Feasibility assessment of using oxygen-enhanced magnetic resonance imaging for evaluating the effect of pharmacological treatment in COPD.

Autor: Morgan AR; Bioxydyn Ltd, Manchester, UK; Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK. Electronic address: alex.morgan@bioxydyn.com., Parker GJ; Bioxydyn Ltd, Manchester, UK; Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK., Roberts C; Bioxydyn Ltd, Manchester, UK; Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK., Buonaccorsi GA; Bioxydyn Ltd, Manchester, UK., Maguire NC; Bioxydyn Ltd, Manchester, UK., Hubbard Cristinacce PL; Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK., Singh D; University of Manchester, Medicines Evaluation Unit, Manchester Academic Health Sciences Centre, University Hospital of South Manchester, Manchester, UK., Vestbo J; University of Manchester, Medicines Evaluation Unit, Manchester Academic Health Sciences Centre, University Hospital of South Manchester, Manchester, UK., Bjermer L; Department of Respiratory Medicine & Allergology, Skåne University Hospital, Lund, Sweden., Jögi J; Department of Clinical Physiology, Skåne University Hospital and Lund University, Lund, Sweden., Taib Z; AstraZeneca R&D, Mölndal, Sweden., Sarv J; AstraZeneca R&D, Mölndal, Sweden., Bruijnzeel PL; AstraZeneca R&D, Mölndal, Sweden., Olsson LE; AstraZeneca R&D, Mölndal, Sweden., Bondesson E; AstraZeneca R&D, Mölndal, Sweden., Nihlén U; Department of Respiratory Medicine & Allergology, Skåne University Hospital, Lund, Sweden; AstraZeneca R&D, Mölndal, Sweden., McGrath DM; Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK., Young SS; AstraZeneca R&D, Alderley Park, UK., Waterton JC; Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; AstraZeneca R&D, Alderley Park, UK., Nordenmark LH; AstraZeneca R&D, Mölndal, Sweden.
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2014 Nov; Vol. 83 (11), pp. 2093-101. Date of Electronic Publication: 2014 Aug 17.
DOI: 10.1016/j.ejrad.2014.08.004
Abstrakt: Objectives: Oxygen-enhanced MRI (OE-MRI) biomarkers have potential value in assessment of COPD, but need further evaluation before treatment-induced changes can be interpreted. The objective was to evaluate how OE-MRI parameters of regional ventilation and oxygen uptake respond to standard pharmacological interventions in COPD, and how the response compares to that of gold standard pulmonary function tests.
Materials and Methods: COPD patients (n=40), mean FEV1 58% predicted normal, received single-dose inhaled formoterol 9μg, or placebo, followed by 8 weeks treatment bid with a combination of budesonide and formoterol Turbuhaler(®) 320/9μg or formoterol Turbuhaler(®). OE-MRI biomarkers were obtained, as well as X-ray computed tomography (CT) biomarkers and pulmonary function tests, in a two-center study. An ANCOVA statistical model was used to assess effect size of intervention measurable in OE-MRI parameters of lung function.
Results: OE-MRI data were successfully acquired at both study sites. 8-week treatment with budesonide/formoterol significantly decreased lung wash-out time by 31% (p<0.01), decreased the change in lung oxygen level upon breathing pure oxygen by 13% (p<0.05) and increased oxygen extraction from the lung by 58% (p<0.01). Single-dose formoterol increased both lung wash-out time (+47%, p<0.05) and lung oxygenation time (+47%, p<0.05). FEV1 was improved by single-dose formoterol (+12%, p<0.001) and 8 weeks of budesonide/formoterol (+ 18%, p<0.001), consistent with published studies.
Conclusions: In COPD, OE-MRI parameters showed response to both single-dose bronchodilatory effects of a β2-agonist, formoterol, and 8-week treatment with an inhaled corticosteroid, budesonide, and the measurements are feasible in a small-scale multi-center trial setting.
(Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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