Innovative scanning technology enables better monitoring of lung function

Innovative scanning technology enables better monitoring of lung function

A new method of scanning the lungs can show the effects of treatment on lung function in real time, allowing experts to see the function of transplanted lungs.

This could allow doctors to detect deterioration in lung function earlier.

Using the scanning method, the team led by researchers from the University of Newcastle (UK) was able to observe how air moves in and out of the lungs when inhaled by patients with asthma, chronic obstructive pulmonary disease (COPD) and patients who have received a lung transplant.

Publication of two supplementary articles inradiologyAndJHLT openedthe team explains how they use a special gas called perfluoropropane, which is visible on an MRI scanner. The gas can be inhaled and exhaled safely by the patient and scans can then be carried out to determine where in the lungs the gas has reached.

The project leader, Professor Pete Thelwall, is Professor of Magnetic Resonance Physics and Director of the Center for In Vivo Imaging at Newcastle University. He said; "Our scans show where there are gaps in ventilation in patients with lung disease and show us which parts of the lung are improving with treatment. For example, if we scan a patient while they are taking their asthma medication, we can see how much of their lung is left." and which parts of their lungs are better able to move air in and out with each breath.”

With the new scanning method, the team is able to reveal the parts of the lungs that air does not reach properly when breathing. By measuring how much of the lung is well ventilated and how much is poorly ventilated, experts can assess the impact of a patient's respiratory disease and locate and visualize the lung regions with ventilation defects.

The team of experts from various universities and NHS trusts in Newcastle and Sheffield show that the scans work on patients with asthma or COPD and publish the first article inRadiology.

The new scanning technique allows the team to quantify the degree of improvement in ventilation when patients receive treatment, in this case a widely used inhaler, the bronchodilator salbutamol. This shows that imaging techniques could be valuable in clinical trials of new treatments for lung diseases.

Use in lung transplants

Another study published inJHLT openedexamined patients who had previously received a lung transplant for very severe lung disease at Newcastle upon Tyne Hospitals NHS Foundation Trust. It shows how the team further developed the imaging method to enable lung function measurements that could be used to better support lung transplant recipients in the future. Thanks to the sensitivity of the measurement, doctors can detect changes in lung function at an early stage and thus identify lung problems earlier and thus provide better care for patients.

In research studies, the team scanned the lungs of transplant recipients over multiple inhalations and exhalations and collected MRI images showing how the gaseous air reached different areas of the lungs. The team looked at those who either had normal lung function or who experienced chronic rejection after a lung transplant, which is a common problem in lung transplant recipients because their immune system attacks the donor lung. In patients with chronic rejection, scans showed worse air movement to the edges of the lungs, most likely due to damage to the very small breathing tubes (airways) in the lungs, a feature typical of chronic rejectionchronic lung allograft dysfunction.

We hope that with this new type of scan we will be able to detect changes in the transplant lung earlier, before signs of damage appear in the usual blast tests. This would allow treatment to begin earlier and help protect the transplanted lung from further damage.”

Professor Andrew Fisher, Professor of Respiratory Transplantation Medicine at Newcastle Hospitals NHS Foundation Trust and Newcastle University, UK, co-author of the study

The team believes that this scanning method may have potential future use in the clinical treatment of lung transplant recipients and other lung diseases. This is a sensitive measurement that may detect early changes in lung function, allowing better treatment of these diseases.

This lung imaging work was funded by the Medical Research Council and the Rosetrees Trust.

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