MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF Study

Xuzhe Zhang¹, Christopher B Cooper¹, Martin R Prince¹, Bharath Ambale-Venkatesh¹, Prachi P Agarwal¹, Michael C Backman¹, David A Bluemke¹, David Couper¹, Stephen M Dashnaw¹, John P Finn¹, Nadia N Hansel¹, Eric A Hoffman¹, Sachin Jambawalikar¹, Dalane W Kitzman¹, Jerry A Krishnan¹, Yoo Jin Lee¹, João A C Lima¹, Jing Liu¹, Martha G Menchaca¹, Jill Ohar¹, Victor E Ortega¹, Robert Paine 3rd¹, Stephen P Peters¹, Joyce D Schroeder¹, Jens Vogel-Claussen¹, Prescott G Woodruff¹, R Graham Barr¹, Wei Shen¹

Affiliations

Affiliation

¹ From the Department of Biomedical Engineering (X.Z.) and Columbia Magnetic Resonance Research Center (CMRRC) (W.S.), Columbia University, New York, NY; Departments of Medicine (C.B.C., J.P.F.) and Radiology (J.P.F.), University of California at Los Angeles, Los Angeles, Calif; Department of Radiology, Weill Cornell Medicine, New York, NY (M.R.P.); Department of Radiology (M.R.P., S.M.D., S.J.), Department of Medicine (M.C.B., R.G.B.), Department of Epidemiology (R.G.B.), Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics (W.S.), and Institute of Human Nutrition (W.S.), Columbia University Irving Medical Center, 632 W 168th St, PH-17, New York, NY 10032; Department of Radiology (B.A.V., J.A.C.L.) and Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine (N.N.H.), Johns Hopkins University, Baltimore, Md; Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (D.A.B.); Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (D.C.); Departments of Radiology, Medicine, and the Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa (E.A.H.); Sections on Cardiology and Geriatrics, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC (D.W.K.); Division of Pulmonary, Critical Care, Sleep, and Allergy (J.A.K.) and Department of Radiology, College of Medicine (M.G.M.), University of Illinois at Chicago, Chicago, Ill; Department of Radiology and Biomedical Imaging (Y.J.L., J.L.), Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine (P.G.W.), and Cardiovascular Research Institute (P.G.W.), University of California at San Francisco, San Francisco, Calif; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Wake Forest University, Winston-Salem, NC (J.O., S.P.P.); Division of Pulmonary Medicine, Department of Medicine, Mayo Clinic, Phoenix, Ariz (V.E.O.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.S.); Department of Radiology, Hannover Medical School, Hannover, Germany (J.V.C.); and BREATH, Member of the German Center for Lung Research (DZL), Hannover, Germany (J.V.C.).

PMID: 39836055
PMCID: PMC11880862 (available on 2026-02-01)
DOI: 10.1148/ryct.240053

Observational Study

MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF Study

Xuzhe Zhang et al. Radiol Cardiothorac Imaging. 2025 Feb.

. 2025 Feb;7(1):e240053.

doi: 10.1148/ryct.240053.

