Comparison of single breath hyperpolarized (129)Xe MRI with dynamic (19)F MRI in cystic fibrosis lung disease

PURPOSE: To quantitatively compare dynamic (19)F and single breath hyperpolarized (129)Xe MRI for the detection of ventilation abnormalities in subjects with mild cystic fibrosis (CF) lung disease. METHODS: Ten participants with stable CF and a baseline FEV1 > 70% completed a single imaging session where dynamic (19)F and single breath (129)Xe lung ventilation images were acquired on a 3T MRI scanner. Ventilation defect percentages (VDP) values between (19)F early‐breath, (19)F maximum‐ventilation, (129)Xe low‐resolution, and (129)Xe high‐resolution images were compared. Dynamic (19)F images were used to determine gas wash‐in/out rates in regions of ventilation congruency and mismatch between (129)Xe and (19)F. RESULTS: VDP values from high‐resolution (129)Xe images were greater than from low‐resolution images (P = .001), although these values were significantly correlated (r = 0.68, P = .03). Early‐breath (19)F VDP and max‐vent (19)F VDP also showed significant correlation (r = 0.75, P = .012), with early‐breath (19)F VDP values being significantly greater (P < .001). No correlation in VDP values were detected between either (19)F method or high‐res (129)Xe images. In addition, the location and volume of ventilation defects were often different when comparing (129)Xe and (19)F images from the same subject. Areas of ventilation congruence displayed the expected ventilation kinetics, while areas of ventilation mismatch displayed abnormally slow gas wash‐in and wash‐out. CONCLUSION: In CF subjects, ventilation abnormalities are identified by both (19)F and HP (129)Xe imaging. However, these ventilation abnormalities are not entirely congruent. (19)F and HP (129)Xe imaging provide complementary information that enable differentiation of normally ventilated, slowly ventilated, and non‐ventilated regions in the lungs.