{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:25:19Z","timestamp":1786116319840,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["0208A120"],"award-info":[{"award-number":["0208A120"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Pulmonary function tests (PFTs) and medical imaging in cystic fibrosis (CF) occasionally show discrepancies in severity levels, potentially due to different postures during testing (seated PFTs and supine imaging). To assess this, we utilised multiple breath washout with Short extension (MBW\n ShX<\/jats:sub>\n ) and oxygen\u2010enhanced MRI (OE\u2010MRI). MBW\n ShX<\/jats:sub>\n is a more sensitive PFT and offers novel insights into global ventilation efficiency by incorporating signal from under\u2010ventilated lung units (UVLU). We hypothesised there would be a significant difference in MBW\n ShX<\/jats:sub>\n parameters between seated and supine postures and aimed to compare the relationship between MBW\n ShX<\/jats:sub>\n obtained in both posture and OE\u2010MRI.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Twenty three CF patients performed two seated and at least 1onesupine MBW, along with same day OE\u2010MRI. MBW\n ShX<\/jats:sub>\n outcome measures included conventional lung clearance index (LCI\n 2.5<\/jats:sub>\n ), and two novel parameters: LCI\n ShX<\/jats:sub>\n and UVLU. The primary OE\u2010MRI parameter was the ventilation defect percentage (VDP%).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We demonstrated a significant increase in LCI\n ShX<\/jats:sub>\n (median difference [IQR]:2.00[0.16; 2.61];\n p<\/jats:italic>\n \u2009<\u20090.01) and UVLU (0.66[0.11; 2.22];\n p<\/jats:italic>\n \u2009<\u20090.05) from seated to supine posture, but no significant change in LCI\n 2.5<\/jats:sub>\n (0.27 [\u22120.21; 0.89];\n p<\/jats:italic>\n \u2009=\u20090.06). Moreover, we showed strong correlation between MBW and VDP% of OE\u2010MRI parameters across postures (\n \u03c1<\/jats:italic>\n \u2009>\u20090.8). However, no differences were detected between seated and supine MBW correlations with OE\u2010MRI (LCI\n 2.5<\/jats:sub>\n ,\n p<\/jats:italic>\n \u2009=\u20090.77; LCI\n ShX<\/jats:sub>\n ,\n p<\/jats:italic>\n \u2009=\u20090.90; UVLU,\n p<\/jats:italic>\n \u2009=\u20090.29).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n We found significant postural differences in MBW\n ShX<\/jats:sub>\n parameters, with reduced global ventilation efficiency (increased LCI\n ShX<\/jats:sub>\n ) and increased UVLU in supine posture. However, the relationship between MBW and OE\u2010MRI remained unaffected by posture. In conclusion, supine MBW may offer novel clinical insights but does not enhance sensitivity for comparisons with medical imaging.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ppul.71724","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T13:15:35Z","timestamp":1783170935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postural Influence on Ventilation Efficiency and Relationship With Oxygen\u2010Enhanced MRI in Cystic Fibrosis"],"prefix":"10.1002","volume":"61","author":[{"given":"Constantinos","family":"Efthyvoulou","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Semple","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of Paediatrics, Royal Brompton & Harefield Hospitals Part of Guys and St Thomas' Trust London UK"},{"name":"Centre for Paediatrics and Child Health Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Abkir","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of Paediatrics, Royal Brompton & Harefield Hospitals Part of Guys and St Thomas' Trust London UK"},{"name":"Lung Clearance Index Core Facility European Cystic Fibrosis Society London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6857-621X","authenticated-orcid":false,"given":"Marta","family":"Tibiletti","sequence":"additional","affiliation":[{"name":"Bioxydyn Limited Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Padley","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of Paediatrics, Royal Brompton & Harefield Hospitals Part of Guys and St Thomas' Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff J. M.","family":"Parker","sequence":"additional","affiliation":[{"name":"Bioxydyn Limited Manchester UK"},{"name":"Department of Medical Physics & Biomedical Engineering, UCL Hawkes Institute University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane C.","family":"Davies","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of Paediatrics, Royal Brompton & Harefield Hospitals Part of Guys and St Thomas' Trust London UK"},{"name":"Centre for Paediatrics and Child Health Imperial College London UK"},{"name":"Lung Clearance Index Core Facility European Cystic Fibrosis Society London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3131-7639","authenticated-orcid":false,"given":"Christopher","family":"Short","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of Paediatrics, Royal Brompton & Harefield Hospitals Part of Guys and St Thomas' Trust London UK"},{"name":"Lung Clearance Index Core Facility European Cystic Fibrosis Society London 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