{
  "abstract": "Rationale Airways dysanapsis is defined by CT or spirometry as a mismatch between the size of the airways and lung volume and is associated with increased risk of developing chronic obstructive pulmonary disease (COPD). Lung disease in participants with dysanapsis and a label of asthma and/or COPD remains poorly understood.Methods In participants with asthma and/or COPD, we used 129Xe-MRI to assess ventilation, acinar dimensions and gas exchange, and pulmonary function tests, and compared people with spirometric dysanapsis (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)<−1.64 z and FEV1>−1.64 z) to those with normal spirometry (FEV1, FVC and FEV1/FVC>−1.64 z).Results From 165 participants assessed in the NOVELTY (NOVEL observational longiTudinal studY) ADPro (advanced diagnostic profiling) study with a physician-assigned diagnosis of asthma and/or COPD, 43 had spirometric dysanapsis and were age-matched to 43 participants with normal spirometry. Participants with dysanapsis had significantly increased ventilation defects (median difference (md) (95% CI) = 4.0% (1.42% to 5.38%), p<0.001), ventilation heterogeneity (md (95% CI) = 2.56% (1.31% to 3.56%), p<0.001) and measures of acinar dimensions (md (95% CI) = 0.004 cm 2.s−1 (0.0009 to 0.007), p=0.009) from 129Xe-MRI, than those with normal spirometry. At the 1-year follow-up, only participants with dysanapsis had a significant increase in ventilation defects (md (95% CI)=0.45% (0.09% to 2.1%),p=0.016). Lower FEV1/FVC in the dysanapsis cohort was associated with increased ventilation defects (r=−0.64, R2=0.41, p<0.001) and increased acinar dimensions (r=−0.52, R2=0.38, p<0.001), with the highest values seen in those with an FVC above the upper limit of normal.Conclusions Participants with asthma and/or COPD, presenting to primary care with spirometric dysanapsis, exhibited increased lung abnormalities on 129Xe-MRI, when compared with those with normal spirometry. Spirometric dysanapsis in asthma and/or COPD is therefore associated with significant lung disease, and the FEV1/FVC is related to the degree of airways abnormality on 129Xe-MRI.",
  "authors": [
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Laurie J Smith"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Helen Marshall"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Demi Jakymelen"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Alberto Biancardi"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Guilhem J Collier"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Ho-Fung Chan"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Paul J C Hughes"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Martin L Brook"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Josh R Astley"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Ryan Munro"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Smitha Rajaram"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Andrew J Swift"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "David Capener"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Jody Bray"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Jimmy E Ball"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Oliver Rodgers"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Bilal A Tahir"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Madhwesha Rao"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Graham Norquay"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Nicholas D Weatherley"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Leanne Armstrong"
    },
    {
      "affiliations": [
        "Priory Medical Group, York, UK"
      ],
      "name": "Latife Hardaker"
    },
    {
      "affiliations": [
        "Respiratory Unit, University Hospital S Anna, Ferarra, Italy"
      ],
      "name": "Alberto Papi"
    },
    {
      "affiliations": [
        "Early Development Respiratory, AstraZeneca, Cambridge, UK"
      ],
      "name": "Rod Hughes"
    },
    {
      "affiliations": [
        "POLARIS, Section of Medical Imaging and Technology, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK"
      ],
      "name": "Jim M Wild"
    }
  ],
  "title": "129Xe-MRI ventilation and acinar abnormalities highlight the significance of spirometric dysanapsis: findings from the NOVELTY ADPro UK substudy",
  "uid": "037f9174-1826-54a8-9399-2daa80350553"
}