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PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A Retrospective Analysis of a Randomized Controlled Trial
PURPOSE: To assess whether dynamic ventilation and perfusion (Q) biomarkers derived by phase-resolved functional lung (PREFUL) MRI can measure treatment response to 14-day therapy with indacaterol-glycopyrronium (IND-GLY) and correlate to clinical outcomes including lung function, symptoms, and card...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Radiological Society of North America
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059092/ https://www.ncbi.nlm.nih.gov/pubmed/35506142 http://dx.doi.org/10.1148/ryct.210147 |
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author | Voskrebenzev, Andreas Kaireit, Till F. Klimeš, Filip Pöhler, Gesa H. Behrendt, Lea Biller, Heike Berschneider, Korbinian Wacker, Frank Welte, Tobias Hohlfeld, Jens M. Vogel-Claussen, Jens |
author_facet | Voskrebenzev, Andreas Kaireit, Till F. Klimeš, Filip Pöhler, Gesa H. Behrendt, Lea Biller, Heike Berschneider, Korbinian Wacker, Frank Welte, Tobias Hohlfeld, Jens M. Vogel-Claussen, Jens |
author_sort | Voskrebenzev, Andreas |
collection | PubMed |
description | PURPOSE: To assess whether dynamic ventilation and perfusion (Q) biomarkers derived by phase-resolved functional lung (PREFUL) MRI can measure treatment response to 14-day therapy with indacaterol-glycopyrronium (IND-GLY) and correlate to clinical outcomes including lung function, symptoms, and cardiac function in patients with chronic obstructive pulmonary disease (COPD), as determined by spirometry, body plethysmography, cardiac MRI, and dyspnea score measurements. MATERIALS AND METHODS: The cardiac left ventricular function in COPD (CLAIM) study enrolled patients aged 40 years or older with COPD, stable cardiovascular function, and hyperinflation (residual volume > 135% predicted). Dynamic MRI data of these patients were retrospectively analyzed using the PREFUL technique to assess the effect of 14-day IND-GLY treatment versus placebo on regional measurements of ventilation dynamics. After manual segmentation of the lung parenchyma, flow-volume loops of each voxel were correlated to an individualized reference flow-volume loop, creating a two-dimensional flow-volume loop correlation map (FVL-CM) as a measure of ventilation dynamics. Ventilation-perfusion match (VQM) was evaluated in combination with perfusion and regional ventilation (VQM(RVent)) and with perfusion and the FVL-CM measurement (VQM(CM)). For image and statistical analysis, the lung parenchyma was segmented as a region of interest by manually delineating the lung boundary and excluding the large (central) vessels for each section. Differences in ventilation, perfusion, and VQM between IND-GLY and placebo were compared using analysis of variance, with study treatment, patient, and period included as factors. RESULTS: Fifty patients (mean age, 64.3 years ± 7.65 [SD]; 35 men) were included in this analysis. IND-GLY significantly increased mean correlation as measured with FVL-CM versus that of placebo (least squares [LS] means treatment difference: 0.05 [95% CI: 0.03, 0.07]; P < .0001). Compared with placebo, IND-GLY increased mean Q (LS means treatment difference: 9.27 mL/min/100 mL [95% CI: 0.05, 18.49]; P = .049) and improved both VQM(CM) and VQM(RVent) (LS means treatment difference: 0.06 [95% CI: 0.03, 0.08]; P < .0001 and 0.05 [95% CI: 0.02, 0.08]; P = .001, respectively). CONCLUSION: Regional ventilation dynamics and VQM measured by PREFUL MRI show treatment response in COPD. Supplemental material is available for this article. Clinical trial registration no. NTR6831 Keywords: MRI, COPD, Perfusion, Ventilation, Lung, Pulmonary Published under a CC BY 4.0 license |
format | Online Article Text |
id | pubmed-9059092 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Radiological Society of North America |
record_format | MEDLINE/PubMed |
