A new method of lung scanning can show the effects of treatment on lung function in real time and allow experts to see how transplanted lungs are functioning.
This could allow doctors to identify any deterioration in lung function sooner.
The scanning method has allowed the team, led by researchers at the University of Newcastle, UK, to observe how air enters and leaves the lungs when people breathe in patients with asthma, chronic obstructive pulmonary disease (COPD) and patients with received a lung transplant.
Publication of two complementary articles in Radiology and JHLT openThe team explains how they use a special gas, called perfluoropropane, which can be seen in an MRI scanner. Patients can safely inhale and exhale the gas and then perform scans to see where in the lungs the gas has reached.
Project leader Professor Pete Thelwallis, Professor of Magnetic Resonance Physics and Director of the In Vivo Imaging Center at the University of Newcastle. He said; “Our scans show where there is irregular ventilation in patients with lung disease and show us which parts of the lung improve with treatment. For example, when we scan a patient while they are using their asthma medication, we can see which part of their lungs and which Parts of your lungs are better able to take air in and out with each breath.”
Using the new scanning method, the team can reveal the parts of the lung that air does not reach properly during breathing. By measuring which part of the lung is well ventilated and which part is poorly ventilated, experts can evaluate the effects of a patient’s respiratory disease and can locate and visualize lung regions with ventilation defects.
Demonstrating that scans work in patients with asthma or COPD, team made up of experts from across universities and NHS Trusts in Newcastle and Sheffield publish first paper in Radiology.
The new scanning technique allows the team to quantify the degree of improvement in ventilation when patients receive a treatment, in this case a widely used inhaler, the bronchodilator salbutamol. This shows that imaging methods could be valuable in clinical trials of new treatments for lung diseases.
Use in lung transplants
Another study, published in JHLT openexamined patients who had previously received a lung transplant for very severe lung disease at Newcastle upon Tyne Hospitals NHS Foundation Trust. It demonstrates how the team further developed the imaging method to provide measurements of lung function that could be used to better support lung transplant recipients in the future. The sensitivity of the measurement means doctors can detect early changes in lung function, allowing them to identify lung problems earlier and thus provide better care to patients.
In research studies, the team scanned the lungs of transplant recipients through multiple inhalations and exhalations, collecting MRI images that show how air containing the gas reaches different areas of the lung. The team examined those who had normal lung function or who experienced chronic rejection after lung transplant, which is a common problem in lung transplant recipients as their immune system attacks the donor’s lungs. In those with chronic rejection, scans showed poorer air movement toward the edges of the lungs, probably due to damage to the very small breathing tubes (airways) in the lungs, a typical feature of chronic rejection also known as chronic lung allograft dysfunction.
Professor Andrew Fisher, professor of respiratory transplant medicine at Newcastle Hospitals NHS Foundation Trust and the University of Newcastle, UK, co-author of the study, said: “We hope that this new type of scan will allow us to see changes in transplanted lungs before and before signs of damage appear on routine blow tests. This would allow any treatment to be started earlier and would help protect the transplanted lungs from further damage.”
The team says there is potential for this scanning method to be used in the clinical treatment of lung transplant recipients and other lung diseases in the future, providing a sensitive measurement that can detect early changes in lung function that allow for better treatment of these conditions.
This work on lung imaging has been funded by the Medical Research Council and The Rosetrees Trust.