PMID- 34589542
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220427
IS  - 2312-0541 (Print)
IS  - 2312-0541 (Electronic)
IS  - 2312-0541 (Linking)
VI  - 7
IP  - 3
DP  - 2021 Jul
TI  - Xenon ventilation MRI in difficult asthma: initial experience in a clinical 
      setting.
LID - 00785-2020 [pii]
LID - 10.1183/23120541.00785-2020 [doi]
AB  - BACKGROUND: Hyperpolarised gas magnetic resonance imaging (MRI) can be used to 
      assess ventilation patterns. Previous studies have shown the image-derived metric 
      of ventilation defect per cent (VDP) to correlate with forced expiratory volume 
      in 1 s (FEV(1))/forced vital capacity (FVC) and FEV(1) in asthma. OBJECTIVES: The 
      aim of this study was to explore the utility of hyperpolarised xenon-129 
      ((129)Xe) ventilation MRI in clinical care and examine its relationship with 
      spirometry and other clinical metrics in people seen in a severe asthma service. 
      METHODS: 26 people referred from a severe asthma clinic for MRI scanning were 
      assessed by contemporaneous (129)Xe MRI and spirometry. A subgroup of 18 patients 
      also underwent reversibility testing with spirometry and MRI. Quantitative MRI 
      measures of ventilation were calculated, VDP and the ventilation heterogeneity 
      index (VH(I)), and compared to spirometry, Asthma Control Questionnaire 7 (ACQ7) 
      and blood eosinophil count. Images were reviewed by a multidisciplinary team. 
      RESULTS: VDP and VH(I) correlated with FEV(1), FEV(1)/FVC and forced expiratory 
      flow between 25% and 75% of FVC but not with ACQ7 or blood eosinophil count. 
      Discordance of MRI imaging and symptoms and/or pulmonary function tests also 
      occurred, prompting diagnostic re-evaluation in some cases. CONCLUSION: 
      Hyperpolarised gas MRI provides a complementary method of assessment in people 
      with difficult to manage asthma in a clinical setting. When used as a tool 
      supporting clinical care in a severe asthma service, occurrences of discordance 
      between symptoms, spirometry and MRI scanning indicate how MRI scanning may add 
      to a management pathway.
CI  - Copyright (c)The authors 2021.
FAU - Mussell, Grace T
AU  - Mussell GT
AUID- ORCID: 0000-0002-3093-0650
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Marshall, Helen
AU  - Marshall H
AUID- ORCID: 0000-0002-7425-1449
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Smith, Laurie J
AU  - Smith LJ
AUID- ORCID: 0000-0002-5769-423X
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Biancardi, Alberto M
AU  - Biancardi AM
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Hughes, Paul J C
AU  - Hughes PJC
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Capener, David J
AU  - Capener DJ
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Bray, Jody
AU  - Bray J
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Swift, Andrew J
AU  - Swift AJ
AUID- ORCID: 0000-0002-8772-409X
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Rajaram, Smitha
AU  - Rajaram S
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Condliffe, Alison M
AU  - Condliffe AM
AUID- ORCID: 0000-0002-6697-8648
AD  - Dept of Infection, Immunity and Cardiovascular Disease, University of Sheffield, 
      Sheffield, UK.
AD  - Respiratory Medicine, Sheffield Teaching Hospitals, NHS Foundation Trust, 
      Sheffield, UK.
FAU - Collier, Guilhem J
AU  - Collier GJ
AUID- ORCID: 0000-0002-1874-4775
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Johns, Chris S
AU  - Johns CS
AUID- ORCID: 0000-0003-3724-0430
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Weatherley, Nick D
AU  - Weatherley ND
AUID- ORCID: 0000-0001-5589-2219
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
AD  - Respiratory Medicine, Sheffield Teaching Hospitals, NHS Foundation Trust, 
      Sheffield, UK.
FAU - Wild, Jim M
AU  - Wild JM
AUID- ORCID: 0000-0002-7246-8660
AD  - POLARIS, Academic Radiology, Dept of Infection, Immunity and Cardiovascular 
      Disease, University of Sheffield, Sheffield, UK.
FAU - Sabroe, Ian
AU  - Sabroe I
AUID- ORCID: 0000-0001-9750-8975
AD  - Respiratory Medicine, Sheffield Teaching Hospitals, NHS Foundation Trust, 
      Sheffield, UK.
LA  - eng
GR  - 205188/Z/16/Z/WT_/Wellcome Trust/United Kingdom
GR  - MR/M008894/1/MRC_/Medical Research Council/United Kingdom
GR  - SP/14/6/31350/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
DEP - 20210927
PL  - England
TA  - ERJ Open Res
JT  - ERJ open research
JID - 101671641
PMC - PMC8473920
COIS- Conflict of interest: AstraZeneca awarded a research grant to I. Sabroe, J.M. 
      Wild, H. Marshall and colleagues for the period 2020-2023 to study effects of 
      therapies on airway imaging. In 2019, I. Sabroe participated in a scientific 
      advisory board for AstraZeneca, generating a small consultancy income paid to the 
      University of Sheffield to support research, and has attended an annual 
      respiratory research meeting supported by Boehringer Ingelheim. J.M. Wild and H. 
      Marshall attended and advised on an AstraZeneca global respiratory experts 
      meeting, generating a small consultancy income paid to the University. All other 
      authors declare no conflicts of interest related to this study.
EDAT- 2021/10/01 06:00
MHDA- 2021/10/01 06:01
PMCR- 2021/09/27
CRDT- 2021/09/30 07:17
PHST- 2020/11/06 00:00 [received]
PHST- 2021/07/09 00:00 [accepted]
PHST- 2021/09/30 07:17 [entrez]
PHST- 2021/10/01 06:00 [pubmed]
PHST- 2021/10/01 06:01 [medline]
PHST- 2021/09/27 00:00 [pmc-release]
AID - 00785-2020 [pii]
AID - 10.1183/23120541.00785-2020 [doi]
PST - epublish
SO  - ERJ Open Res. 2021 Sep 27;7(3):00785-2020. doi: 10.1183/23120541.00785-2020. 
      eCollection 2021 Jul.