spelling | pubmed-90590922022-05-02 PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A Retrospective Analysis of a Randomized Controlled Trial Voskrebenzev, Andreas Kaireit, Till F. Klimeš, Filip Pöhler, Gesa H. Behrendt, Lea Biller, Heike Berschneider, Korbinian Wacker, Frank Welte, Tobias Hohlfeld, Jens M. Vogel-Claussen, Jens Radiol Cardiothorac Imaging Original Research PURPOSE: To assess whether dynamic ventilation and perfusion (Q) biomarkers derived by phase-resolved functional lung (PREFUL) MRI can measure treatment response to 14-day therapy with indacaterol-glycopyrronium (IND-GLY) and correlate to clinical outcomes including lung function, symptoms, and cardiac function in patients with chronic obstructive pulmonary disease (COPD), as determined by spirometry, body plethysmography, cardiac MRI, and dyspnea score measurements. MATERIALS AND METHODS: The cardiac left ventricular function in COPD (CLAIM) study enrolled patients aged 40 years or older with COPD, stable cardiovascular function, and hyperinflation (residual volume > 135% predicted). Dynamic MRI data of these patients were retrospectively analyzed using the PREFUL technique to assess the effect of 14-day IND-GLY treatment versus placebo on regional measurements of ventilation dynamics. After manual segmentation of the lung parenchyma, flow-volume loops of each voxel were correlated to an individualized reference flow-volume loop, creating a two-dimensional flow-volume loop correlation map (FVL-CM) as a measure of ventilation dynamics. Ventilation-perfusion match (VQM) was evaluated in combination with perfusion and regional ventilation (VQM(RVent)) and with perfusion and the FVL-CM measurement (VQM(CM)). For image and statistical analysis, the lung parenchyma was segmented as a region of interest by manually delineating the lung boundary and excluding the large (central) vessels for each section. Differences in ventilation, perfusion, and VQM between IND-GLY and placebo were compared using analysis of variance, with study treatment, patient, and period included as factors. RESULTS: Fifty patients (mean age, 64.3 years ± 7.65 [SD]; 35 men) were included in this analysis. IND-GLY significantly increased mean correlation as measured with FVL-CM versus that of placebo (least squares [LS] means treatment difference: 0.05 [95% CI: 0.03, 0.07]; P < .0001). Compared with placebo, IND-GLY increased mean Q (LS means treatment difference: 9.27 mL/min/100 mL [95% CI: 0.05, 18.49]; P = .049) and improved both VQM(CM) and VQM(RVent) (LS means treatment difference: 0.06 [95% CI: 0.03, 0.08]; P < .0001 and 0.05 [95% CI: 0.02, 0.08]; P = .001, respectively). CONCLUSION: Regional ventilation dynamics and VQM measured by PREFUL MRI show treatment response in COPD. Supplemental material is available for this article. Clinical trial registration no. NTR6831 Keywords: MRI, COPD, Perfusion, Ventilation, Lung, Pulmonary Published under a CC BY 4.0 license Radiological Society of North America 2022-04-21 /pmc/articles/PMC9059092/ /pubmed/35506142 http://dx.doi.org/10.1148/ryct.210147 Text en © 2022 by the Radiological Society of North America, Inc. https://creativecommons.org/licenses/by/4.0/Published under a (https://creativecommons.org/licenses/by/4.0/) CC BY 4.0 license. |
spellingShingle | Original Research Voskrebenzev, Andreas Kaireit, Till F. Klimeš, Filip Pöhler, Gesa H. Behrendt, Lea Biller, Heike Berschneider, Korbinian Wacker, Frank Welte, Tobias Hohlfeld, Jens M. Vogel-Claussen, Jens PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A Retrospective Analysis of a Randomized Controlled Trial |
title | PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A
Retrospective Analysis of a Randomized Controlled Trial |
title_full | PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A
Retrospective Analysis of a Randomized Controlled Trial |
title_fullStr | PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A
Retrospective Analysis of a Randomized Controlled Trial |
title_full_unstemmed | PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A
Retrospective Analysis of a Randomized Controlled Trial |
title_short | PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A
Retrospective Analysis of a Randomized Controlled Trial |
title_sort | preful mri depicts dual bronchodilator changes in copd: a
retrospective analysis of a randomized controlled trial |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059092/ https://www.ncbi.nlm.nih.gov/pubmed/35506142 http://dx.doi.org/10.1148/ryct.210147 |
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