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Title: Functional lung assessment using hyperpolarised xenon gas magnetic resonance imaging
Author: Matin, Tahreema Nihad Hashmi
ISNI:       0000 0004 6499 7188
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2016
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Purpose 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 129Xe-MRI) as a technique to evaluate regional lung function. Methods Studies were approved by the National Research Ethics Service (NRES). Eleven volunteers and 25 patients with COPD underwent HP 129Xe-MRI, pulmonary function tests (PFTs) and quantitative computerised tomography (QCT). Gravitational-dependent gradients of HP 129Xe-MRI were compared between prone and supine postures in healthy volunteers. Lobar quantification of HP 129Xe-MRI was completed in COPD patients, who also underwent time-resolved HP 129Xe-MRI and HP 129Xe-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. Results HP 129Xe-MR ventilation gradients were more marked in the supine than prone posture in healthy volunteers, whereas diffusion-weighted gradients were more uniform. HP 129Xe-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 129Xe-MRI. Differential regional ventilation change was detected with HP 129Xe-MRI post-salbutamol. Conclusion These data demonstrate technical optimisation of HP 129Xe-MRI in healthy volunteers and COPD patients. Successful generation of lobar HP 129Xe-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 129Xe-MRI in evaluating regional treatments and assessing therapeutic response. Future work will evaluate the role of HP 129Xe-MRI in patient selection for lung volume reduction therapy and as a surrogate end-point in drug development studies.
Supervisor: Matin, Tahreema Nihad Hashmi ; Gleeson, Fergus V. Sponsor: NIHR Oxford Biomedical Research Centre Programme
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Magnetic resonance imaging ; Pulmonary function ; Functional lung imaging ; Hyperpolarised xenon gas MRI