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Functional and Structural Lung Imaging in Chronic Obstructive Pulmonary Disease

Conditions
Alpha 1-Antitrypsin Deficiency
Chronic Obstructive Pulmonary Disease
Interventions
Diagnostic Test: Lung MRI scan
Registration Number
NCT04966221
Lead Sponsor
University of Nottingham
Brief Summary

This study aims to use novel proton-based MRI techniques to assess lung function and structure in healthy volunteers and patients with chronic obstructive pulmonary disease (COPD) and alpha-1-anti-trypsin deficiency (A1ATD). These novel MRI measures will be compared to matched contemporary clinical diagnostic tools, namely pulmonary function tests (PFTs) and computed tomography (CT) scans. MRI has the advantages of avoiding ionising radiation exposure (unlike CT scans) and can also provide regional measures of lung function (unlike PFTs which provide global measures of function). In addition, these MRI techniques do not require the use of any inhaled or injected contrast agents.

Some patients enrolled in this study will be undergoing a lung volume reduction (LVR) procedure as part of their normal clinical care. LVR is an intervention for patients with severe lung disease and hyperinflation. It is a palliative therapy that helps to reduce lung hyperinflation through insertion of small valves in the airway or surgical removal of parts of the lung. This can lead to improvements in symptoms such as breathlessness and improve exercise tolerance due to better functioning of the lung. In this study, we will explore how lung MRI measures can be used to assess patients before and after an LVR intervention.

This study will take place at the University of Nottingham in collaboration with Nottingham University Hospitals NHS Trust. The study will last for 3 years and participants will be asked to attend a screening visit (lasting up to 1 hour) and either one or two study visits (each lasting up to 3 hours).

Detailed Description

This is a single centre pilot study. The research team aims to recruit adult healthy volunteers and adult patient volunteers with COPD and A1ATD. We have used similar proton-based MRI techniques in healthy volunteers and people with other lung diseases and the MRI scans have been well tolerated.

All participants will be adults (both male and female) who can give informed consent and are able to undertake the study procedures. Potential participants who cannot have an MRI scan for safety reasons (e.g. have a pacemaker) will not be recruited. During study visits, all research activities will be observed by a member of the research team.

During the screening visit (following consent), the following information and measures will be taken:

Relevant past medical history, COPD assessment tool (questionnaire), height, weight, blood pressure and pulse oximetry.

During study visits, a combination of structural and functional lung MRI scans will be performed with the participant lying in the scanner. Participants will be asked to breathe normally during scans and may also be asked to perform breathing manoeuvres such as holding their breath temporarily.

The participants will be assigned unique codes, and their data will be anonymised. Participants' medical reports will only be accessed for study purposes and will be treated as confidential.

The investigators will aim to use the data to plan future studies, and the data from this study may contribute to publications and presentations. Participants will not be identified in any publications arising from the research. The data obtained will be published without any identifying information.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
75
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Adult healthy volunteersLung MRI scanAdult healthy volunteers, age matched to patient volunteers. Will undergo a combination of functional and structural lung MRI scans.
Adults with Chronic Obstructive Pulmonary DiseaseLung MRI scanWill undergo a combination of functional and structural lung MRI scans. Some participants in this cohort will have lung volume reduction (LVR) as part of their normal clinical care. These participants will be given the option to attend two study visits - one before and one after LVR.
Adults with alpha-1-antitrypsin deficiencyLung MRI scanWill undergo a combination of functional and structural lung MRI scans.
Primary Outcome Measures
NameTimeMethod
To acquire structural and functional proton-based lung MRI scans from patients with COPD and COPD due to A1ATD and produce baseline data for these groups to inform future clinical studies3 years

To compare functional MRI outcomes with matched clinical physiological data (e.g. pulmonary function tests) To compare structural lung images with matched conventional imaging techniques done for clinical reasons (e.g. computed tomography) of the diaphragm and lungs

Secondary Outcome Measures
NameTimeMethod
To assess any change of MR outcomes across study visits for participants who undergo LVR3 years
To assess the ability of participants of each group to adhere to the protocols, thus informing the study design of future trials3 years
To assess any change of MR outcomes across study visits for those participants undertaking more than one MR scanning visit.3 years

Trial Locations

Locations (1)

Sir Peter Mansfield Imaging Centre, University of Nottingham

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Nottingham, Nottinghamshire, United Kingdom

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