Emphysematous changes and normal variation in smokers and COPD patients using diffusion ³He MRI

Abstract 

Introduction:

This study aims to quantify global and regional changes of diffusive motion of ³He gas within the lung, as determined by hyperpolarized ³He MR apparent diffusion coefficient (ADC) measurement, in non-smokers, smokers and chronic obstructive pulmonary disease (COPD) patients.

Methods:

Age-matched groups of six healthy non-smokers, five healthy smokers and five patients with COPD. The experiments were performed with approval from the local Research Ethics Committee. Diffusion imaging was performed following hyperpolarized ³He gas inhalation, producing ADC maps. Mean and standard deviation of the ADCs were used to compare the subject groups and assess regional variations within individuals.

Results:

The intra-individual standard deviation of ADC in the healthy smokers was significantly larger than that of the non-smoking group (P < 0.02). Compared to the non-smoking group, COPD patients had significantly higher mean and standard deviation of ADC (P < 0.01). The mean ADC in the anterior half of the chest was systematically higher than in the posterior half in the healthy non-smoking subject group.

Discussion:

This study suggests that there are regional trends in the ADC values of healthy volunteers that may have implications for the clinical interpretation of ADC values. Less homogeneous ADC values have been detected in asymptomatic smokers, indicative of damage to the distal air spaces.

Abbreviations: ADC, apparent diffusion coefficient, FEV₁, forced expiratory volume in 1s, FEV₁/FVC, FEV₁/forced vital capacity, FRC, functional residual capacity, SNR, signal-to-noise ratio

Keywords: Chronic obstructive pulmonary diseases (COPD), Emphysema, Smoking, ³He, MRI, Apparent diffusion coefficient (ADC)