2014 CRRN Studentship Recipient

Supervisor: Dr. Grace Parraga

Institution: Western University

Twitter: @ssvenningsen

CRRN Research Platform: Airway Imaging

Imaging Biomarkers of Airways Disease in Severe Asthma

Asthma is a common chronic respiratory disease that leads to sudden and unpredictable shortness of breath, chest tightness, wheeze and cough. These symptoms are related to airway abnormalities including smooth muscle hyper-responsiveness and inflammation that over time may result in more permanent structural changes.  As more and more Canadian’s are diagnosed with asthma, there is an urgent need for new therapies that target asthmatic airways and result in improved symptoms and better disease control.  We also need to better understand why some asthmatics progress to very serious disease that cannot be easily controlled.  One therapy for patients with severe uncontrolled asthma, bronchial thermoplasty, aims to locally change the airways by reducing the amount of smooth muscle mass that is believed to be responsible for asthma attacks.  Using novel magnetic resonance imaging methods that our team developed, we now have good evidence that the airways that are abnormal in severe asthma are not random, but heterogeneously distributed within the lung.  This finding is important because most asthma treatments including bronchial thermoplasty are geared to all airways with the belief that all airways in asthmatics are abnormal.  Therefore, the goal of this project is to develop a better understanding of the relationship of asthmatic airway function and microstructure with asthma control and symptoms.

Why is the research project/program important?

With a focus on translational interdisciplinary respiratory research our goal is improved asthma care and outcomes.  To achieve this goal, we are building a new capacity for pulmonary functional imaging and imaging intermediate endpoints of airways disease.  We previously developed inhaled gas MRI as a safe, and non-invasive way to regionally evaluate airways - information that is not available using current clinical methods.  Innovation will be derived from the results of this study that show direct imaging evidence that certain abnormal airways, once altered, improve asthma measurements and quality of life/control and that regional airway targeted therapy results in improvements similar to the conventional whole lung approach.  

Based on the enormous burden on the health care system and the vastly diminished quality of life for patients, MRI biomarkers that provide treatment targets and help improve outcomes have high potential clinical and economic impact.  We aim to translate the new knowledge that will result from this research nationally across the CRRN network to dramatically improve understanding of the origins and progression of chronic airways disease. 

Publications

F Guo, S Svenningsen, R Eddy, D Capaldi, K Sheikh, A Fenster, and G Parraga.  Anatomical Pulmonary Magnetic Resonance Imaging Segmentation for Regional Structure-Function Measurements of Asthma.  Med Phys. 2016 Jun;43(6):2911. doi: 10.1118/1.4948999.

S Svenningsen, P Nair, F Guo, D McCormack, and G Parraga.  Is Ventilation Heterogeneity related to Asthma Control? Eur Resp J. 2016 May 12. doi: 10.1183/13993003.00393-2016.

D Leary, S Svenningsen, F Guo, S Bhatawadekar, G Parraga, and GN Maksym.  Hyperpolarized 3He Magnetic Resonance Imaging Ventilation Defects in Asthma: Relationship to Airway Mechanics. Physio Reports. 2016 Apr 4. pii: e12761. doi: 10.14814/phy2.12761.

C Davis, D Pike, S Svenningsen, DG McCormack, D O'Donnell, A Neder and G Parraga.  Ventilation Heterogeneity in Never-smokers and COPD: Comparison of Pulmonary Functional Magnetic Resonance Imaging with Poorly Communicating Fraction derived from Plethysmography. Acad Radiol. 2016 Jan 8. pii: S1076-6332(15)00527-9. doi: 10.1016/j.acra.2015.10.022.

N Zha, D Pike, S Svenningsen, DPI Capaldi, DG McCormack and G Parraga.  Second-order Texture Measurements of 3He Ventilation MRI: Proof of Concept Evaluation of Asthma Bronchodilator Response. Acad Radiol. 2015 Nov. doi: 10.1016/j.acra.2015.10.010.

S Svenningsen, GA Paulin, K Sheikh, F Guo, A Hasany, M Kirby, R Etemad-Rezai, DG McCormack and G Parraga.  Oscillatory Positive Expiratory Pressure in Chronic Obstructive Pulmonary Disease. JCOPD. 2015 Oct:1-9. doi: 10.3109/15412555.2015.1043523.

F Guo, J Yuan, M Rajchl, S Svenningsen, DPI Capaldi, K Sheikh, A Fenster and G Parraga.  Globally Optimal Co-Segmentation of Three-dimensional Pulmonary 1H and Hyperpolarized 3He MRI with Spatial Consistence Prior.  Medical Image Analysis. 2015 July;23(1):43-55.  doi: 10.1016/j.media.2015.04.001.

DPI Capaldi, K Sheikh, F Guo, S Svenningsen, R Etemad-Rezai, J Leipsic, HO Coxson, DG McCormack and G Parraga. Free-breathing Pulmonary 1H and Hyperpolarized 3He MRI: Comparison in COPD and Bronchiectasis. Acad Radiol. 2015 Mar;22(3):320-9. doi: 10.1016/j.acra.2014.10.003.

