Scientists at Newcastle University have developed a new lung scanning method that reveals the real-time effects on lung function. The technique allows the team to track how air moves in and out of the lungs during breathing, specifically in patients with asthma, chronic obstructive pulmonary disease (COPD), and those with a lung transplant.
This innovation could help doctors detect declines in lung function earlier.
The team utilized a gas known as perfluoropropane, which is visible under MRI scans. Patients can safely inhale and exhale this gas, and scans are performed to identify the areas where the gas has entered the lungs.
The project lead, Professor Pete Thelwall, Professor of Magnetic Resonance Physics and Director of the Centre for In Vivo Imaging at Newcastle University, said, “Our scans show where there is patchy ventilation in patients with lung disease and which parts of the lung improve with treatment. For example, when we scan a patient using their asthma medication, we can see how much of their lungs and which parts of their lung can better move air in and out with each breath.”
Using a new scanning technique, the team can identify areas of the lung that do not receive adequate air during breathing. Experts evaluate the ratio of well-ventilated lung regions to those with ventilation deficiencies to determine the impact of a patient’s respiratory condition and visualize the affected areas.
The team, which included specialists from universities and NHS Trusts in Newcastle and Sheffield, proving that the scans are effective in patients with asthma or COPD.
When patients receive treatment—in this case, a standard inhaler, the bronchodilator salbutamol- the team can measure the extent of improvement in ventilation thanks to the new scanning approach. This indicates that imaging techniques may be useful in clinical trials of novel treatments for lung disease.
Another study, published in JHLT Open, looked at patients at the Newcastle upon Tyne Hospitals NHS Foundation Trust who had previously had a lung transplant for extremely severe lung illness. The researchers further improved the imaging technique to give lung function measurements that could be utilized to support lung transplant recipients in the future.
Because of the measurement’s sensitivity, medical professionals can detect early alterations in lung function, enabling them to detect lung issues sooner and give patients better care.
To obtain MRI images demonstrating how the gas-containing air reached various parts of the lung, the team examined the lungs of transplant recipients during several inhalations and exhalations. Following a lung transplant, the team assessed people who either had normal lung function or were dealing with chronic rejection, a typical problem in which the recipient’s immune system destroys the donor’s lungs.
Chronic rejection, often called chronic lung allograft dysfunction, is characterized by poorer air circulation to the lungs’ edges. This is most likely caused by damage to the lungs’ tiny breathing tubes or airways.
Professor Andrew Fisher, Professor of Respiratory Transplant Medicine at Newcastle Hospitals NHS Foundation Trust and Newcastle University, UK, co-author of the study, said, “We hope this new type of scan might allow us to see changes in the transplant lungs earlier and before signs of damage are present in the usual blowing tests. This would allow any treatment to be started earlier and help protect the transplanted lungs from further damage.”
The team says, “There is potential for this scan method to be used in the clinical management of lung transplant recipients and other lung diseases in the future, bringing a sensitive measurement that may spot early changes in lung function that enable better management of these conditions.”
Journal References:
- Pippard BJ, Neal MA, Holland CW, Maunder AM, Forrest I, Lawson RA, Fisher HF, Matthews JNS, Wild JM, Simpson AJ, Thelwall, PE. Assessing Lung Ventilation and Bronchodilator Response in Asthma and Chronic Obstructive Pulmonary Disease with Fluorine 19 MRI. Radiology. DOI: 10.1148/radiol.240949
- Neal MA, Bos S, Holland CW, Hollingsworth KG, Meachery G, Nair A, Lordan JL, Fisher AJ, Thelwall, PE. Dynamic 19F-MRI of pulmonary ventilation in lung transplant recipients with and without chronic lung allograft dysfunction. JHLT Open. DOI: 10.1016/j.jhlto.2024.100167