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Lookup NU author(s): Dr Ben PippardORCiD, Dr Mary Neal, Dr Charlotte Holland, Dr Holly FisherORCiD, Professor John MatthewsORCiD, Professor John SimpsonORCiD, Professor Peter Thelwall
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Background: Pulmonary function tests are central to diagnosis and monitoring of respiratory diseases but lack information on regional lung function heterogeneity. Fluorine-19 (19F)-MRI of inhaled perfluoropropane permits quantitative and spatially localized assessment of pulmonary ventilation properties without tracer gas hyperpolarization.Purpose: To assess regional lung ventilation properties using 19F-MRI of inhaled perfluoropropane in participants with asthma, participants with chronic obstructive pulmonary disease (COPD), and healthy participants, including quantitative evaluation of bronchodilator response in participants with asthma and COPD.Materials and Methods: This prospective, dual-center study recruited participants with asthma, and COPD, from July 2019 to September 2022 and healthy participants from May 2018 to June 2019. Participants underwent conventional spirometry, proton MRI, and 19F-MRI following inhalation of a 79% perfluoropropane / 21% oxygen gas mixture. 3D 19F-MRI scans were acquired during a single breath-hold. For participants with asthma or COPD, spirometric and MRI measurements were repeated following administration of nebulized salbutamol. Ventilation defect percentage (VDP) was calculated from perfluoropropane distribution. Linear mixed-effects models assessed differences in VDP between participant groups and pre- and post-bronchodilator. Results: Thirty-five participants with asthma (mean age ± standard deviation, 50 ± 18; 21 male), 21 participants with COPD (69 ± 6; 14 male), and 38 healthy participants (41 ± 11; 20 male) were evaluated. 19F-MRI-derived VDP was elevated in participants with COPD (geometric mean, 27.2%) and in participants with asthma (8.3%) compared to healthy participants (1.8%) (geometric mean ratio (95% CI) = 15.2 (11.1, 20.6) for COPD and 4.6 (3.2, 6.6) for asthma (p<.001 for both)). Post-bronchodilator, VDP reduced by 33% in participants with asthma (from 8.3% to 5.6%) and 14% in those with COPD (from 27.2% to 23.3%) (p<.001 for both).Conclusion: 19F-MRI of inhaled perfluoropropane was sensitive to changes in regional ventilation properties associated with lung disease and quantified changes following bronchodilator therapy.
Author(s): Pippard BJ, Neal MA, Holland CW, Maunder AM, Forrest I, Lawson RA, Fisher HF, Matthews JNS, Wild JM, Simpson AJ, Thelwall PE
Publication type: Article
Publication status: In Press
Journal: Radiology
Year: 2024
Acceptance date: 01/10/2024
ISSN (print): 0033-8419
ISSN (electronic): 1527-1315
Publisher: Radiological Society of North America, Inc.
