MRI Ventilation Texture Features Discriminate Severe Asthmatics with and without Eosinophilic Airway Inflammation

Previous work suggests that inhaled gas MRI conceals minable features that are distinctly different between severe asthma inflammatory endotypes and these may be used to predict inflammatory endotype. We evaluated the performance of inhaled gas MRI ventilation defect percent, ventilation coefficient of variation and texture features to discriminate severe asthmatics with and without the eosinophilic inflammatory endotype. MRI measurements of ventilation significantly discriminated asthmatics with eosinophilic inflammation from those without eosinophilic inflammation. Non-invasive MRI-based biomarkers and signatures of asthma inflammatory endotype may serve to guide treatment selection in individual asthmatics or evaluate the effectiveness of anti-inflammatory treatments in clinical trials.