Hyperpolarised 129xe MR Imaging of Lung Ventilation in Neonates with Bronchopulmonary Dysplasia: Initial Experience

Introduction: There are currently no robust, sensitive techniques to assess infant lung disease. Thus, the characterisation and management of disorders such as bronchopulmonary dysplasia (BPD) remains challenging. Inhaled hyperpolarised (HP) 129Xe MRI is a safe, sensitive means to assess lung ventilation, but has yet to be explored in infants. Here, we report our initial experience with HP 129Xe MRI in neonates with BPD. Methods: Two preterm neonates with severe BPD (born at 24, 22 wk gestation; scanned at 41, 43 wk) were imaged under parental consent and IRB approval. A multi-nuclear 1.5T neonatal-sized MRI system was used. A neonatologist delivered 129Xe gas (50:50 mix with N2) by compressing a Tedlar bag into a face mask at 15cm H2O to induce a ≤3s apnea. Coronal 129Xe MR images were continuously acquired at 7 slices per second using 2D spiral-based techniques. Results: Heart-rate and SpO2 remained within 40 bpm and 8% of baseline 2 minutes post-inhalation. 129Xe MRI of lung ventilation showed good image quality across ~5 temporal phases (SNR ~20), with sufficient sensitivity to detect mild ventilation abnormalities in both subjects (Figure; arrows). Conclusion: Our initial experience indicates that HP 129Xe MRI of lung ventilation is safe and technically feasible in neonates with BPD. With further data, this technique has the potential to be used in infant lung disease assessment and management.