Pulmonary MRI & Cluster Analysis Help Identify Novel Asthma Phenotypes

Pulmonary functional MRI measurements have never been evaluated for the generation of imaging-based asthma patient clusters, although computed tomography (CT)-based clusters have been determined. Here we investigated hyperpolarized 129XeMRI ventilation in combination with CT airway measurements in 45 patients with asthma and identified 4 phenotypic clusters with distinct structure-function and clinical characteristics. Our results revealed a novel cluster of patients only distinguished by MRI ventilation measurements, underscoring the utility of MRI to discriminate airway pathologies in asthma. Imaging-based clusters of asthma provide novel structure-function insights that may be exploited in future studies and challenge current clinical paradigms for asthma phenotyping.