{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:39:58Z","timestamp":1790264398894,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T00:00:00Z","timestamp":1620345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","award":["ESR\u201017\u201012722"],"award-info":[{"award-number":["ESR\u201017\u201012722"]}],"id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL105643"],"award-info":[{"award-number":["R01HL105643"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2021,9]]},"abstract":"Background<\/jats:title>Hyperpolarized 129<\/jats:sup>Xe magnetic resonance imaging (MRI) provides a non\u2010invasive assessment of regional pulmonary gas exchange function. This technique has demonstrated that chronic obstructive pulmonary disease (COPD) patients exhibit ventilation defects, reduced interstitial barrier tissue uptake, and poor transfer to capillary red blood cells (RBCs). However, the behavior of these measurements following therapeutic intervention is unknown.<\/jats:p><\/jats:sec>Purpose<\/jats:title>To characterize changes in 129<\/jats:sup>Xe gas transfer function following administration of an inhaled long\u2010acting beta\u2010agonist\/long\u2010acting muscarinic receptor antagonist (LABA\/LAMA) bronchodilator.<\/jats:p><\/jats:sec>Study Type<\/jats:title>Prospective.<\/jats:p><\/jats:sec>Population<\/jats:title>Seventeen COPD<\/jats:styled-content> subjects (GOLD<\/jats:styled-content> II\/III classification per Global Initiative for Chronic Obstructive Lung Disease criteria) were imaged before and after 2\u2009weeks of LABA<\/jats:styled-content>\/LAMA<\/jats:styled-content> therapy.<\/jats:p><\/jats:sec>Field Strength\/Sequences<\/jats:title>Dedicated ventilation imaging used a multi\u2010slice 2D gradient echo sequence. Three\u2010dimensional images of ventilation, barrier uptake, and RBC transfer used an interleaved, radial, 1\u2010point Dixon sequence. Imaging was acquired at 3\u2009T.<\/jats:p><\/jats:sec>Assessment<\/jats:title>129<\/jats:sup>Xe measurements were quantified before and after LABA\/LAMA treatment by ventilation defect\u2009+\u2009low percent (vendef\u2009+\u2009low<\/jats:sub>) and by barrier uptake and RBC transfer relative to a healthy reference population (bar%ref<\/jats:sub> and RBC%ref<\/jats:sub>). Pulmonary function tests, including diffusing capacity of the lung for carbon monoxide (DLCO<\/jats:sub>), were also performed before and after treatment.<\/jats:p><\/jats:sec>Statistical Tests<\/jats:title>Paired t<\/jats:italic>\u2010test, Pearson correlation coefficient (r<\/jats:italic>).<\/jats:p><\/jats:sec>Results<\/jats:title>Baseline vendef\u2009+\u2009low<\/jats:sub> was 57.8\u2009\u00b1\u20098.4%, bar%ref<\/jats:sub> was 73.2\u2009\u00b1\u200919.6%, and RBC%ref<\/jats:sub> was 36.5\u2009\u00b1\u200913.6%. Following treatment, vendef\u2009+\u2009low<\/jats:sub> decreased to 52.5\u2009\u00b1\u200910.6% (P<\/jats:italic>\u2009<\u20090.05), and improved in 14\/17 (82.4%) of subjects. However, RBC%ref<\/jats:sub> decreased in 10\/17 (58.8%) of subjects. Baseline measurements of bar%ref<\/jats:sub> and DLCO<\/jats:sub> were correlated with the degree of post\u2010treatment change in vendef\u2009+\u2009low<\/jats:sub> (r<\/jats:italic>\u00a0=\u00a0\u22120.49, P<\/jats:italic>\u2009<\u20090.05 and r<\/jats:italic>\u00a0=\u00a0\u22120.52, P<\/jats:italic>\u2009<\u20090.05, respectively).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>LABA\/LAMA therapy tended to preferentially improve ventilation in subjects whose 129<\/jats:sup>Xe barrier uptake and DLCO<\/jats:sub> were relatively preserved. However, newly ventilated regions often revealed RBC transfer defects, an aspect of lung function opaque to spirometry. These microvasculature abnormalities must be accounted for when assessing the effects of LABA\/LAMA therapy.<\/jats:p><\/jats:sec>Level of Evidence<\/jats:title>1<\/jats:p><\/jats:sec>Technical Efficacy Stage<\/jats:title>4<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27662","type":"journal-article","created":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T20:47:18Z","timestamp":1620506838000},"page":"964-974","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Regional Gas Exchange Measured by 129<\/sup>Xe<\/scp> Magnetic Resonance Imaging Before and After Combination Bronchodilators Treatment in Chronic Obstructive Pulmonary Disease"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7885-109X","authenticated-orcid":false,"given":"David G.","family":"Mummy","sequence":"first","affiliation":[{"name":"Center for In Vivo Microscopy Duke University Durham North Carolina 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