Authors

Affiliation

¹ From the Department of Biomedical Engineering (X.Z.) and Columbia Magnetic Resonance Research Center (CMRRC) (W.S.), Columbia University, New York, NY; Departments of Medicine (C.B.C., J.P.F.) and Radiology (J.P.F.), University of California at Los Angeles, Los Angeles, Calif; Department of Radiology, Weill Cornell Medicine, New York, NY (M.R.P.); Department of Radiology (M.R.P., S.M.D., S.J.), Department of Medicine (M.C.B., R.G.B.), Department of Epidemiology (R.G.B.), Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics (W.S.), and Institute of Human Nutrition (W.S.), Columbia University Irving Medical Center, 632 W 168th St, PH-17, New York, NY 10032; Department of Radiology (B.A.V., J.A.C.L.) and Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine (N.N.H.), Johns Hopkins University, Baltimore, Md; Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (D.A.B.); Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (D.C.); Departments of Radiology, Medicine, and the Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa (E.A.H.); Sections on Cardiology and Geriatrics, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC (D.W.K.); Division of Pulmonary, Critical Care, Sleep, and Allergy (J.A.K.) and Department of Radiology, College of Medicine (M.G.M.), University of Illinois at Chicago, Chicago, Ill; Department of Radiology and Biomedical Imaging (Y.J.L., J.L.), Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine (P.G.W.), and Cardiovascular Research Institute (P.G.W.), University of California at San Francisco, San Francisco, Calif; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Wake Forest University, Winston-Salem, NC (J.O., S.P.P.); Division of Pulmonary Medicine, Department of Medicine, Mayo Clinic, Phoenix, Ariz (V.E.O.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.S.); Department of Radiology, Hannover Medical School, Hannover, Germany (J.V.C.); and BREATH, Member of the German Center for Lung Research (DZL), Hannover, Germany (J.V.C.).

PMID: 39836055
PMCID: PMC11880862 (available on 2026-02-01)
DOI: 10.1148/ryct.240053

Abstract

Purpose To assess the repeatability of real-time cine pulmonary MRI measures of metronome-paced tachypnea (MPT)-induced dynamic hyperinflation and its relationship with chronic obstructive pulmonary disease (COPD) severity. Materials and Methods SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) (ClinicalTrials.gov identifier no. NCT01969344) is a multicenter prospective cohort study that recruited individuals with COPD with 20 or more pack-years smoking history and controls aged 40-80 years. SPIROMICS-HF is a cross-sectional study evaluating cardiopulmonary interactions in COPD from December 2019 to April 2024. Two-dimensional coronal real-time cine pulmonary MRI (3.2 frames/sec) was performed during MPT twice. Lung masks and lung MR images from an independent study were used for transfer learning to segment real-time cine pulmonary MR images. Dynamic hyperinflation was evaluated as the increase in end-expiratory lung volume (EELV) during tidal breathing to the end of MPT. Repeatability was assessed with intraclass correlation coefficients, and multivariable associations with COPD severity were examined. Results Of the 70 participants (mean age, 67 years ± 10 [SD]; 37 male, 33 female) included in the study, 59% had COPD. The transfer learning model achieved high accuracy in lung segmentation (Dice similarity coefficient, 0.94 ± 0.03). There was good scan-rescan agreement for EELV and dynamic hyperinflation (intraclass correlation coefficient, 0.99 and 0.87, respectively). Dynamic hyperinflation was associated with COPD severity (P trend = .01, with a mean difference between severe COPD and controls of 0.24 L). Conclusion A transfer learning model yielded reproducible quantification of MPT-induced dynamic hyperinflation at real-time cine pulmonary MRI, with greater dynamic hyperinflation in participants with more severe COPD. Keywords: Chronic Obstructive Pulmonary Disease, MR Imaging, Pulmonary, Lung, Technology Assessment Supplemental material is available for this article. ClinicalTrials.gov identifier: NCT01969344 © RSNA, 2025.

Keywords: Chronic Obstructive Pulmonary Disease; Lung; MR Imaging; Pulmonary; Technology Assessment.

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Conflict of interest statement

