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Hyperpolarized gas magnetic resonance imaging (MRI) ventilation abnormalities and computed tomography (CT) air trapping are related to lung function and asthma severity but have not been used to target segmental inflammation and remodeling. We evaluate the feasibility of using bronchoscopy guided by <jats:sup>3<\/jats:sup>He MRI and CT to reveal differences in inflammatory response, morphology, and cellular activity in poorly\u2010 (defect) versus well\u2010ventilated (control) lung regions. Eleven participants (5 female; age, 22.8\u2009\u00b1\u20093.4\u2009years; 9 asthma) who experienced a cold with increased lower airway symptoms underwent <jats:sup>3<\/jats:sup>He MRI and\/or CT at least 6\u2009weeks after recovery. Differences between defect and control regions were compared. In defect as compared to control sites, bronchoalveolar lavage neutrophils (<jats:italic>p<\/jats:italic>\u2009=\u20090.06) and granulocytes (<jats:italic>p<\/jats:italic>\u2009=\u20090.08) trended towards an increase; inflammatory mediators (i.e., 15\u2010epi\u2010LXA4, LXA4) were also significantly different (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) between sites. Correlations were observed between macrophages, neutrophils, and eosinophils with inflammatory mediators (i.e., 15\u2010epi\u2010LXA4, LXA4, LTB4). Correlations were observed for macrophages and neutrophils with 15\u2010epi\u2010LXA4, and eosinophils with LXA4 and leukotriene B4. Basement membrane wall thickness was similar for defect versus control sites (<jats:italic>p<\/jats:italic>\u2009=\u20090.9). These results support the feasibility of image\u2010guided methods to identify airway obstruction phenotypes.<\/jats:p>","DOI":"10.14814\/phy2.70119","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T06:15:39Z","timestamp":1740118539000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A method for <scp>MRI<\/scp>\u2010guided bronchoscopy to identify obstructed airway segments"],"prefix":"10.14814","volume":"13","author":[{"given":"David G.","family":"Mummy","sequence":"first","affiliation":[{"name":"Department of Radiology Duke University Medical Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marrissa J.","family":"McIntosh","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine J.","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Medical Physics University of Wisconsin\u2014Madison  Madison Wisconsin USA"},{"name":"Department of Radiology University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Kehoe","sequence":"additional","affiliation":[{"name":"Department of Medical Physics University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephane","family":"Esnault","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine University of Wisconsin\u2014Madison  Madison Wisconsin USA"},{"name":"Institute for Translational Research in Inflammation\u2014U1286\u2014INFINITE University of Lille  Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mats W.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Evans","sequence":"additional","affiliation":[{"name":"Clinical and Translational Science Institute University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald L.","family":"Sorkness","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Schiebler","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nizar N.","family":"Jarjour","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1299-1186","authenticated-orcid":false,"given":"Loren C.","family":"Denlinger","sequence":"additional","affiliation":[{"name":"Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine University of Wisconsin\u2014Madison  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-0646","authenticated-orcid":false,"given":"Sean B.","family":"Fain","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Iowa  Iowa City Iowa USA"},{"name":"Roy. 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