Xenon-enhanced CT imaging of local pulmonary ventilation

We are using the unique features of electron beam CT (EBCT) in conjunction with respiratory and cardiac gating to explore the use of non-radioactive xenon gas as a pulmonary ventilation contrast agent. The goal is to construct accurate and quantitative high-resolution maps of local pulmonary ventilation in humans. We are evaluating xenon-enhanced computed tomography in the pig model with dynamic tracer washout/dilution and single breath inhalation imaging protocols. Scanning is done via an EBCT scanner which offers 50 msec scan aperture speeds. CT attenuation coefficients (image gray scale value) show a linear increase with xenon concentration (r equals 0.99). We measure a 1.55 Hounsfield Unit (HU) enhancement (kV equals 130, mA equals 623) per percentage increase in xenon gas concentration giving an approximately 155 HU enhancement with 100% xenon gas concentration as measured in a plexiglass super-syringe. Early results indicate that a single breath (from functional residual capacity to total lung capacity) of 100% xenon gas provides an average 32 +/- 1.85 (SE) HU enhancement in the lung parenchyma (maximum 50 HU) and should not encounter unwanted xenon side effects. However, changes in lung density occurring during even short breath holds (as short as 10 seconds) may limit using a single breath technique to synchronous volumetric scanning, currently possible only with EBCT. Preliminary results indicate close agreement between measured regional xenon concentration-time curves and theoretical predictions for the same sample. More than 10 breaths with inspirations to as high as 25 cmH2O airway pressure were needed to clear tracer from all lung regions and some regions had nearly linear rather than mono-exponential clearance curves. When regional parenchymal xenon concentration-time curves were analyzed, vertical gradients in ventilation and redistribution of ventilation at higher inspiratory flow rates were consistent with known pulmonary physiology. We present here a works in progress, showing results from two pigs illustrating the high resolution and detailed regional information obtainable with careful attention to cardiac and respiratory gating during a multi-breath washout period.