Abstract
Asthma is a heterogeneous, chronic airway disease resulting from inflammation, airway hyperresponsiveness and remodeling as well as abnormal mucus secretions that obstruct airflow. Asthma patients report symptoms of debilitating and unpredictable dyspnea and wheeze that dramatically diminish quality of life and exercise capacity that increase healthcare resource utilization and lost work and school days. Due in part to the limitations of spirometry and despite decades of research, it remains difficult, if not impossible, to identify and measure the pathologies directly responsible for asthma symptoms, response to therapy, and chronic worsening. In vivo imaging offers the potential to measure asthma airway structure and function simultaneously, noninvasively and repeatedly; pulmonary structure-function imaging in particular provides a wide array of applications that have been developed and evaluated in the research setting to support patient phenotyping, treatment decisions, therapy response evaluations, and longitudinal monitoring. However, despite the potential to improve asthma outcomes, medical imaging methods have played very little, if not negligible, role in asthma patient clinical care. To bridge this knowledge and healthcare gap, we summarize the potential for anatomical and functional imaging methods in asthma patients. This chapter focuses on Xe-enhanced dual-energy CT, PET imaging using 18F-FDG glucose, 13NN, and 18F-(±)iNOS, OCT, and a variety of MRI techniques including Fourier decomposition 1H MRI, 4DMRI, and inhaled gas (O2, 19F, 3He, 129Xe) applications. The novel and clinically relevant information pulmonary imaging provides in asthma patients may now be considered in patients to personalize care and improve asthma patient outcomes while decreasing healthcare costs and resource utilization.
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Barker, A.L., Eddy, R.L., Yaremko, H., Kirby, M., Parraga, G. (2021). Structure-Function Imaging of Asthma: Airway and Ventilation Biomarkers. In: Ohno, Y., Hatabu, H., Kauczor, HU. (eds) Pulmonary Functional Imaging. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-43539-4_9
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