Cystic Fibrosis or asthma? Discerning dyspnea with hyperpolarizaed xenon gas magnetic resonance imaging

Hyperpolarized Xenon MRI (HPG MRI) has been studied for its potential use in assessing lung function in patients with cystic fibrosis (CF) and in patients with asthma. We present a case of a man with overlapping cystic fibrosis and allergic asthma with severe obstructive lung disease in which spirometry and computed topography (CT) imaging was unable to determine the primary cause for his uncontrolled symptoms. HPG MRI was used to guide a tissue biopsy and determine the primary driver to be allergic asthma. After starting targeted therapy for severe asthma, his symptoms have greatly improved.