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Abstract #5158

Utilising hyperpolarised xenon and dynamic contrast enhanced MRI to assess the potential pulmonary sequelae of bleomycin therapy - a pilot study

Paul John Clifford Hughes1, Raman Kular1,2, Marta Tibiletti3, Guilhem J Collier1, Laurie J Smith1, Robin Young4, Jan Wolber1,5, Geoffrey J.M. Parker3,6, Jim M Wild1, and Stephen M Bianchi7
1POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, SMPH, University of Sheffield, Sheffield, United Kingdom, 2Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, 3Bioxydyn Limited, Manchester, United Kingdom, 4Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, 5Pharmaceutical Diagnostics, GE HealthCare, Chalfont St Giles, United Kingdom, 6UCL Hawkes Institute, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom, 7Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

Synopsis

Keywords: Lung, Lung

Motivation: Drug-induced interstitial lung disease (DI-ILD) is particularly difficult to diagnose. We sought to assess whether MR imaging biomarkers can provide new insights into the changes caused by bleomycin.

Goal(s): To evaluate if hyperpolarised xenon and dynamic contrast-enhanced MRI can better describe pathophysiological changes from bleomycin chemotherapy.

Approach: A single-centre prospective study with imaging: prior to chemotherapy, 1-6 weeks post cycle 1, 8-14 weeks post cycle 3 OR 4 and 24-28 weeks following completion of chemotherapy.

Results: Eleven patients were recruited. RBC:M ratio and PBV changes suggesting inflammatory rather than fibrotic alterations in this cohort of patients.

Impact: Improved early diagnosis of drug-induced lung toxicity using a combination of structural and functional MRI may directly influence how inflammatory and fibrotic ILD is managed, particularly in patients undergoing novel therapies.

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