Assessment of Post-Transplant Lung Function Alterations Using Free-Breathing Hyperpolarized Xenon MRI

Motivation: CLAD is the leading cause of long-term mortality in lung transplant (LTX) recipients, often diagnosed only after irreversible lung damage has occurred. Goal(s): To evaluate the effectiveness of dynamic Hyperpolarized Xenon-129 MRI in detecting early gas exchange abnormalities post LTX. Approach: We imaged lung transplant recipients, healthy controls, and COPD patients using dynamic HP-Xe MRI during free-breathing. Results: LTX recipients showed gradual declines and loss of gravitational gradients of the DP/GP over time, indicating impaired gas exchange even when appearing healthy. CLAD patients exhibited increased intraregional heterogeneity and diminished gravitational gradients, similar to patients with emphysema. Impact: The findings suggest that dynamic HP-Xe MRI is a sensitive tool for detecting early pulmonary function alterations in lung transplant recipients that traditional imaging methods might miss. This could enable earlier diagnosis and intervention of CLAD, potentially improving long-term survival.