigating success rates, sensitivity, and correlations with clinical demographics and pulmonary function testing. Approach: In 24 patients, Xe ventilation, restricted diffusion, and gas-exchange MRI were collected along with pulmonary function testing and electronic health records. Results: We found hyperpolarized Xe-MRI detects ventilation, lung microstructure, and gas-exchange abnormalities in 53%, 59%, and 82% of patients, respectively. Additionally, ventilation obstruction worsened with age, and two imaging phenotypes were detected. Impact: Hyperpolarized Xe-MRI detected significant ventilation defects in 53% and lung microstructure abnormalities in 59% of bronchopulmonary dysplasia patients. Gas-exchange MRI revealed two phenotypes, with abnormalities in membrane-uptake (82%), RBC-transfer (65%), and RBC:Membrane ratio (29%).