@article{WillemsUrlichsSeidenspinneretal.2012, author = {Willems, Coen H. M. P. and Urlichs, Florian and Seidenspinner, Silvia and Kunzmann, Steffen and Speer, Christian P. and Kramer, Boris W.}, title = {Poractant alfa (Curosurf (R)) increases phagocytosis of apoptotic neutrophils by alveolar macrophages in vivo}, series = {Respiratory Research}, volume = {13}, journal = {Respiratory Research}, number = {17}, doi = {10.1186/1465-9921-13-17}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130721}, year = {2012}, abstract = {Background: Clearance of apoptotic neutrophils in the lung is an essential process to limit inflammation, since they could become a pro-inflammatory stimulus themselves. The clearance is partially mediated by alveolar macrophages, which phagocytose these apoptotic cells. The phagocytosis of apoptotic immune cells by monocytes in vitro has been shown to be augmented by several constituents of pulmonary surfactant, e. g. phospholipids and hydrophobic surfactant proteins. In this study, we assessed the influence of exogenous poractant alfa (Curosurf (R)) instillation on the in vivo phagocytosis of apoptotic neutrophils by alveolar macrophages. Methods: Poractant alfa (200 mg/kg) was instilled intratracheally in the lungs of three months old adult male C57/Black 6 mice, followed by apoptotic neutrophil instillation. Bronchoalveloar lavage was performed and alveolar macrophages and neutrophils were counted. Phagocytosis of apoptotic neutrophils was quantified by determining the number of apoptotic neutrophils per alveolar macrophages. Results: Exogenous surfactant increased the number of alveolar macrophages engulfing apoptotic neutrophils 2.6 fold. The phagocytosis of apoptotic neutrophils was increased in the presence of exogenous surfactant by a 4.7 fold increase in phagocytosed apoptotic neutrophils per alveolar macrophage. Conclusions: We conclude that the anti-inflammatory properties of surfactant therapy may be mediated in part by increased numbers of alveolar macrophages and increased phagocytosis of apoptotic neutrophils by alveolar macrophages.}, language = {en} } @article{WildMarshallBocketal.2012, author = {Wild, J. M. and Marshall, H. and Bock, M. and Schad, L. R. and Jakob, P. M. and Puderbach, M. and Molinari, F. and Van Beek, E. J. R. and Biederer, J.}, title = {MRI of the lung (1/3): methods}, series = {Insights into Imaging}, volume = {3}, journal = {Insights into Imaging}, number = {4}, doi = {10.1007/s13244-012-0176-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124238}, pages = {345-353}, year = {2012}, abstract = {Proton magnetic resonance imaging (MRI) has recently emerged as a clinical tool to image the lungs. This paper outlines the current technical aspects of MRI pulse sequences, radiofrequency (RF) coils and MRI system requirements needed for imaging the pulmonary parenchyma and vasculature. Lung MRI techniques are presented as a "technical toolkit", from which MR protocols will be composed in the subsequent papers for comprehensive imaging of lung disease and function (parts 2 and 3). This paper is pitched at MR scientists, technicians and radiologists who are interested in understanding and establishing lung MRI methods. Images from a 1.5 T scanner are used for illustration of the sequences and methods that are highlighted. Main Messages • Outline of the hardware and pulse sequence requirements for proton lung MRI • Overview of pulse sequences for lung parenchyma, vascular and functional imaging with protons • Demonstration of the pulse-sequence building blocks for clinical lung MRI protocols}, language = {en} } @article{WengHeidenreichMetzetal.2021, author = {Weng, Andreas M. and Heidenreich, Julius F. and Metz, Corona and Veldhoen, Simon and Bley, Thorsten A. and Wech, Tobias}, title = {Deep learning-based segmentation of the lung in MR-images acquired by a stack-of-spirals trajectory at ultra-short echo-times}, series = {BMC Medical Imaging}, volume = {21}, journal = {BMC Medical Imaging}, doi = {10.1186/s12880-021-00608-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260520}, year = {2021}, abstract = {Background Functional lung MRI techniques are usually associated with time-consuming post-processing, where manual lung segmentation represents the most cumbersome part. The aim of this study was to investigate whether deep learning-based segmentation of lung images which were scanned by a fast UTE sequence exploiting the stack-of-spirals trajectory can provide sufficiently good accuracy for the calculation of functional parameters. Methods In this study, lung images were acquired in 20 patients suffering from cystic fibrosis (CF) and 33 healthy volunteers, by a fast UTE sequence with a stack-of-spirals trajectory and a minimum echo-time of 0.05 ms. A convolutional neural network was then trained for semantic lung segmentation using 17,713 2D coronal slices, each paired with a label obtained from manual segmentation. Subsequently, the network was applied to 4920 independent 2D test images and results were compared to a manual segmentation using the S{\o}rensen-Dice similarity coefficient (DSC) and the Hausdorff distance (HD). Obtained lung volumes and fractional ventilation values calculated from both segmentations were compared using Pearson's correlation