MRI ventilation abnormalities predict quality-of-life and lung function changes in mild-to-moderate COPD: longitudinal TINCan study

: COPD biomarkers are urgently required for clinical trials of new therapies. We evaluated the longitudinal change and relationship of MRI and CT biomarkers of COPD with St. George's Respiratory Questionnaire (SGRO) and FEV₁ worsening over 30 months. Among imaging biomarkers, only the longitudinal change in MRI ventilation defect percent (VDP) was greater in ever-smoker (n=34/p<0.05) and COPD (n=48/p<0.0001) subgroups compared with never-smokers (n=42). Only the longitudinal change in VDP was correlated with change in SGRQ (r=0.26/p=0.03), and only baseline VDP predicted longitudinal change in SGRQ>minimum clinically important difference (p=0.047) in mild-to-moderate COPD. These data strongly support the use of MRI intermediate endpoints in COPD studies. TRIAL REGISTRATION NUMBER: NCT02723474; Status: Recruiting.