• Jens Vogel-Claussen, Julius Renne, Jan Hinrichs, Christian Schönfeld, Marcel Gutberlet, Frank Schaumann, Carla Winkler, Cornelia Faulenbach, Norbert Krug, Frank K Wacker, and Jens M Hohlfeld.
• 1 Institute of Diagnostic and Interventional Radiology and.
• Am. J. Respir. Crit. Care Med.. 2014 Mar 15;189(6):650-7.

RationaleThere is a need to develop novel noninvasive imaging biomarkers that help to evaluate antiinflammatory asthma treatments.ObjectivesTo investigate whether the extent of the segmental lung edema measured noninvasively using turbo-inversion recovery-magnitude magnetic resonance imaging (TIRM MRI) corresponds to the severity of the regional allergic reaction determined by the percentage of eosinophils in bronchoalveolar lavage fluid (BAL) 24 hours after segmental allergen challenge in patients with asthma compared with normal control subjects.MethodsEleven volunteers with allergic asthma and five healthy volunteers underwent segmental challenges with different allergen doses by two bronchoscopies 24 hours apart. They had lung MRI at baseline and 6 and 24 hours after segmental challenge. MRI TIRM scores were correlated with the eosinophilic response at 24 hours.Measurements And Main ResultsIn patients with asthma, there were significant differences of eosinophil percentages in BAL at 24 hours from segments given standard-dose, low-dose, or no allergen (saline) (P < 0.001). Correspondingly significant differences between the TIRM score in allergen standard-dose, low-dose, and saline-treated segments were observed at 24 hours post-challenge (P < 0.001). With increasing TIRM score at 24 hours the percent eosinophils per segment 24 hours post-challenge also increased accordingly (P < 0.001). There was interobserver agreement for TIRM score grading (kappa = 0.72 for 24-h time point).ConclusionsThe MRI-based noninvasive TIRM score is a promising biomarker for the noninvasive detection of the inflammatory response after segmental allergen challenge in patients with asthma and may serve to monitor the therapeutic effectiveness of novel antiinflammatory drugs in future human trials.

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