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Abstract #0772

Pulmonary Functional MRI to Phenotype COPD and Evaluate Treatment Efficacy: Intermediate Endpoints and Predictors of Efficacy when Conventional endpoints fail?

Sarah Svenningsen 1,2 , Gregory Paulin 1,2 , Miranda Kirby 1,2 , Nikhil Kanhere 1,3 , Roya Etemad-Rezai 4 , David G McCormack 5 , and Grace Parraga 1,2

1 Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada, 2 Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada, 3 Graduate Program in Biomedical Engineering, The University of Western Ontario, London, Ontario, Canada, 4 Department of Medical Imaging, The University of Western Ontario, London, Ontario, Canada, 5 Department of Medicine, The University of Western Ontario, London, Ontario, Canada

In subjects with advanced COPD, we evaluated hyperpolarized 3 He MRI measurements of emphysema and airways disease in a study of the 4-week treatment efficacy of a handheld airway clearance device for mobilizing mucous secretions. Whereas all subjects reported a modest improvement in ease of clearing mucous following therapy, 6/14 subjects showed improved 3 He MRI ventilation (p=0.04), with concomitantly improved forced vital capacity and 6MWD, and this was not observed in imaging non-responders. In addition, imaging measurements of emphysema was a negative-predictor of response. Non-invasive imaging measurements of COPD can be used as intermediate endpoints and phenotypes in therapy trials.

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