Disclosures of conflicts of interest: X.Z. No relevant relationships. C.B.C. Support for the present manuscript from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) Foundation and the NIH COPD Foundation; royalties or licenses from Cambridge University Press; consulting fees from MGC Diagnostics, Chiesi, Herbalife Nutrition Institute, Respiree, and Aer Therapeutics; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from GSK and Chulalongkorn University; payment from various law firms for expert testimony; support from MGC Diagnostics for attending meetings and/or travel; participation on a Data Safety Monitoring Board or advisory board for Nuvaira and Horizon Therapeutics. M.R.P. Support for the present manuscript from NIH grant R01 HL093081, author is co-investigator (August 23, 2008, through June 30, 2024), Combined Cardiopulmonary Failure in COPD: Spiromics HF. B.A.V. No relevant relationships. P.P.A. Support for the present manuscript from NIH grant RO1 HL093081: SPIROMICS II Heart Failure Substudy, author is co-investigator, SubK-NIH-DHHS-US sourced funding through Columbia University, September 2019 through June 2023 ($577 527); grants or contracts from Cytokinetics for a phase 3, multicenter, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of CK-3773274 in adults with symptomatic hypertrophic cardiomyopathy and left ventricular outflow tract obstruction, author is co-investigator, September 2022 through March 2024 ($417 696), from the American College of Radiology for Impact of a Patient-centered Approach for Communicating Coronary Calcium on Cardiovascular Health, author is primary investigator, January 2022 through January 2024 ($65 334), and from MyoKardia for A Randomized, Double-blind, Placebo-controlled Clinical Study to Evaluate Mavacamtem (MYK-461) in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy, author is co-investigator, June 2018 through March 2022 ($303 323); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from The Ottawa Hospital for visiting professorship (March 2023), Radiology in the Desert (Scottsdale, Ariz, March 2023), and Columbia University for visiting professorship: case-based presentation for residents and lecture titled Hemodynamically Significant Coronary Artery Anomalies (New York City, April 2021); support for ABR-related travel; editor in chief for Seminars in Roentgenology; NASCI president-elect; member of Radiology: Cardiothoracic Imaging editorial board. M.C.B. No relevant relationships. D.A.B. Support for the present manuscript from the NIH; member of the RSNA Publication Ethics Committee; editor emeritus for Radiology. D.C. Support for the present manuscript from the NHLBI COPD Foundation (research grants to author’s institution). S.M.D. No relevant relationships. J.P.F. Grants or contracts from the SPIROMICS multicenter trial. N.N.H. Grants for contracts from the NIH COPD Foundation (paid to author’s institution), AstraZeneca (paid to author’s institution), and GSK (paid to author’s institution); participation on advisory boards for AstraZeneca, GSK, Regeneron, and Smoking in COPD US. E.A.H. Support for the present manuscript from the NIH/NHLBI (grant to University of Iowa); NIH subcontract to University of Iowa; royalties from VIDA Diagnostics, paid to University of Iowa; consulting fees from VIDA Diagnostics, paid to author; founder and shareholder of VIDA Diagnostics, a company commercializing lung image analysis software developed, in part, at the University of Iowa; member of Siemens Healthineers Thoracic Imaging with Photon-Counting CT Advisory Board. S.J. No relevant relationships. D.W.K. Support for the present manuscript for an NIH grant; consulting fees from AstraZeneca, Pfizer, Corvia Medical, Bayer, Boehringer Ingelheim, Novo Nordisk, Rivus, and St Luke’s Medical Center; grant support from Novartis, AstraZeneca, Bayer, Pfizer, Novo Nordisk, Rivus, and St Luke’s Medical Center; owns stock in Gilead Sciences. J.A.K. Support for the present manuscript from the NIH; grants or contracts from the Patient-Centered Outcomes Research Institute (paid to author’s institution), the American Lung Association (paid to author’s institution), and the COPD Foundation (paid to author’s institution); consulting fees from AstraZeneca for monoclonal Ab for asthma (paid to author’s university), CereVu for medical device for dyspnea (paid to author’s university), BData for severe asthma registry (paid to author’s university), the American Board of Internal Medicine for board certification exam questions (paid to author), and