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Updated: Jan 15, 2026
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Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
988
Phenotyping asthma and/or chronic obstructive pulmonary disease using 129Xe MRI and comprehensive physiologic testing
Helen Marshall1,2, Laurie J Smith1, Alberto M Biancardi1,2
1POLARIS, Section of Medical Imaging and Technologies, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, United Kingdom.
American Journal of Respiratory and Critical Care Medicine
|October 10, 2025
Summary
Hyperpolarized xenon-129 MRI and pulmonary function tests can distinguish between asthma and COPD phenotypes. This imaging technique aids in diagnosing airway diseases and guiding treatment for patients with asthma and/or COPD.
Area of Science:
- Pulmonary Medicine
- Medical Imaging
- Respiratory Physiology
Background:
- Asthma and COPD share diagnostic criteria but have distinct treatments and outcomes.
- Patients with co-existing asthma and COPD (asthma+COPD) experience poorer clinical results.
- Hyperpolarized xenon-129 MRI (129Xe MRI) and pulmonary function tests (PFTs) assess lung function and structure.
Purpose of the Study:
- To evaluate if 129Xe MRI combined with PFTs can aid in phenotyping patients with asthma and/or COPD.
- To identify distinct imaging and functional signatures for different respiratory disease groups.
Main Methods:
- Recruited 165 adult patients diagnosed with asthma and/or COPD from primary care.
- Assessed patients using 129Xe MRI, proton MRI, spirometry, oscillometry, nitrogen washout, and TLco post-bronchodilator.
- Analyzed differences in 129Xe MRI and PFT metrics across diagnostic groups.
Main Results:
- Significant differences in 129Xe MRI and PFT metrics were observed between asthma, COPD, and asthma+COPD groups.
- COPD patients showed reduced, heterogeneous ventilation, larger acinar dimensions, and lower gas transfer on 129Xe MRI compared to asthma patients.
- 129Xe MRI identified abnormalities even in patients with normal spirometry or TLco, highlighting its sensitivity to early or subtle lung disease.
Conclusions:
- 129Xe MRI and PFTs provide distinct airway disease signatures, aiding in the diagnosis of asthma and/or COPD.
- 129Xe MRI is highly sensitive to minimal lung disease, identifying functional and structural phenotypes.
- These findings may help guide personalized treatment decisions for respiratory conditions.
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