Research at CPC-M - Obtaining a snapshot of the lung

Research at CPC-M

Obtaining a snapshot of the lung

The Imaging platform of the Radiology Department at Munich University Hospital

Imaging techniques play an important role in diagnosing pathological lung changes. Whether microscopy, computed tomography or magnetic resonance imaging – the images facilitate and improve diagnosis and enable more precise treatment as early as possible.
Advances in computed tomography (CT), the reduction of radiation dose and the improvement of magnetic resonance imaging (MRI) have already led to a significant improvement and increased depth of imaging. 

The DZL promotes research in the field of thoracic radiology. The aim is to open up new fields of indication for other disease areas. Research is also being carried out into how doctors can use imaging to differentiate more precisely between malignant and benign lung diseases. The Radiology Imaging Platform at the Munich University Hospital provides state-of-the-art techniques and equipment for this purpose and thus supports research in the DZL and beyond.

Current projects in the field of radiological imaging:

High Contrast - Novel X-ray based imaging of the lungs

Grating-based phase contrast computed tomography (PC-CT) is a new X-ray-based imaging technique developed in recent years. Pre-experiments have shown that the contrast produced by this measurement technique reacts extremely specifically to changes in complicated lung tissue. In cooperation with Professor Pfeiffer (Chair of Biomedical Physics at Technische Universität München) and Dr. Andrea Bähr (Chair of Molecular Animal Breeding and Biotechnology), initial experiments have already shown that this technology can be used for lung diseases:

PC-CT image of a pig lung
PC-CT image of a pig lung
© LMU Klinikum München

Explanation of images: Images of a healthy pig lung in a conventional transmission image/X-ray image (upper row) and using a novel X-ray phase contrast dark field radiography (lower row). After filling the pleural space (space between the lungs and the chest wall) with air (this corresponds to the clinical picture of a pneumothorax), it appears in the dark field image as a dark area between the lungs and ribs (in the middle, arrow). The pneumothorax is not visible in the transmission image. Only after increasing filling with air into the pleural cavity (right) can the pneumothorax also be seen in the transmission image.

© Hellbach K, Bähr A, De Marco F, Willer K, Gromann L, Herzen J, Dmochewitz M, Auweter S, Fingerle AA, Noël PB, Rummeny EJ, Yaroshenko A, Maack I, Pralow T, van der Heijden H, Wieberneit N, Proksa R, Koehler T, Rindt K, Schroeter TJ, Mohr J, Bamberg F, Ertl-Wagner B, Pfeiffer F, Reiser MF. Depiction of pneumothoraces in a large animal model using x-ray dark-field radiography. Sci Rep. 2018 Feb 8;8(1):2602.)

Magnetic resonance imaging – continuous improvement of performance

Modern MRI scanners are already much faster and more powerful than their predecessors. Due to the large volume of the lung, however, long recording times still occur, which is still a major challenge for the use of this imaging method. In addition, other lung parameters such as local blood flow shall be visualized using new MRI methods. The aim is to establish MRI methods for lung imaging on patients. Although a large number of studies prove the benefit of MRI scans, its clinical application is still very limited.

MRI images of local blood flow in the lung tissue
MRI images of local blood flow in the lung tissue, left a healthy lung, on the right a patient with pulmonary hypertension - © LMU Klinikum München

Lung phantom – device for the simulation of lung diseases

Testing new methods, techniques or devices for imaging procedures sometimes poses special problems for scientists – especially for diseases of the lungs. For example, a defined dose may not be exceeded in CT images or irradiation techniques. Or patients breathe irregularly or are unable to hold their breath. Controlled studies are therefore very difficult. In order to circumvent these limitations, the researchers of the imaging platform use a so-called lung phantom. This device enables the stable ventilation of a freshly removed animal or human lung for hours.  This enables lung diseases to be simulated and better investigated. Experimental tests with the lung phantom are intended, for example, to test new imaging techniques in radiotherapy. One goal is to better detect the movement of tumors even though the patient changes position or moves solely by breathing.

Reduced radiation dose in computed tomography – Dual-Source CT

The debate about the risks of radiation for the patient during CT examinations has never lost its relevance. The radiation dose has therefore been continuously reduced. This low-dose principle plays a particularly important role in follow-up examinations, especially in children. A recently developed CT device, a dual-source CT, allows the user to activate a mode for dose reduction that is expected to require one-tenth of the conventional dose for specific lung examinations. First images and first tests using this device are promising. A more accurate, realistic study should now help to assess the usability of this technique. 

[Translate to Englisch:] Frühgeborenes mit Lungenkrankheit

MRI – LATEST TECHNOLOGY IN CLINICAL USE

 

Experience in pictures, text and videos how MRI images
help to diagnose chronic lung diseases in premature babies
(AIRR study).

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