DynaMed for reviewing topics related to pulmonary medicine (paid to author); support for attending meetings and/or travel from the NIH Patient-Centered Outcomes Research Institute; participation on a Data Safety Monitoring Board or advisory board for the NIH; leadership or fiduciary role for the Respiratory Health Association and the COPD Foundation Medical and Scientific Advisory Committee. Y.J.L. No relevant relationships. J.A.C.L. Grant support from Canon Medical Systems. J.L. Support for the present manuscript from subcontract NIH funding for this SPIROMICS study. M.G.M. No relevant relationships. J.O. Grants or contracts from the COPD Foundation for Inhale trial (paid to author’s institution), Mylan for Effect of PIF on Relevant Clinical Endpoints (paid to author’s institution), The Society to Improve Diagnostics in Medicine, under a grant from the Gordon and Betty Moore Foundation, for Finding the Missing Millions with COPD (paid to author’s institution), TEVA for Use of ProAir Digihaler in COPD – Characterization of Inhalation Metrics from a Cohort of Patients At-Risk for AECOPD in an outpatient setting (paid to author’s institution), and Boehringer Ingelheim for Associations of Peak Inspiratory Flow (PIFR) and Patient Characteristics and Outcomes in COPD (paid to author’s institution); payment from Chiesi, Verona, Genetech, and AstraZeneca for advisory boards and consulting, payment from Wallace & Graham, SWMW, Morgan Lewis & Bockius, Poisson, Poisson & Bower, Franklin Casualty, Roven Law Group, Simmons, Hanley Conroy, and Coffey Law for expert testimony in asbestos litigation. V.E.O. Support for the present manuscript from the NIH, NHLBI, and COPD Foundation; grants or contracts from NIH subaward (Inspiration Point, A Digital Pulmonary Rehabilitation Tool for Use with Self-Management Interventions, author is sub-primary investigatory, 2021–2023, $146 836), Boehringer Ingelheim (Associations of Peak Inspiratory Flow [PIFR] with Patient Characteristics and Outcomes in COPD, author is primary investigatory, 2019–2022, $347 418), TEVA (Use of ProAir Digihaler in COPD– characterization of inhalation metrics form a cohort of patients at-risk for AECOPD in an outpatient setting, author is primary investigator, 2021–2023, $142 123), The Society to Improve Diagnosis in Medicine, under a grant from the Gordon and Betty Moore Foundation, Finding the Missing Millions with COPD (2022, $49 000), Mylan (Effect of PIF on Relevant Clinical Endpoints, $144 000/year), and Inhale: COPD Foundation (a multicenter observational trial designed to examine inhalation technique and its effects on drug delivery); payment from Morgan Lewis & Bockius, Poisson, Poisson & Bower, Wallace & Graham, Roven Law, Simmons Hanley Conroy, Coffey Law, and Fox Rothschild, for expert testimony; participation on a Data Safety Monitoring Board or advisory board from Chiesi, AstraZeneca, and Verona. R.P. Grant support for the present manuscript from the NHLBI COPD Foundation; research grant from the Department of Veterans Affairs; research consultant fees from Partner Therapeutics. S.P.P. Support for the present manuscript from the NIH and NHLBI, for which author was the primary investigator of the Wake Forest clinical site. J.D.S. No relevant relationships. J.V.C. Grants or contracts from the NIH, BMBF, Siemens Healthineers, GSK, AstraZeneca, and the National Research Council Canada; consulting fees from IQWiG; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Siemens Healthineers and Corelinesoft; cofounder of BioVisioneers; member of the Radiology: Cardiothoracic Imaging editorial board. P.G.W. Support for the present manuscript from the NIH; grant from the COPD Foundation to support SPIROMICS; consulting fees from Sanofi (2021–present), Regeneron (2021–present), AstraZeneca (2021–present), Amgen, and Roche (2021–present), unrelated to this manuscript. R.G.B. Support for the present manuscript from the NIH Foundation for the NIH COPD Foundation; grants or contracts from the American Lung Association; support from the COPD Foundation for attending meetings and/or travel; participation on the COPD Foundation Scientific Advisory Board (unpaid). W.S. No relevant relationships.

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MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF Study

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MRI-assessed Dynamic Hyperinflation Induced by Tachypnea in Chronic Obstructive Pulmonary Disease: The SPIROMICS-HF Study

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