The focus of the Airway Research Group is to discover how respiratory airflow is affected by disease. Our aim is to aid clinical decision making by understanding how certain treatment options will improve breathing, through reduced airway resistance, collapse, and breathing effort. Currently, we are concentrating on two areas of research – children with obstructive sleep apnea (OSA) and premature babies who have tracheomalacia.
We use dynamic MR imaging to visualize the size, shape, and motion of the airway, and computational fluid dynamics (CFD) modeling to calculate how the air moves through that airway. We determine how the airway could be altered by respiratory support, surgery, and therapeutic drugs, and calculate how that would benefit the passage of air to and from the lungs.
As an example, preterm babies often experience dynamic collapse in the airway which increases their work of breathing, often resulting in oxygen support or mechanical ventilation. The goal is to understand the effect of airway abnormalities and how they contribute to patient symptoms separately from lung issues. In this research in premature babies, we use ultrashort echo time (UTE) MRI to capture the dynamic airway. The following video shows how the airway moves and influences the air flowing through it during one breathing cycle in a preterm subject with tracheomalacia.
- Bates AJ, Schuh A, McConnell K, Williams BM, Lanier JM, Willmering MM, Woods JC, Fleck RJ, Dumoulin CL, Amin RS. A Novel Method to Generate Dynamic Boundary Conditions for Airway CFD by Mapping Upper Airway Movement with Non-Rigid Registration of Dynamic and Static MRI. Int j numer method biomed eng 2018;e3144.
- Gunatilaka CC, Bates AJ, Higano NS, Hahn AD, Fain SB, Hysinger EB, Kingma PS, Woods JC. Elevated Work of Breathing in Neonates with Tracheomalacia Using Computational Fluid Dynamics. Am J Respir Crit Care Med 2020;201:A4684.
- Higano NS, Hahn AD, Tkach JA, Cao X, Walkup LL, Thomen RP, Merhar SL, Kingma PS, Fain SB, Woods JC. Retrospective respiratory self-gating and removal of bulk motion in pulmonary UTE MRI of neonates and adults. Magn Reson Med 2017;77:1284–1295.
- Bates AJ, Schuh A, Amine-Eddine G, McConnell K, Loew W, Fleck RJ, Woods JC, Dumoulin CL, Amin RS. Assessing the relationship between movement and airflow in the upper airway using computational fluid dynamics with motion determined from magnetic resonance imaging. Clin Biomech 2019;66:88–96.
- Hysinger EB, Bates AJ, Higano NS, Benscoter D, Fleck RJ, Hart CK, Burg G, De Alarcon A, Kingma PS, Woods JC. Ultrashort Echo-Time MRI for the Assessment of Tracheomalacia in Neonates. Chest 2020;157:595–602.