For families weighing years of lung scans against repeated radiation exposure, researchers in Sheffield say a new kind of MRI is changing the equation.

Scientists at the University of Sheffield’s POLARIS research group have been developing a pulmonary MRI technique that uses a specially prepared form of xenon gas. The university says the method is already helping doctors identify early signs of lung disease in children with cystic fibrosis without using radiation, and it is now being used in patient care at Sheffield Children’s Hospital.

MRI is already widely used because it creates detailed images with magnetic fields and radio waves rather than ionizing radiation. But lungs have long been difficult to scan with MRI because they are mostly filled with air, which produces relatively little of the conventional MRI signal, and because they are constantly moving as a patient breathes.

The Sheffield team’s approach uses hyperpolarized Xenon-129, which patients inhale before the scan. The gas creates a strong signal that an MRI scanner can detect inside the lungs.

“Patients are asked to inhale the Xenon gas, hold their breath for a few seconds while the scanner collects the images and then breathe the gas away,” Professor Jim Wild, who leads the POLARIS research group, explained.

The images show where air is and is not reaching inside the lungs. Because some of the xenon also dissolves through lung tissue and into the bloodstream, researchers can also collect information about how the lungs transfer gases from the air into the blood.

Combined with other advanced MRI techniques, doctors can potentially assess ventilation, blood flow, lung structure and gas exchange without exposing patients to ionizing radiation.

Researchers have investigated pulmonary MRI in cystic fibrosis, severe asthma, interstitial lung disease and pulmonary vascular disorders. The Sheffield team says its xenon MRI technique has revealed lung abnormalities that routine tests did not detect.

In children with cystic fibrosis, POLARIS researchers found details of ventilation difficulties that had not been picked up on previous CT scans. Sheffield Children’s Hospital is now using the MRI method to detect early functional lung disease in those patients, which the university says is the first of its kind in the UK.

The scan takes only a few minutes. Some newer pulmonary MRI techniques can acquire images in as little as 4 seconds, which can help with children who find it difficult to stay still or hold their breath for long periods.

The team is now working with GE HealthCare to develop hardware and software that could allow hyperpolarized xenon imaging on existing MRI systems. POLARIS is also supporting new clinical sites around the world with the equipment and expertise needed to perform the scans.

Wild said the collaboration could “make the revolutionary imaging available to more patients”.

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