Utilizing flip angle/TR equivalence to reduce breath hold duration in hyperpolarized Xe-129 1-point Dixon gas exchange imaging

Purpose To reduce scan duration in hyperpolarized Xe-129 1-point Dixon gas exchange imaging by utilizing flip angle (FA)/TR equivalence. Methods Images were acquired in 12 subjects (n = 3 radiation therapy, n = 1 unexplained dyspnea, n = 8 healthy) using both standard (TR = 15 ms, FA = 20 degrees, duration = 15 s, 998 projections) and "fast" (TR = 5.4 ms, FA = 12 degrees, duration = 11.3 s, 2100 projections) acquisition parameters. For the fast acquisition, 3 image sets were reconstructed using subsets of 1900, 1500, and 1000 projections. From the resulting ventilation, tissue ("barrier"), and red blood cell (RBC) images, image metrics and biomarkers were compared to assess agreement between methods. Results Images acquired using both FA/TR settings had similar qualitative appearance. There were no significant differences in SNR, image mean, or image SD between images. Moreover, the percentage of the lungs in "defect", "normal", and "high" bins for each image (ventilation, RBC, barrier) was not significantly different among the acquisition types. After registration, comparison of 3D image metrics (Dice, volume similarity, average distance) agreed well between bins. Images using 1000 projections for reconstruction had no significant differences from images using all projections. Conclusion Using flip angle/TR equivalence, hyperpolarized Xe-129 gas exchange images can be acquired via the 1-point Dixon technique in as little as 6 s, compared to similar to 15 s for previously reported parameter settings. The resulting images from this accelerated scan have no significant differences from the standard method in qualitative appearance or quantitative metrics.