S Svenningsen, F Guo, M Kirby, S Choy, DG McCormack and G Parraga.  Pulmonary Functional Magnetic Resonance Imaging: Asthma Temporal-Spatial Maps. Acad Radiol. 2014 Nov;21(11):1402-10. doi: 10.1016/j.acra.2014.08.002.

GA Paulin, S Svenningsen, B Jobse, S Mohan, M Kirby, J Lewis and G Parraga.  Longitudinal Hyperpolarized 3He Magnetic Resonance Imaging of Cystic Fibrosis.  J Magn Reson Imaging. 2014 Aug 30. doi: 10.1002/jmri.24744.

M Kirby, A Ouriadov, S Svenningsen, A Owrangi, A Wheatley, R Etemad-Rezai, GE Santyr, DG McCormack and G Parraga. Hyperpolarized 3He and 129Xe Magnetic Resonance Imaging Apparent Diffusion Coefficients:  Physiological Relevance in Older Never- and Ex-smokers.  Physio Rep. 2014 Jul 16;2(7). Pii: e12068. doi: 10.14814/phy2.12068.

K Sheikh, G Paulin, S Svenningsen, M Kirby, NAM Paterson, DG McCormack and G Parraga.  Pulmonary Ventilation Defects in Older Never-Smokers.  J Appl Physiol. 2014 Aug 1;117(3):297-306. doi: 10.1152/japplphysiol.00046.2014.

W Ma, K Sheikh, S Svenningsen, D Pike, F Guo, R Etemad-Reza, J Leipsic, HO Coxson, DG McCormack and G Parraga.  Ultra-short Echo-time Pulmonary Magnetic Resonance Imaging: Evaluation and Reproducibility in COPD subjects with and without Bronchiectasis.  J Magn Reson Imaging. 2014 June 26. doi: 10.1002/jmri.24680.

S Svenningsen, M Kirby, D Starr, HO Coxson, NAM Paterson, DG McCormack and G Parraga.  What are ventilation defects in asthma? Thorax. 2014 Jan;69(1):63-71. doi: 10.1136/thoraxjnl-2013-203711. ***This manuscript was editorialized and featured on the cover of the journal.

M Kirby, A Owrangi, S Svenningsen, A Wheatley, HO Coxson, NAM Paterson, DG McCormack and G Parraga.  On the role of abnormal DLCO in ex-smokers without airflow limitation: symptoms, exercise capacity and hyperpolarised helium-3 MRI.  Thorax. 2013 Aug;68(8):752-9. doi: 10.1136/thoraxjnl-2012-203108.

S Svenningsen, M Kirby, D Starr, D Leary, A Wheatley, GN Maksym, DG McCormack and G Parraga.  Hyperpolarized 3He and 129Xe MRI: Differences in asthma before bronchodilation.  J Magn Reson Imaging. 2013 Dec;38(6):1521-30. doi: 10.1002/jmri.24111.

M  Kirby, S Svenningsen, N Kanhere, A Owrangi, A Wheatley, HO Coxson, GE Santyr, NAM Paterson, DG McCormack and G Parraga.  Pulmonary Ventilation Visualized using Hyperpolarized Helium-3 and Xenon-129 Magnetic Resonance Imaging: Differences in COPD and Relationship to Emphysema.  J Appl Physiol. 2013 Mar 15;114(6):707-15. doi: 10.1152/japplphysiol.01206.2012.

M  Kirby, S Svenningsen, A Owrangi, A Wheatley, A Farag, A Ouriadov, GE Santyr, R Etemad-Rezai, HO Coxson, DG McCormack and G Parraga.  Hyperpolarized Helium-3 and Xenon-129 Magnetic Resonance Imaging in Healthy Volunteers and Subjects with Chronic Obstructive Pulmonary Disease.  Radiology. 2012 Nov; 265(2):600-10. doi: 10.1148/radiol.12120485.

Y Shukla, A Wheatley, M Kirby, S Svenningsen, A Farag, G Santyr, NAM Paterson, DG McCormack and G Parraga.  Hyperpolarized 129Xe Magnetic Resonance Imaging: Tolerability in Healthy Volunteers and Subjects with Pulmonary Disease.  Acad Radiol. 2012 Aug; 19(8):941-51. doi: 10.1016/j.acra.2012.03.018.

M Kirby, M Heydarian, S Svenningsen, A Wheatley, DG McCormack, R Etemad-Rezai and G Parraga.  Hyperpolarized 3He Magnetic Resonance Functional Imaging Semiautomated Segmentation.  Acad Radiol. 2012 Feb; 19(2):141-52. doi: 10.1016/j.acra.2011.10.007.

M Kirby, S Svenningsen, H Ahmed, NAM Paterson and G Parraga.  Quantitative Evaluation of Hyperpolarized Helium-3 Magnetic Resonance Imaging of Lung Function Variability in Cystic Fibrosis. Acad Radiol. 2011 Aug; 18(8):1006-13. doi: 10.1016/j.acra.2011.03.005.