Treatment Monitoring of Pediatric Cystic Fibrosis Lung Disease using Free Breathing Lung MRI
Bibliographic record
Abstract
Hyperpolarized 129-Xenon MRI (Xe-MRI) has been shown to capture subtle ventilation defects in lung disease but requires special equipment (i.e. polarizer) and needs the patient to perform a static breath-hold of 8-15s. Alternatively, the free breathing 1-H MRI technique, phase resolved functional lung (PREFUL) MRI, does not require any special equipment and measures local changes in signal arising from lung tissue deformations corresponding to specific phases of ventilation (i.e., expiration vs. inspiration) captured in 2D slices. PREFUL MRI correlates with Xe-MRI in pediatric CF lung disease. This thesis presents the application of free breathing lung MRI to assess lung function of pediatric patients with cystic fibrosis (CF) lung disease undergoing treatment. First, the repeatability of ventilation-weighted PREFUL MRI was assessed in stable pediatric CF lung disease as compared to healthy pediatric volunteers. Similar to Xe-MRI, PREFUL MRI showed high intra-visit repeatability but moderate inter-visit repeatability in CF, which may be due to inherent disease instability. Next, PREFUL MRI was used to track ventilatory changes in CF children treated with intravenous antibiotics for a pulmonary exacerbation (PEx). Ventilation defect percentage (VDP) derived from PREFUL MRI ventilation maps showed a significant decrease in CF patients post-antibiotic treatment, in agreement with Xe-MRI. Then, PREFUL MRI was used to evaluate the effect of CF transmembrane regulator modulator treatment on pediatric CF patients. VDP and perfusion defection percentage (QDP) derived from ventilation- and perfusion-weighted PREFUL MRI maps, respectively, showed significant improvement 1-month following initiation of treatment and plateaued across 6-months and 12-month, in accordance with Xe-MRI. Finally, to assess whole lung ventilation and potentially improve signal within the lung tissue, a 3D ultra-short echo time (UTE) PREFUL MRI method was developed and compared against conventional 2D multi-slice PREFUL MRI and Xe-MRI in pediatric CF lung disease. The VDP derived from 3D UTE PREFUL MRI correlated with Xe-MRI, but the spatial matching of defects was low, possibly due to the intrinsic differences between the two methods. Thus, free breathing lung MRI with PREFUL shows potential for evaluating and monitoring treatment of CF lung disease and may be a more accessible alternative to Xe-MRI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".