A new type of MRI scan has been created by a team of scientists and clinicians from the University of Nottingham Medical School, part of the Queen’s Medical Centre campus. The research unit was established to study respiratory diseases ranging from asthma and lung fibrosis to chronic obstructive pulmonary disease (COPD), the latter of which the World Health Organization categorizes as among the top five causes of death worldwide. Although x-rays and CT scans monitor and detect lung disease, they show only the structure of the lungs, not the details of their functionality, and they also expose the patient to small amounts of radiation, limiting repeat scanning. The new technique uses xenon 129, a specially treated harmless noble gas that is inhaled by the patient. The gas is hyperpolarized using lasers, rendering it much more detectable by the MRI scan and offering exquisitely detailed images of lung tissue. It also images the gas being absorbed into the bloodstream, providing doctors with a clear idea of how well the various parts of the lungs are transferring oxygen. Shown is an MRI of hyperpolarized xenon 129 (red) within human lungs. Courtesy of W. Kilian, Physikalisch-Technische Bundesanstalt, Berlin. The approach was tried previously using helium 3, but because this gas is difficult to obtain, it was rendered unsuitable for routine clinical work. The project, led by professor Ian Hall of the medical school and by professor Peter Morris, director of the Sir Peter Mansfield Magnetic Resonance Centre, also will include work from professor Thomas Meersman from Colorado State University in Fort Collins, who will help lead the hyperpolarization research. “This research has huge implications for the treatment and monitoring of lung disease,” Hall said. “We are very excited to be able to combine our world-renowned MRI knowledge with the clinical expertise at the Queen’s Medical Centre in Nottingham to try and develop hyperpolarized xenon MRI as the diagnostic and therapeutic monitoring tool of choice for lung-related diseases in the future.” According to Hall and Morris, the major advances in the project have been from improving the degree of hyperpolarization; e.g., frequency-narrowed lasers. “The aim is to undertake dose-ranging studies with xenon 129, to define the minimum volume required to be inhaled, to obtain useful images on regional oxygen uptake, and then to compare xenon 129 imaging with other measures used for diagnosis and monitoring of patients with lung disease, initially focusing on interstitial lung disease and COPD,” Hall said. “We are awaiting MHRA [Medicines and Healthcare Products Regulatory Agency] clearance to do clinical studies on patients in Nottingham, which should happen in 2010,” he added. The project is funded by the Engineering and Physical Sciences Research Council, GE Healthcare, the Medical Research Council, the Wolfson Foundation, East Midlands Development Agency and the University of Nottingham. This is an initial image of axial and sagittal hyperpolarized xenon glass cell phantoms. Courtesy of the University of Nottingham. Clinical trials on the use of hyperpolarized xenon/MRI in healthy volunteers are scheduled to begin in the next few months, followed by trials involving patients with COPD and lung fibrosis. Those interested in volunteering for the trials may contact the researchers at +44 115 97 09783.