Airspace Dimension Assessment with nanoparticles reflects lung density as quantified by MRI

H Laura Aaltonen,1,2,* Simon S Kindvall,3,* Jonas K Jakobsson,4 Jakob Löndahl,4 Lars E Olsson,3,5 Sandra Diaz,1,2 Sophia Zackrisson,1,2 Per Wollmer1,2 1Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden; 2Department of Translational Medicine, Lund University, Malmö, Sweden; 3Department of Medical Radiation Physics, Lund University, Malmö, Sweden; 4Department of Design Sciences, Lund University, Lund, Sweden; 5Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden *These authors contributed equally to this work Background: Airspace Dimension Assessment with inhaled nanoparticles is a novel method to determine distal airway morphology. This is the first empirical study using Airspace Dimension Assessment with nanoparticles (AiDA) to estimate distal airspace radius. The technology is relatively simple and potentially accessible in clinical outpatient settings. Method: Nineteen never-smoking volunteers performed nanoparticle inhalation tests at multiple breath-hold times, and the difference in nanoparticle concentration of inhaled and exhaled gas was measured. An exponential decay curve was fitted to the concentration of recovered nanoparticles, and airspace dimensions were assessed from the half-life of the decay. Pulmonary tissue density was measured using magnetic resonance imaging (MRI). Results: The distal airspace radius measured by AiDA correlated with lung tissue density as measured by MRI (ρ = -0.584; p = 0.0086). The linear intercept of the logarithm of the exponential decay curve correlated with forced expiratory volume in one second (FEV1) (ρ = 0.549; p = 0.0149). Conclusion: The AiDA method shows potential to be developed into a tool to assess conditions involving changes in distal airways, eg, emphysema. The intercept may reflect airway properties; this finding should be further investigated. Keywo