Chapter 18 – Imaging Procedures and Bronchial Thermoplasty for Asthma Assessment and Intervention

Newer imaging techniques such quantitative computed tomography chest, hyperpolarized gas magnetic resonance imaging, positron emission tomography, endobronchial ultrasound, and optical coherence tomography are currently being developed to assess structural changes, such as airway remodeling, and functional changes, such as air trapping and ventilation defects, in asthma. The application of these imaging tools in asthma has the potential to advance our management of the disease. We now recognize the key pathophysiologic processes in asthma are heterogeneous throughout the airway and lung. These imaging tools will help clinicians assess asthma phenotypes such as remodeling due to chronic airflow obstruction, monitor disease progression, and evaluate response to asthma therapies. Emerging asthma therapies, such as bronchial thermoplasty, have started to utilize these imaging modalities to assess response and target treatment. In the future, clinicians will have a new imaging armamentarium to optimally manage their asthma patients.