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MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF
Xuzhe Zhang1, Christopher B Cooper1, Martin R Prince1
1From the Department of Biomedical Engineering (X.Z.) and Columbia Magnetic Resonance Research Center (CMRRC) (W.S.), Columbia University, New York, NY; Departments of Medicine (C.B.C., J.P.F.) and Radiology (J.P.F.), University of California at Los Angeles, Los Angeles, Calif; Department of Radiology, Weill Cornell Medicine, New York, NY (M.R.P.); Department of Radiology (M.R.P., S.M.D., S.J.), Department of Medicine (M.C.B., R.G.B.), Department of Epidemiology (R.G.B.), Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics (W.S.), and Institute of Human Nutrition (W.S.), Columbia University Irving Medical Center, 632 W 168th St, PH-17, New York, NY 10032; Department of Radiology (B.A.V., J.A.C.L.) and Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine (N.N.H.), Johns Hopkins University, Baltimore, Md; Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (D.A.B.); Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (D.C.); Departments of Radiology, Medicine, and the Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa (E.A.H.); Sections on Cardiology and Geriatrics, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC (D.W.K.); Division of Pulmonary, Critical Care, Sleep, and Allergy (J.A.K.) and Department of Radiology, College of Medicine (M.G.M.), University of Illinois at Chicago, Chicago, Ill; Department of Radiology and Biomedical Imaging (Y.J.L., J.L.), Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine (P.G.W.), and Cardiovascular Research Institute (P.G.W.), University of California at San Francisco, San Francisco, Calif; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Wake Forest University, Winston-Salem, NC (J.O., S.P.P.); Division of Pulmonary Medicine, Department of Medicine, Mayo Clinic, Phoenix, Ariz (V.E.O.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.S.); Department of Radiology, Hannover Medical School, Hannover, Germany (J.V.C.); and BREATH, Member of the German Center for Lung Research (DZL), Hannover, Germany (J.V.C.).
None:
Purpose To assess the repeatability of real-time cine pulmonary MRI measures of metronome-paced tachypnea (MPT)-induced dynamic hyperinflation and its relationship with chronic obstructive pulmonary disease (COPD) severity. Materials and Methods SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) (ClinicalTrials.gov identifier no. NCT01969344) is a multicenter prospective cohort study that recruited individuals with COPD with 20 or more pack-years smoking history and controls aged 40-80 years. SPIROMICS-HF is a cross-sectional study evaluating cardiopulmonary interactions in COPD from December 2019 to April 2024. Two-dimensional coronal real-time cine pulmonary MRI (3.2 frames/sec) was performed during MPT twice. Lung masks and lung MR images from an independent study were used for transfer learning to segment real-time cine pulmonary MR images. Dynamic hyperinflation was evaluated as the increase in end-expiratory lung volume (EELV) during tidal breathing to the end of MPT. Repeatability was assessed with intraclass correlation coefficients, and multivariable associations with COPD severity were examined. Results Of the 70 participants (mean age, 67 years ± 10 [SD]; 37 male, 33 female) included in the study, 59% had COPD. The transfer learning model achieved high accuracy in lung segmentation (Dice similarity coefficient, 0.94 ± 0.03). There was good scan-rescan agreement for EELV and dynamic hyperinflation (intraclass correlation coefficient, 0.99 and 0.87, respectively). Dynamic hyperinflation was associated with COPD severity (P trend = .01, with a mean difference between severe COPD and controls of 0.24 L). Conclusion A transfer learning model yielded reproducible quantification of MPT-induced dynamic hyperinflation at real-time cine pulmonary MRI, with greater dynamic hyperinflation in participants with more severe COPD. Keywords: Chronic Obstructive Pulmonary Disease, MR Imaging, Pulmonary, Lung, Technology Assessment Supplemental material is available for this article. ClinicalTrials.gov identifier: NCT01969344 © RSNA, 2025.
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