Comprehensive Review of Hyperpolarized Xenon-129 MRI: Clinical Study, Testing, and Implementation in Advancing Pulmonary In Vivo Imaging and Diagnostic Applications

Hyperpolarized Xenon-129 MRI (129XeMRI) has emerged as a powerful tool in the identification, evaluation, and assessment of disease endotyping and response to interventions for a myriad of pulmonary diseases. Growing investigative efforts ranging from basic science to application in translational research have employed 129XeMRI in the evaluation of pulmonary conditions such as chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), asthma, and cystic fibrosis (CF). The novel feature of 129XeMRI is its ability to generate anatomic and physiologic readouts of the lung with resolution from the whole lung down to the lobar level. Additional advantages include being non-invasive, non-radioactive, and utilizing an inexpensive and ubiquitous noble gas as an inhalation contrast agent: Xenon-129. In this review, we outline the clinical advances provided by 129XeMRI among common pulmonary diseases with high healthcare burdens in recent decades.