# Imaging the functional response of the lung to bronchoscopic lung volume reduction

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $653,209

## Abstract

Summary
Advanced emphysema is primarily characterized by chronic inflammation, small airways obstruction, and
parenchymal destruction leading to hyperinflation, compromised respiratory mechanics, and progressive
functional decline. Medical therapy has proven effective in treating symptoms such as coughing and shortness
of breath, and can also help to prevent acute exacerbations, but does little to improve either mortality or restore
lost function. While lung volume reduction surgery (LVRS) has demonstrated the ability to improve lung function,
quality of life and mortality in certain, rigorously selected patients, it is associated with a significant increase in
perioperative and short-term morbidity and remains an underutilized treatment.
In 2018, treatment with Zephyr Endobronchial Valves (Zephyr EBV) became the first bronchoscopic lung volume
reduction technique to receive FDA approval. Valves are inserted via catheter in order to occlude a target
emphysematous lobe, causing partial or complete lobar atelectasis, decreasing residual volume, reducing
hyperinflation and improving breathing mechanics and lung function similarly to LVRS with improved morbidity
and mortality. Despite numerous studies demonstrating clinically significant average improvements in various
functional and anatomical outcome measures, however, there currently remain a significant number of EBV
recipients who fail to experience meaningful quality of life benefits as a result.
In order to address this discrepancy, the proposed project will use hyperpolarized xenon-129 MRI's unique ability
to measure regional lung function, in combination with the assessment of systemic inflammatory biomarkers, to
attain a more comprehensive understanding of the mechanisms through which EBV placement perturbs and
alters the lung. We hypothesize that this consists primarily of a redistribution of both ventilation and perfusion to
the healthier lung as well as a decrease in both local and systemic inflammatory burden—and that sensitively
assessing the presence/absence of these changes, as well as their degree, will help to explain the frequent
divergence between quantitative and qualitative assessments of EBV treatment efficacy.
Using a previously developed multi-breath hyperpolarized 129Xe buildup/washout sequence, combined with a
measurement of signal intensity buildup, to produce quantitative maps of minute ventilation and functional
residual capacity, we will quantify ventilation redistribution and residual volume at a lobar or segmental level.
These maps are compared to registered and segmented CT-derived measurements of airways disease and
emphysema. Next, we will employ HP 129Xe dissolved-phase imaging to quantify gas uptake by the red blood
cells in the lung—a measurement that relates more closely to blood oxygenation than measurements of
perfusion, and investigate the use of dynamic airflow imaging to distinguish clinically important cases of collateral
ventilation and leakage around t...

## Key facts

- **NIH application ID:** 10898053
- **Project number:** 5R01HL159898-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** RAHIM R RIZI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $653,209
- **Award type:** 5
- **Project period:** 2022-08-10 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10898053

## Citation

> US National Institutes of Health, RePORTER application 10898053, Imaging the functional response of the lung to bronchoscopic lung volume reduction (5R01HL159898-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10898053. Licensed CC0.

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