Hyperpolarized 129Xe MRI is emerging as a unique means of imaging pulmonary gas exchange, enabling separate 3D encoding of 129Xe in the gas-phase, interstitial barrier, and red blood cells (RBC). In patients where diffusion limitation is not significant, defects in RBC transfer and perfusion deficits should more closely reflect diminished capillary blood volume or perfusion limitation. Here we establish an initial approach to correlate RBC transfer images against an accepted perfusion imaging reference— 99mTc scintigraphy. We demonstrate in patients with pulmonary arterial hypertension and COPD that RBC transfer projections compare both qualitatively and quantitatively with 99mTc scintigraphy.
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