title: Pulmonary CT and MRI phenotypes that help explain chronic pulmonary obstruction disease pathophysiology and outcomes.
abstract: Pulmonary x-ray computed tomographic (CT) and magnetic resonance imaging (MRI) research and development has been motivated, in part, by the quest to subphenotype common chronic lung diseases such as chronic obstructive pulmonary disease (COPD). For thoracic CT and MRI, the main COPD research tools, disease biomarkers are being validated that go beyond anatomy and structure to include pulmonary functional measurements such as regional ventilation, perfusion, and inflammation. In addition, there has also been a drive to improve spatial and contrast resolution while at the same time reducing or eliminating radiation exposure. Therefore, this review focuses on our evolving understanding of patient-relevant and clinically important COPD endpoints and how current and emerging MRI and CT tools and measurements may be exploited for their identification, quantification, and utilization. Since reviews of the imaging physics of pulmonary CT and MRI and reviews of other COPD imaging methods were previously published and well-summarized, we focus on the current clinical challenges in COPD and the potential of newly emerging MR and CT imaging measurements to address them. Here we summarize MRI and CT imaging methods and their clinical translation for generating reproducible and sensitive measurements of COPD related to pulmonary ventilation and perfusion as well as parenchyma morphology. The key clinical problems in COPD provide an important framework in which pulmonary imaging needs to rapidly move in order to address the staggering burden, costs, as well as the mortality and morbidity associated with COPD.
authors.affiliation: Department of Radiology, University of Iowa, Iowa City, Iowa, USA.|Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA.|Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Hoffman
authors.affiliation: Department of Radiology, National Jewish Health Center, Denver, Colorado, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
authors.affiliation: Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Columbia University Medical Center, New York, New York, USA.|Department of Epidemiology, Columbia University Medical Center, New York, New York, USA.
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.affiliation: Clinical Research Imaging Centre, Queen's Medical Research Institute, University of Edinburgh, Scotland, UK.
authors.forename: Edwin J R
authors.initials: EJ
authors.lastname: van Beek
authors.affiliation: Robarts Research Institute, University of Western Ontario, London, Canada.|Department of Medical Biophysics, University of Western Ontario, London, Canada.
authors.forename: Grace
authors.initials: G
authors.lastname: Parraga
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D018450:Disease Progression; D005461:Fluorine / Q000737:chemistry; D005682:Gadolinium / Q000737:chemistry; D006371:Helium / Q000737:chemistry; D006801:Humans; D007249:Inflammation; D007554:Isotopes / Q000737:chemistry; D008168:Lung / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D010477:Perfusion; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015203:Reproducibility of Results; D013552:Swine; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014979:Xenon Isotopes / Q000737:chemistry
chemical_list: D007554:Isotopes; D014979:Xenon Isotopes; D006371:Helium; D005461:Fluorine; D005682:Gadolinium
keywords: COPD; dual energy CT; phenotypes; pulmonary MRI; pulmonary ventilation and perfusion; quantitative CT