Source: Annual Congress 2010 - State of the art imaging
Disease area: Airway diseases

Abstract

Exercise-induced bronchoconstriction (EIB) is characterized by heterogeneous airway obstruction in response to physical exercise. Prophylactic drug therapies depend on the duration and characterization of their bronchoprotective effect. Images of ventilation on hyperpolarized helium-3 (He-3) MRI can be used as an end-point for regional therapy response.
13 subjects with EIB were studied with He-3 MRI in a 3-period placebo-controlled double-blind design; 2 placebo, and 1 treatment with oral Montelukast 10 mg (Merck, Whitehouse Station, NJ). MRI was performed at 30 min prior to dosing, and 3 hours later at 10, and 45 min post-exercise challenge. Image end-points included ventilated volume (VV) and defect number by lung lobe, both compared to FEV1.
Inter-rater agreement with the intra-class correlation coefficient was 0.85 for VV and 0.91 for defect number. Large ventilation defects observed after exercise challenge resolved after treatment in 10 of 13 subjects (77%).

The postchallenge FEV1 dropped 19±12% after placebo compared to 3±7% after treatment (p<0.001). Postchallenge VV dropped 10±12% after placebo compared to 3±8% after treatment (p=0.046). Lung lobes responded equally to challenge after placebo on MRI, but upper lobes were more responsive after treatment (p = 0.0042).
Lung VV on MRI showed similar response to treatment as FEV1, but MRI revealed regional responses not detected by conventional methods.

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S. Fain, G. Parraga, B. Dardzinski, M. Ruddy, A. Harman, L. Mixson, S. Nagle, S. Choy, C. Francois, D. Niles, S. Kruger, R. Burton, N. Jarjour, D. McCormack (Madison, Whitehouse Station, United States Of America; London, Canada). Helium-3 magnetic resonance imaging of treatment response in exercise induced bronchoconstriction. Eur Respir J 2010; 36: Suppl. 54, 5287

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