coefficient and Bland Altman analysis. To investigate generalizability to patients outside the CF collective, in particular to those exhibiting larger consolidations inside the lung, the network was additionally applied to UTE images from four patients with pneumonia and one with lung cancer. Results The overall DSC for lung tissue was 0.967 ± 0.076 (mean ± standard deviation) and HD was 4.1 ± 4.4 mm. Lung volumes derived from manual and deep learning based segmentations as well as values for fractional ventilation exhibited a high overall correlation (Pearson's correlation coefficent = 0.99 and 1.00). For the additional cohort with unseen pathologies / consolidations, mean DSC was 0.930 ± 0.083, HD = 12.9 ± 16.2 mm and the mean difference in lung volume was 0.032 ± 0.048 L. Conclusions Deep learning-based image segmentation in stack-of-spirals based lung MRI allows for accurate estimation of lung volumes and fractional ventilation values and promises to replace the time-consuming step of manual image segmentation in the future.}, language = {en} } @article{SagivMichaeliAssietal.2015, author = {Sagiv, Jitka Y. and Michaeli, Janna and Assi, Simaan and Mishalian, Inbal and Kisos, Hen and Levy, Liran and Damti, Pazzit and Lumbroso, Delphine and Polyansky, Lola and Sionov, Ronit V. and Ariel, Amiram and Hovav, Avi-Hai and Henke, Erik and Fridlender, Zvi G. and Granot, Zvi}, title = {Phenotypic diversity and plasticity in circulating neutrophil subpopulations in cancer}, series = {Cell Reports}, volume = {10}, journal = {Cell Reports}, number = {4}, doi = {10.1016/j.celrep.2014.12.039}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-144102}, pages = {562-573}, year = {2015}, abstract = {Controversy surrounds neutrophil function in cancer because neutrophils were shown to provide both pro-and antitumor functions. We identified a heterogeneous subset of low-density neutrophils (LDNs) that appear transiently in self-resolving inflammation but accumulate continuously with cancer progression. LDNs display impaired neutrophil function and immunosuppressive properties, characteristics that are in stark contrast to those of mature, high-density neutrophils (HDNs). LDNs consist of both immature myeloid-derived suppressor cells (MDSCs) and mature cells that are derived from HDNs in a TGF-beta-dependent mechanism. Our findings identify three distinct populations of circulating neutrophils and challenge the concept that mature neutrophils have limited plasticity. Furthermore, our findings provide a mechanistic explanation to mitigate the controversy surrounding neutrophil function in cancer.}, language = {en} } @article{RichterWechWengetal.2020, author = {Richter, Julian A. J. and Wech, Tobias and Weng, Andreas M. and Stich, Manuel and Weick, Stefan and Breuer, Kathrin and Bley, Thorsten A. and K{\"o}stler, Herbert}, title = {Free-breathing self-gated 4D lung MRI using wave-CAIPI}, series = {Magnetic Resonance in Medicine}, volume = {84}, journal = {Magnetic Resonance in Medicine}, number = {6}, doi = {10.1002/mrm.28383}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218075}, pages = {3223 -- 3233}, year = {2020}, abstract = {Purpose The aim of this study was to compare the wave-CAIPI (controlled aliasing in parallel imaging) trajectory to the Cartesian sampling for accelerated free-breathing 4D lung MRI. Methods The wave-CAIPI k-space trajectory was implemented in a respiratory self-gated 3D spoiled gradient echo pulse sequence. Trajectory correction applying the gradient system transfer function was used, and images were reconstructed using an iterative conjugate gradient SENSE (CG SENSE) algorithm. Five healthy volunteers and one patient with squamous cell carcinoma in the lung were examined on a clinical 3T scanner, using both sampling schemes. For quantitative comparison of wave-CAIPI and standard Cartesian imaging, the normalized mutual information and the RMS error between retrospectively accelerated acquisitions and their respective references were calculated. The SNR ratios were investigated in a phantom study. Results The obtained normalized mutual information values indicate a lower information loss due to acceleration for the wave-CAIPI approach. Average normalized mutual information values of the wave-CAIPI acquisitions were 10\% higher, compared with Cartesian sampling. Furthermore, the RMS error of the wave-CAIPI technique was lower by 19\% and the SNR was higher by 14\%. Especially for short acquisition times (down to 1 minute), the undersampled Cartesian images showed an increased artifact level, compared with wave-CAIPI. Conclusion The application of the wave-CAIPI technique to 4D lung MRI reduces undersampling artifacts, in comparison to a Cartesian acquisition of the same scan time. The benefit of wave-CAIPI sampling can therefore be traded for shorter examinations, or enhancing image quality of undersampled 4D lung acquisitions, keeping the scan time constant.}, language = {en} } @article{BiedererBeerHirschetal.2012, author = {Biederer, J. and Beer, M. and Hirsch, W. and Wild, J. and Fabel, M. and Puderbach, M. and Van Beek, E. J. R.}, title = {MRI of the lung (2/3). Why … when … how?