MICA: Non-invasive quantitative ventilation imaging by MRI of fluorocarbon gases

呼吸道疾病是全世界的主要死因之一。呼吸道疾病的新疗法越来越多地出现，并且确定对治疗的反应的测试对于患者呼吸道疾病的管理至关重要。不幸的是，评估肺功能和结构的现有措施具有局限性。例如，肺活量测定法不能提供肺内区域变化的信息，因此通气特性的早期局部变化可能无法检测到。计算机断层扫描（CT）扫描提供肺部结构的图像，但使用电离辐射（X射线）来生成这些图像，相关的辐射剂量意味着定期扫描以监测疾病进展或对治疗的反应通常是不可能的。因此，迫切需要一种新的技术，可以进行安全，客观，可重复和准确的测量肺通气特性，以更好地了解呼吸系统疾病如何随着时间的推移进展，并评估他们如何应对治疗策略。我们正在开发非侵入性和无辐射的肺通气量成像，使用新的MRI技术。MRI是一种安全且可重复的医学成像技术，它使用强磁场来生成身体图像。我们正在使用MRI来可视化可以安全吸入的气体，使我们能够生成肺部图像，显示通风良好（和不通风）的区域。我们的目标是表明，我们可以测量的差异，肺通气功能的人与健康的肺和那些与呼吸系统疾病，并测量通气性能的变化时，呼吸系统疾病的患者服用支气管扩张剂（一种常见的治疗哮喘）。这项工作是有意义的，因为目前还没有成像测量与广泛的临床实践中的这种能力。我们的总体目标是开发这项技术，以便将其引入临床实践，提供新的测量方法，帮助临床医生护理呼吸系统疾病患者。在这项研究中，我们将进行一项概念验证研究，在一组健康志愿者中测试我们的MRI扫描方法的重现性。然后，我们将招募哮喘患者和慢性阻塞性肺疾病（COPD）患者，并证明我们的MRI扫描方法可以消除与这些疾病相关的通气功能受损。我们还将在这些患者接受支气管扩张剂之前和之后进行MRI扫描，以测试我们是否可以检测到由于药物治疗引起的通气特性的变化。本研究是一项试验用药品的临床试验，将在适当的监管批准和监督下进行。一旦我们完成了这些研究，我们将能够更好地发展我们的MRI技术，以评估肺通气特性。我们打算遵循这个目前的项目与更大的多站点研究，证明全氟丙烷MRI在呼吸系统疾病患者的管理中的实用性，然后进一步开发该技术，使其准备好被NHS和其他医疗保健提供者采用。该项目将在两个站点进行，纽卡斯尔和谢菲尔德，是纽卡斯尔大学，谢菲尔德大学、泰恩河畔纽卡斯尔医院NHS基金会信托基金和谢菲尔德教学医院NHS基金会信托基金。

Respiratory diseases are among the leading causes of death worldwide. New treatments for respiratory diseases are increasingly emerging, and tests to determine response to treatments are vital for management of a patient's respiratory disease. Unfortunately, existing measures of assessing lung function and structure have limitations. For example, spirometry cannot provide information on regional change within the lungs, so early localised changes in ventilation properties may pass undetected. Computed tomography (CT) scanning provides images of lung structure, but uses ionising radiation (x-rays) to generate these images and the associated radiation dose means that regular scanning to monitor disease progression or response to therapy is typically impossible. There is therefore a pressing need for new techniques that can perform safe, objective, repeatable and accurate measurement of lung ventilation properties, to better understand how respiratory diseases progress over time and to assess how they respond to therapy strategies.We are developing non-invasive and radiation-free imaging of lung ventilated volume, using new MRI technologies. MRI is a safe and repeatable medical imaging technology that uses strong magnetic fields to generate images of the body. We are using MRI to visualise a gas that can be safely inhaled, allowing us to generate images of the lungs that show areas that are (and that are not) well ventilated. We aim to show that we can measure the differences in lung ventilation properties between people with healthy lungs and those with a respiratory disease, and measure the change in ventilation properties when patients with a respiratory disease take a bronchodilator (a common treatment for asthma).This work is significant because at present there is no imaging measurement with such capabilities in widespread clinical practice. Our overall aim is to develop this technology so that it can be introduced to clinical practice, delivering new measurements to help clinicians care for patients with respiratory disease.In this study we will perform a proof of concept study that tests the reproducibility of our MRI scan methods in a group of healthy volunteers. We will then recruit patients with asthma and patients with chronic obstructive pulmonary disease (COPD) and demonstrate that our MRI scan methods can characterise the impaired ventilation properties associated with these conditions. We will also perform MRI scans before and after these patients receive a bronchodilator, to test whether we can detect a change in ventilation properties due to drug treatment. The study is a clinical trial of an investigational medicinal product, and will be performed with appropriate regulatory approval and oversight.Once we have performed these studies we will be well positioned to further develop our MRI techniques to assess lung ventilation properties. We intend to follow this current project with larger multi-site studies that demonstrate the utility of perfluoropropane MRI in the management of patients with a respiratory disease, and then to further develop the technology such that it is ready for adoption by the NHS and other healthcare providers.This project will be performed at two sites, Newcastle and Sheffield, and is a collaborative project between Newcastle University, The University of Sheffield, the Newcastle upon Tyne Hospitals NHS Foundation Trust, and the Sheffield Teaching Hospitals NHS Foundation Trust.