Imaging techniques have been used for decades to detect anomalies, study organ function and for diagnostic purposes. Advances in imaging techniques and image processing as well as a wider availability of lung imaging is providing an increasing amount of data and new insights into lung structure and function and their alterations in common lung diseases. Functional imaging biomarkers have the potential to better characterize individual patient phenotypes, predict disease trajectories, and help personalize therapy. The wealth of new data also confronts us with new challenges in terms of identifying, quantifying, deciphering, and standardizing image-based parameters pertaining to regional lung function.

This book reviews the basics of pulmonary functional imaging using new CT and MR techniques and describes the clinical applications of these techniques in detail. The intention is to equip readers with a full understanding of pulmonary functional imaging that will allow optimal application of all relevant techniques in the assessment of a variety of diseases, including COPD, asthma, cystic fibrosis, pulmonary thromboembolism, pulmonary hypertension, lung cancer and pulmonary nodule. Pulmonary functional imaging has been promoted as a research and diagnostic tool that has the capability to overcome the limitations of morphological assessments as well as functional evaluation based on traditional nuclear medicine studies. The recent advances in CT and MRI and in medical image processing and analysis have given further impetus to pulmonary functional imaging and provide the basis for future expansion of its use in clinical applications. In documenting the utility of state-of-the-art pulmonary functional imaging in diagnostic radiology and pulmonary medicine, this book will be of high value for chest radiologists, pulmonologists, pulmonary surgeons, and radiation technologists.

For a long time, imaging of the chest was based on the use of either radiography, demonstrating lung morphology, or scintigraphy, looking at lung function. However, as a result of recent developments in CT and MRI technology it is now possible to perform dedicated investigations of different aspects of lung function, such as ventilation, perfusion, gas exchange, and respiratory mechanics. This volume, written by acknowledged experts in the field, provides a well-illustrated and comprehensive review of these novel approaches to functional imaging of the chest. It will be of great assistance to all who are establishing such strategies in the research or clinical arenas for the diagnostic work-up and follow-up of patients with lung diseases.

Fluorine-19 (19F) magnetic resonance imaging (MRI) of the lungs using inhaled inert fluorinated gases can potentially provide high quality anatomical and functional images of the lungs. This technique is able to visualize the distribution of the inhaled gas, similar to hyperpolarized (HP) helium-3 (3He) and xenon-129 (129Xe) MRI. Inert fluorinated gases have the advantages of being nontoxic, abundant, and inexpensive compared to HP gases. Due to the high gyromagnetic ratio of 19F, there is sufficient thermally polarized signal for imaging, and averaging within a single breath-hold is possible due to short longitudinal relaxation times. Since inert fluorinated gases do not need to be hyperpolarized prior to their use in MRI, this eliminates the need for an expensive polarizer and expensive isotopes. Inert fluorinated gas MRI of the lungs has been studied extensively in animals since the 1980s, and more recently in healthy volunteers and patients with lung diseases. This thesis focused on the development of static breath-hold inert fluorinated gas MR imaging techniques, as well as the development functional imaging biomarkers in humans and animal models of pulmonary disease. Optimized ultrashort echo time (UTE) 19F MR imaging was performed in healthy volunteers, and images from different gas breathing techniques were quantitatively compared. 19F UTE MR imaging was then quantitatively compared to 19F gradient echo imaging in both healthy volunteers and in a resolution phantom. A preliminary comparison to HP 3He MR imaging is also presented, along with preliminary 19F measurements of the apparent diffusion coefficient (ADC) and iv gravitational gradients of ventilation in healthy volunteers. The potential of inert fluorinated gas MRI in detecting pulmonary diseases was further explored by performing ventilation mapping in animal models of inflammation and fibrosis. Overall, interest in pulmonary 19F MRI of inert fluorinated gases is increasing, and numerous sites around the world are now interested in developing this technique. This work may help to demonstrate that inert fluorinated gas MRI has the potential to be a viable clinical imaging modality that can provide useful information for the diagnosis and management of chronic respiratory diseases.

During the past decade significant developments have been achieved in the field of magnetic resonance imaging (MRI), enabling MRI to enter the clinical arena of chest imaging. Standard protocols can now be implemented on up-to-date scanners, allowing MRI to be used as a first-line imaging modality for various lung diseases, including cystic fibrosis, pulmonary hypertension and even lung cancer. The diagnostic benefits stem from the ability of MRI to visualize changes in lung structure while simultaneously imaging different aspects of lung function, such as perfusion, respiratory motion, ventilation and gas exchange. On this basis, novel quantitative surrogates for lung function can be obtained. This book provides a comprehensive overview of how to use MRI for imaging of lung disease. Special emphasis is placed on benign diseases requiring regular monitoring, given that it is patients with these diseases who derive the greatest benefit from the avoidance of ionizing radiation.

This is the ideal resource for all those requiring an authoritative and up-to-date review of imaging appearances of diseases of the lung, pleura and mediastinum. Chest radiography and CT are integrated with other imaging techniques, including MRI and PET, where appropriate. The clinical and pathologic features of different diseases are provided in varying degrees of detail with more in depth coverage given to rarer and less well understood conditions. A single volume, comprehensive reference text on chest radiology.Provides in a single resource all of the information a generalist in diagnostic radiology needs to know. Concisely and clearly written by a team of 4 internationally recognized authors.Avoids the inconsistency, repetition, and unevenness of coverage that is inherent in multi-contributed books. Multimodality coverage integrated throughout every chapter.All of the applicable imaging modalities are covered in a clinically relevant, diagnostically helpful way. Approximately 3,000 high quality, good-sized images.Provides a complete visual guide that the practitioner can refer to for help in interpretation and diagnosis. Covers both common and uncommon disorders.Provides the user with a single comprehensive resource, no need to consult alternative resources. Access the full text online and download images via Expert Consult Access the latest version of the Fleischner Society's glossary of terms for thoracic imaging. Outlines, summary boxes, key points used throughout.Makes content more accessible by highlighting essential information. Brand new color images to illustrate Functional imaging techniques.Many of the new imaging techniques can provide functional as well as anatomic information. Introduction of a second color throughout in summary boxes in order to better highlight key information. There’s a wealth of key information in the summary boxes—will be highlighted more from the narrative text and will therefore be easier to access. Practical tips on identifying anatomic variants and artefacts in order to avoid diagnostic pitfalls.Many misdiagnoses are the result of basic errors in correlating the anatomic changes seen with imaging to their underlying pathologic processes. Latest techniques in CT, MRI and PET as they relate to thoracic diseases. The pace of development in imaging modalities and new applications/refined techniques in existing modalities continues to drive radiology forward as a specialty. Emphasis on cost-effective image/modality selection.Addresses the hugely important issue of cost-containment by emphasizing which imaging modality is helpful and which is not in any given clinical diagnosis. COPD and Diffuse Lung Disease, Small Airway disease chapters extensively up-dated. Access the full text online and download images via Expert Consult Access the latest version of the Fleischner Society's glossary of terms for thoracic imaging.