}, series = {Insights into Imaging}, volume = {3}, journal = {Insights into Imaging}, number = {4}, doi = {10.1007/s13244-011-0146-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124268}, pages = {355-371}, year = {2012}, abstract = {Background Among the modalities for lung imaging, proton magnetic resonance imaging (MRI) has been the latest to be introduced into clinical practice. Its value to replace X-ray and computed tomography (CT) when radiation exposure or iodinated contrast material is contra-indicated is well acknowledged: i.e. for paediatric patients and pregnant women or for scientific use. One of the reasons why MRI of the lung is still rarely used, except in a few centres, is the lack of consistent protocols customised to clinical needs. Methods This article makes non-vendor-specific protocol suggestions for general use with state-of-the-art MRI scanners, based on the available literature and a consensus discussion within a panel of experts experienced in lung MRI. Results Various sequences have been successfully tested within scientific or clinical environments. MRI of the lung with appropriate combinations of these sequences comprises morphological and functional imaging aspects in a single examination. It serves in difficult clinical problems encountered in daily routine, such as assessment of the mediastinum and chest wall, and even might challenge molecular imaging techniques in the near future. Conclusion This article helps new users to implement appropriate protocols on their own MRI platforms. Main Messages • MRI of the lung can be readily performed on state-of-the-art 1.5-T MRI scanners. • Protocol suggestions based on the available literature facilitate its use for routine • MRI offers solutions for complicated thoracic masses with atelectasis and chest wall invasion. • MRI is an option for paediatrics and science when CT is contra-indicated}, language = {en} } @phdthesis{Ahmed2014, author = {Ahmed, Arabe}, title = {Assessing particle deposition in a representative in vitro model of the rat respiratory tract}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-104912}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2014}, abstract = {The aim of this thesis was to develop an in vitro model (IVR) of the rat lung for the purpose of investigating the deposition of drug particles in the rat airways. The model attempted to account for the affect of drug product characteristics and physiological parameters on deposition in the lungs. In addition, the model outputs were compared with in vivo lung deposition results from live rats and in silico predictions using published computer model of lung deposition in pre-clinical species. Initial work focussed on developing an aerosol exposure system capable of dosing small rodent to a range of airborne test materials. The system consists of two main parts; a fluidised bed aerosol generator and connection of the generator output to a nose only exposure chamber capable of accommodating 12 small animals in a single layer. In addition, an aerodynamic particle spectrometer (APS) was installed for continuously measuring the size distribution and airborne concentration of aerosol particles generated in the exposure chamber. System validation showed acceptable degree of variation of the test material tested, Fluorescent Microspheres (FMS) throughout the exposure chamber (CV < 15.0\%). Particle size (MMAD ± GSD) using the APS was shown to be stable throughout the exposure periods. The IVR model developed in this project was based on a number of euthanased (n=7), female Sprague-Dawley rats (weight: 372 ± 56 g), which underwent high-resolution micro-CT scans. The physical model consisted of five sub sections; Extra-Thoracic region containing the snout and nasophyarynx, trachea-bronchial region containing the trachea, bronchi, and bronchioles. All sections of the model were attached to one another in numerical order and housed within a containment unit. At the rear end of the cast, a flexible diaphragm was attached in order to collect the fraction of inhaled particles exiting the TB section and possibly reaching the lung, referred to as the Post-TB section. A study was conducted to assess the influence of inhalation parameters such as the breathing frequency and tidal volume on total and regional dose distribution using FMS as test material. The major finding of this study was the demonstration of the model sensitivity to changes in breathing parameters especially respiratory frequency, where the data showed increased deposition in the peripheral regions of the model with decreased respiratory frequency. Other studies assessed the effect of particle characteristics on deposition on the IVR model, such as particle size, dose increase and formulation changes. The results assessing particle size effect showed a slightly higher deposition levels for the 4µm sized particles versus 2µm sized particles in the head region; 90.8 ± 3.6\% and 88.2 ± 6.6\%. However, this difference did not reach statistical significance (P> 0.05) probably due to the polydispersity of aerosolised FMS particles. In addition, the regional deposition analysis showed an increased lung peripheral deposition with the smaller particles. In addition, the model was shown to be sensitive to changes in formulation composition mediated by inclusion of MgSt. The next stage of work was to validate the model in terms of comparison with lung