Phase-Resolved Functional Lung (PREFUL) MRI to Quantify Ventilation : Feasibility and Physiological Relevance in Severe Asthma
Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved..
RATIONALE AND OBJECTIVES: Emergent evidence in several respiratory diseases supports translational potential for Phase-Resolved Functional Lung (PREFUL) MRI to spatially quantify ventilation but its feasibility and physiological relevance have not been demonstrated in patients with asthma. This study compares PREFUL-derived ventilation defect percent (VDP) in severe asthma patients to healthy controls and measures its responsiveness to bronchodilator therapy and relation to established measures of airways disease.
MATERIALS AND METHODS: Forty-one adults with severe asthma and seven healthy controls performed same-day free-breathing 1H MRI, 129Xe MRI, spirometry, and oscillometry. A subset of participants (n = 23) performed chest CT and another subset of participants with asthma (n = 19) repeated 1H MRI following the administration of a bronchodilator. VDP was calculated for both PREFUL and 129Xe MRI. Additionally, the percent of functional small airways disease was determined from CT parametric response maps (PRMfSAD).
RESULTS: PREFUL VDP measured pre-bronchodilator (19.1% [7.4-43.3], p = 0.0002) and post-bronchodilator (16.9% [6.1-38.4], p = 0.0007) were significantly greater than that of healthy controls (7.5% [3.7-15.5]) and was significantly decreased post-bronchodilator (from 21.9% [10.1-36.9] to 16.9% [6.1-38.4], p = 0.0053). PREFUL VDP was correlated with spirometry (FEV1%pred: r = -0.46, p = 0.0023; FVC%pred: r = -0.35, p = 0.024, FEV1/FVC: r = -0.46, p = 0.0028), 129Xe MRI VDP (r = 0.39, p = 0.013), and metrics of small airway disease (CT PRMfSAD: r = 0.55, p = 0.021; Xrs5 Hz: r = -0.44, p = 0.0046, and AX: r = 0.32, p = 0.044).
CONCLUSION: PREFUL-derived VDP is responsive to bronchodilator therapy in asthma and is associated with measures of airflow obstruction and small airway dysfunction. These findings validate PREFUL VDP as a physiologically relevant and accessible ventilation imaging outcome measure in asthma.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Academic radiology - (2024) vom: 19. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Friedlander, Yonni [VerfasserIn] |
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Date Revised 20.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.acra.2024.01.039 |
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| PPN (Katalog-ID): |
NLM368683443 |
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| 100 | 1 | |a Friedlander, Yonni |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Phase-Resolved Functional Lung (PREFUL) MRI to Quantify Ventilation |b Feasibility and Physiological Relevance in Severe Asthma |
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| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Revised 20.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a RATIONALE AND OBJECTIVES: Emergent evidence in several respiratory diseases supports translational potential for Phase-Resolved Functional Lung (PREFUL) MRI to spatially quantify ventilation but its feasibility and physiological relevance have not been demonstrated in patients with asthma. This study compares PREFUL-derived ventilation defect percent (VDP) in severe asthma patients to healthy controls and measures its responsiveness to bronchodilator therapy and relation to established measures of airways disease | ||
| 520 | |a MATERIALS AND METHODS: Forty-one adults with severe asthma and seven healthy controls performed same-day free-breathing 1H MRI, 129Xe MRI, spirometry, and oscillometry. A subset of participants (n = 23) performed chest CT and another subset of participants with asthma (n = 19) repeated 1H MRI following the administration of a bronchodilator. VDP was calculated for both PREFUL and 129Xe MRI. Additionally, the percent of functional small airways disease was determined from CT parametric response maps (PRMfSAD) | ||
| 520 | |a RESULTS: PREFUL VDP measured pre-bronchodilator (19.1% [7.4-43.3], p = 0.0002) and post-bronchodilator (16.9% [6.1-38.4], p = 0.0007) were significantly greater than that of healthy controls (7.5% [3.7-15.5]) and was significantly decreased post-bronchodilator (from 21.9% [10.1-36.9] to 16.9% [6.1-38.4], p = 0.0053). PREFUL VDP was correlated with spirometry (FEV1%pred: r = -0.46, p = 0.0023; FVC%pred: r = -0.35, p = 0.024, FEV1/FVC: r = -0.46, p = 0.0028), 129Xe MRI VDP (r = 0.39, p = 0.013), and metrics of small airway disease (CT PRMfSAD: r = 0.55, p = 0.021; Xrs5 Hz: r = -0.44, p = 0.0046, and AX: r = 0.32, p = 0.044) | ||
| 520 | |a CONCLUSION: PREFUL-derived VDP is responsive to bronchodilator therapy in asthma and is associated with measures of airflow obstruction and small airway dysfunction. These findings validate PREFUL VDP as a physiologically relevant and accessible ventilation imaging outcome measure in asthma | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Munidasa, Samal |e verfasserin |4 aut | |
| 700 | 1 | |a Thakar, Ashutosh |e verfasserin |4 aut | |
| 700 | 1 | |a Ragunayakam, Nandhitha |e verfasserin |4 aut | |
| 700 | 1 | |a Venegas, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Kjarsgaard, Melanie |e verfasserin |4 aut | |
| 700 | 1 | |a Zanette, Brandon |e verfasserin |4 aut | |
| 700 | 1 | |a Capaldi, Dante P I |e verfasserin |4 aut | |
| 700 | 1 | |a Santyr, Giles |e verfasserin |4 aut | |
| 700 | 1 | |a Nair, Parameswaran |e verfasserin |4 aut | |
| 700 | 1 | |a Svenningsen, Sarah |e verfasserin |4 aut | |
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