MRI Shows Lung Perfusion Changes after Vaping and Smoking

Sylvia Nyilas; Grzegorz Bauman; Insa Korten; Orso Pusterla; Florian Singer; Michael Ith; Cindy Groen; Anna Schoeni; Johannes T Heverhagen; Andreas Christe; Nicolas Rodondi; Oliver Bieri; Thomas Geiser; Reto Auer; Manuela Funke-Chambour; Lukas Ebner

doi:10.1148/radiol.211327

MRI Shows Lung Perfusion Changes after Vaping and Smoking

Radiology. 2022 Jul;304(1):195-204. doi: 10.1148/radiol.211327. Epub 2022 Apr 5.

Authors

Sylvia Nyilas^#¹, Grzegorz Bauman^#¹, Insa Korten¹, Orso Pusterla¹, Florian Singer¹, Michael Ith¹, Cindy Groen¹, Anna Schoeni¹, Johannes T Heverhagen¹, Andreas Christe¹, Nicolas Rodondi¹, Oliver Bieri¹, Thomas Geiser¹, Reto Auer¹, Manuela Funke-Chambour^#¹, Lukas Ebner^#¹

Affiliation

¹ From the Department of Diagnostic, Interventional and Pediatric Radiology (S.N., M.I., J.T.H., A.C., L.E.), Department of Pediatrics, Division of Pediatric Respiratory Medicine and Allergology (I.K.), Department of General Internal Medicine (N.R.), and Department of Pulmonary Medicine (T.G., M.F.C.), Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern 3010, Switzerland; Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland (G.B., O.P., O.B.); Department of Biomedical Engineering, University of Basel, Basel, Switzerland (G.B., O.P., O.B.); Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (O.P.); Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria (F.S.); Department of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, Zurich, Switzerland (F.S.); Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland (C.G., A.S., N.R., R.A.); and Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland (R.A.).

^# Contributed equally.

PMID: 35380498
DOI: 10.1148/radiol.211327

Abstract

Background Evidence regarding short-term effects of electronic nicotine delivery systems (ENDS) and tobacco smoke on lung ventilation and perfusion is limited. Purpose To examine the immediate effect of ENDS exposure and tobacco smoke on lung ventilation and perfusion by functional MRI and lung function tests. Materials and Methods This prospective observational pilot study was conducted from November 2019 to September 2021 (substudy of randomized controlled trial NCT03589989). Included were 44 healthy adult participants (10 control participants, nine former tobacco smokers, 13 ENDS users, and 12 active tobacco smokers; mean age, 41 years ± 12 [SD]; 28 men) who underwent noncontrast-enhanced matrix pencil MRI and lung function tests before and immediately after the exposure to ENDS products or tobacco smoke. Baseline measurements were acquired after 2 hours of substance abstinence. Postexposure measurements were performed immediately after the exposure. MRI showed semiquantitative measured impairment of lung perfusion (R_Q) and fractional ventilation (R_FV) impairment as percentages of affected lung volume. Lung clearance index (LCI) was assessed by nitrogen multiple-breath washout to capture ventilation inhomogeneity and spirometry to assess airflow limitation. Absolute differences were calculated with paired Wilcoxon signed-rank test and differences between groups with unpaired Mann-Whitney test. Healthy control participants underwent two consecutive MRI measurements to assess MRI reproducibility. Results MRI was performed and lung function measurement was acquired in tobacco smokers and ENDS users before and after exposure. MRI showed a decrease of perfusion after exposure (R_Q, 8.6% [IQR, 7.2%-10.0%] to 9.1% [IQR, 7.8%-10.7%]; P = .03) and no systematic change in R_FV (P = .31) among tobacco smokers. Perfusion increased in participants who used ENDS after exposure (R_Q, 9.7% [IQR, 7.1%-10.9%] to 9.0% [IQR, 6.9%-10.0%]; P = .01). R_FV did not change (P = .38). Only in tobacco smokers was LCI elevated after smoking (P = .02). Spirometry indexes did not change in any participants. Conclusion MRI showed a decrease of lung perfusion after exposure to tobacco smoke and an increase of lung perfusion after use of electronic nicotine delivery systems. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Kligerman in this issue.

Publication types

Observational Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Humans
Lung / diagnostic imaging
Magnetic Resonance Imaging / methods
Male
Perfusion
Prospective Studies
Reproducibility of Results
Smoking / adverse effects
Tobacco Smoke Pollution*
Vaping* / adverse effects

Substances

Tobacco Smoke Pollution

Associated data

ClinicalTrials.gov/NCT03589989