A new lung scanning technique has been developed that allows for real-time observation of how treatments affect lung function, enabling clinicians to assess the condition of transplanted lungs. This breakthrough could help doctors identify declines in lung function more quickly.

The method, developed by a team of researchers at Newcastle University (Newcastle upon Tyne, UK), allows experts to track how air moves in and out of the lungs in patients with asthma, chronic obstructive pulmonary disease (COPD), and who have undergone a lung transplant. The team published their findings in Radiology and JHLT Open, explaining their use of perfluoropropane, a special gas visible on an MRI scanner. Safe for patients to inhale and exhale, this gas helps reveal which areas of the lungs are receiving air. By using this technique, the team can identify which parts of the lungs are not properly ventilated and assess the extent of lung disease by measuring both well-ventilated and poorly ventilated regions.

The team demonstrated the effectiveness of the scans in patients with asthma or COPD, as detailed in their first paper in Radiology. This scanning method allows them to measure improvements in lung ventilation following treatments, such as the bronchodilator salbutamol. This finding suggests that the technique could be valuable for assessing new treatments for lung diseases in clinical trials. In another study, published in JHLT Open, the team applied the method to lung transplant recipients at Newcastle upon Tyne Hospitals NHS Foundation Trust. They refined the technique to measure lung function in transplant patients, which could improve the care and monitoring of these individuals. The sensitivity of the method enables early detection of lung function changes, allowing for quicker identification of lung problems and better patient care.

In their studies, the researchers scanned transplant recipients’ lungs as they breathed in and out, collecting MRI images that show how the gas reached different parts of the lungs. They examined patients with normal lung function as well as those experiencing chronic rejection, a common complication where the immune system attacks the transplanted lungs. In patients with chronic rejection, the scans revealed reduced air movement to the outer parts of the lungs, likely due to damage in the small airways, a hallmark of chronic lung allograft dysfunction. The researchers believe this scanning method holds promise for enhancing the clinical management of lung transplant recipients and patients with other lung diseases, providing an early, sensitive measurement of lung function that could lead to better treatment outcomes.

“We hope this new type of scan might allow us to see changes in the transplant lungs earlier and before signs of damage are present in the usual blowing tests,” said Professor Andrew Fisher, Professor of Respiratory Transplant Medicine at Newcastle Hospitals NHS Foundation Trust and Newcastle University, co-author of the study. “This would allow any treatment to be started earlier and help protect the transplanted lungs from further damage.”

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