Evaluation of 3D Magnetic Resonance Spirometry: Comparison with Spirometry in Healthy Subjects and Patients with Respiratory Pathologies (asthma, COPD, Bilateral Lung Transplant) (gb-Spiro3D)

Commissariat A L'energie Atomique

Status: Enrolling

Conditions: Asthma; COPD; BOS

Treatments: Drug: 3. Reversibility test with salbutamol; Diagnostic Test: 4. 3D dynamic lung MRI at UTE in supine and prone position; Diagnostic Test: 2. 3D dynamic lung MRI at UTE in prone and supine positions; Diagnostic Test: 1. Standard spirometry

Study type: Interventional

Funder types: Other

Identifiers

NCT05724745

2021-A00672-39 (Other Identifier)

CEA 100-061

Details and patient eligibility

About

Spirometry is now the gold standard technique for assessing lung function in humans. From the shape of a flow-volume curve measured while the patient, trained by the practitioner, performs forced breaths, the forced vital capacity (FVC) and the forced expiratory volume in one second (FEV1) can be deduced and the pulmonologist is able to detect and characterize respiratory diseases as well as to evaluate current treatments. This technique is non-invasive and simple. It is widely available, robust, reproducible and sensitive to intervention. However, it requires proactive cooperation from the patient and only measures global pulmonary ventilation, without locoregional information.

An innovative strategy and an original study framework have been developed in the BioMaps laboratory to establish local maps of flow-volume curves across the lung and to jointly analyze ventilatory function and mechanical behavior at any point in the lung: 3D magnetic resonance spirometry. As respiratory mechanics fundamentally supports ventilatory function, this technique should open a new avenue to non-invasively explore lung function while providing a better diagnosis of regional lung diseases.

Full description

Main objectiif / Evaluate the concordance of the results provided by 3D spirometry using compared with those obtained by spirometry in four populations: healthy four populations: healthy volunteers, asthma patients, patients with chronic obstructive pulmonary, chronic obstructive pulmonary disease (COPD) and lung transplant patients. with and without bronchiolitis obliterans syndrome (BOS). obliterative bronchiolitis syndrome (BOS).

Enrollment: 240 estimated patients

Sex: All

Ages: 18 to 90 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

Generic inclusion criteria

• Ability to understand the nature and objectives of the study
• Ability to remain immobile in an MRI scanner in supine position for the entire duration of the acquisitions
• Ability to give free and informed written consent Specific inclusion criteria for healthy volunteers
• Age: 18-45 years
• No known and diagnosed pulmonary pathology such as respiratory insufficiency, COPD, asthma or cancer
• Ability to remain motionless in an MRI scanner in a prone position for a total of 50 min.
• Non-smoker and non-smoker Specific inclusion criteria for asthma patients
• Age: 18-80 years
• Asthma of varying degrees of severity, depending on inhalation required to achieve control:
• Diagnosis of asthma classified as moderate according to the Global initiative for asthma (GINA) guidelines for at least 6 months
• Diagnosis of asthma classified as severe according to the Global initiative for asthma (GINA) guidelines for at least 6 months months with initiation of biotherapy planned by their pulmonologist
• Non-smoker and non-vapourist Specific inclusion criteria for COPD patients
• Age: 40-80 years
• COPD of varying degrees of severity:
• Diagnosis of COPD classified as moderate according to the Global initiative for chronic obstructive lung disease guidelines (GOLD 2: VEMS = 50-79%)
• Diagnosis of COPD classified as severe according to the guidelines for chronic obstructive lung disease (GOLD 3: VEMS = 30-49%) Specific inclusion criteria for patients with bilateral lung transplants with BOS
• Age: 18-90 years
• Irreversible FEV1 < 80% of baseline with FEV1/FVC ratio FEV1/FVC < 0.7
• Absence of visible parenchymal opacity on CT scan (non inclusion of mixed RAS/CLAD)
• Absence of significant bronchial stenosis (having required endoscopic endoscopic treatment)
• No diaphragmatic involvement (established by sniff test under fluoroscopy fluoroscopy or diaphragmatic ultrasound) Specific inclusion criteria for patients with bilateral lung transplants without BOS
• Age: 18-90 years
• FEV1 > 90% baseline for more than 24 months after the date of date of lung transplantation
• Absence of significant bronchial stenosis (requiring endoscopic endoscopic treatment)
• Absence of diaphragmatic impairment (established by sniff test under fluoroscopy or diaphragmatic ultrasound)

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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240 participants in 1 patient group

Healthy volunteers, Asthmatic patients and COPD patients

Other group

Description:

This arm of the study is essential to establish nominal flow-volume maps of nominal flow-volume curves and to determine the dependence of normal breathing on gravity and response to a bronchodilator in order to evaluate the sensitivity and specificity of the technique for the known lung diseases asthma and COPD by comparing data from healthy the data from healthy subjects with those from sick subjects.

Treatment:

Diagnostic Test: 1. Standard spirometry

Diagnostic Test: 2. 3D dynamic lung MRI at UTE in prone and supine positions

Diagnostic Test: 4. 3D dynamic lung MRI at UTE in supine and prone position

Drug: 3. Reversibility test with salbutamol