HypErpolarised Xenon PuLmonary MRI in the Evaluation for EndobronChial Lung Volume ReductIon Therapy (EXPLICIT) (Explicit)

Research summary

COPD is the third leading cause of deaths worldwide. Lung volume reduction (LVR) therapy improves symptoms and life expectancy in severe COPD. The damaged lungs in COPD become overinflated which may cause compression of the more efficient parts of the lung. One-way expiratory endobronchial valves have been developed to be placed in the airways leading to the overinflated lung by bronchoscopy, only allowing air to exit the lung causing deflation and LVR. In some cases, air can enter the targeted lung via “abnormal” routes other than the main airways and this keeps it inflated (“collateral ventilation (CV)”). The current practice to assess presence of CV is with CT and a technique called Chartis which measures air flow in the airways during bronchoscopy. When/if CV has been excluded, suitable patients may be offered LVR using valves. Current assessments result in failure rate of approximately 30% of patients resulting in either suitable patients not being treated or patients being selected for treatment who do not benefit. MRI scanning with a special gas (hyperpolarised xenon) breathed in during the scan could potentially improve the identification of suitable patients for treatment. This technique shows the movement of xenon within the lungs and has been used safely in thousands of patients around the world, and more than 500 in Oxford. Hyperpolarised xenon MRI (HPX-MRI) has been shown to potentially detect CV in research studies. We will observe the pattern of CV in those who have been selected to undergo valve treatment (Cohort A) and those deemed ineligible (Cohort B). By doing so, we may be able to observe a pattern on HPX-MRI that will help identify those who are more or less likely to benefit from valve treatment, improving patient care by removing the need for a Chartis bronchoscopy, and reduce costs to the NHS.

Principal Investigator

Dr Rob Hallifax

Contact us

Email: Avianna.laws@ouh.nhs.uk

IRAS number

346681