deposition for in vivo rats. For lung deposition comparison, the absolute amount deposited in the IVR lung model (expressed as µg/kg) was shown to have a reasonably strong correlation with in vivo lung concentration measures (µg/kg); R2= 0.66, P < 0.05. Compounds were predicted well and within 2-folds of the measured lung deposition values. However, knowing the variability in biological systems and the multiple components required to estimate lung doses, predictions within 2-fold of the measured values would seem reasonable In terms of comparison with in silico model predictions using MPPD, similar deposition levels were noted between the two models, particularly when the data was expressed as percentage of total particles inhaled. The data showed the highest deposition levels were noted in the head region (> 80\%) and less than 5.0\% deposition for the peripheral lung fractions. With regards to using the IVR model to assess the relationship between dose, particle size and efficacy, an in vivo study using FP with different particle sizes (2.0 and 4.0 µm) but same doses ( 100 and 1000 µg/kg). This study demonstrated that exposure of rat to FP powder resulted in a dose-dependent inhibition of neutrophils in BAL fluids. However, a clear difference in neutrophils suppression was demonstrated for equivalent doses but different particle sizes of FP, where the smaller FP particles (2.0 µm) induced a greater level of neutrophils suppression in comparison with larger FP particles (4.0 µm). In addition, a reasonably good correlation for the relationship between lung deposition in the IVR model and a neutrophils suppression level was demonstrated. Furthermore this data support the hypothesis that regional deposition is an important determinant in efficacy. Therefore, this suggests that the IVR model may be a useful as a tool to describe in vivo efficacy with in vitro data. However, further studies should be conducted to evaluate the validity of this model and relationship. The IVR model has a number of important limitations. First, the model is based on scans up to generation four of the rat respiratory tract as this represented the limits of the micro-CT scanning technology at the time of this study. Therefore deposition in the deeper region of the lung may not be reflected precisely in the IVR model. Second, the regional deposition data generated using the model tended to show an overestimation of deposition in head region and an underestimation of deposition in the peripheral regions of the lung, in comparison with in vivo lung deposition data. Third, the current model does not take into account lung clearance. However, the amount of the drug present in the in vivo lungs is dependent on numerous physiological processes such as dissolution, passive or active absorption into the systemic circulation, binding to lung tissue and mucociliary clearance. Consequently, the results generated using this IVR model for drug molecules with high lung clearance rate should be treated with some caution. Future work extending this research could go in a number of directions. In this research, a representative model of the rat respiratory tract was constructed from analysis of imaging data from a number of euthanised Sprague-Dawley rats. This model represented the "average respiratory tract" in terms of dimensions of Sprague-Dawley rats. However, there is considerable variability in the airway dimensions between rats. This variability encompasses a number of factors such as the strains of rats, sex and age, and disease state. Thus, it may be possible to produce a small number of airway models to represent small and large rats and scaled to represent the extrathoracic and peripheral regions based on literature reports of their dimensions in different rat populations. This approach will then enable the effect of intersubject airway dimensions for different rat populations on aerosol deposition to be thoroughly examined. In addition, due to the limitation of the micro-CT technology used to construct the physical IVR model, detailed morphology only up to generation 4 were captured. However, recent advances in MRI technology, such as the use of in situ-MRI based scanning technology have enabled rat airway morphometry to be extended to 16 airway generation. This coupled with improvements in the resolutions of rapid-prototyping process means it may be possible to construct a rat model that reflects the in vivo lung morphology more accurately, and thus enable greater understanding of the link between aerosol deposition and airway geometry. In conclusion, a model cast of the rat lung was developed and validated to allow the deposition of inhaled particles in the rat lung to be investigated. The model may be used to estimate the lung concentration in vivo rats in preference to exposure concentration measurements based on filter samples which have been shown to be a poor indicator of the lung concentration immediately after exposure. In addition, the model has the potential to be used along with live rats in an inhalation rig in pulmonary pharmaceutics research and may facilitate in development of inhaled formulations to target specific regions within the lung as well as screening of inhaled drugs in preclinical setting.}, subject = {Ratte}, language = {en} }