T2*-weighted oxygen-enhanced pulmonary MRI in COPD is linked to resting and exertional functional measurements.

<bold>Aim:</bold> To examine the feasibility and repeatability of T₂*-OE-MRI (oxygen-enhanced MRI) in COPD and its physiological correlates. <bold>Methods:</bold> 13 COPD patients and 13 age-matched healthy volunteers (HVs)) underwent PFTs, incremental cardiopulmonary exercise test (CPET, patients only), and two lung MRI scans at 3T. For T₂*-OE-MRI, participants were fitted with a non-rebreathing face mask; 21% oxygen was delivered at 15l/min, then switched to 100% oxygen during image acquisition. <bold>Results:</bold> Patients (FEV₁: 60±24%predicted, mean±SD) had evidence of pulmonary gas trapping, small airway disease (SAD), and ventilation heterogeneity. During T₂*-OE-MRI, the percentage difference between mean signal intensity at normoxia and hyperoxia (PSE) and the enhancing fraction (EF) were lower in patients vs. HVs (Fig). Bland-Altman analyses and the intra-class correlation coefficient indicated moderate and good repeatability for PSE and EF, respectively. PSE and EF significantly correlated with FEV₁ (r=0.67 and r=0.72, respectively), lung clearance index (r=-0.68, r=-0.67), and indices of SAD. PSE and EF correlated with measures of dynamic hyperinflation and dyspnea intensity during exercise, Fig. <bold>Conclusion:</bold> In COPD patients, T₂*-OE-MRI can provide useful information on pulmonary ventilation that is linked with physiological measures of disease severity, functional limitation, and important clinical outcomes. <fig><object-id>erj;64/suppl_68/OA1960/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>