Working together to advance detection and treatment of lung disease

Using unique imaging techniques, Professor Grace Parraga, PhD, and her team at Robarts Research Institute are able to detect the earliest stages of lung disease in patients who present as otherwise perfectly healthy. Her lab is the only place in Canada where imaging research is underway to evaluate early detection of chronic obstructive pulmonary disease (COPD) before clinical diagnostic tools reveal disease.

"Because our lungs are over-engineered for day-to-day tasks, lung disease progresses slowly and silently for a long period of time before the actual effects are recognized by the patient, and before it is diagnosed using traditional methods," said Parraga, a professor in the Department of Medical Biophysics at Schulich Medicine & Dentistry. Presently, lung disease is diagnosed using pulmonary function tests that use air-flow measurements made at the mouth which often don't detect abnormalities until disease is advanced.

"We are working to detect abnormalities early before there is a clinical diagnosis," she said. "And if we can do that, there is potential for better and earlier treatments."

Using hyperpolarized gases, conventional proton MRI and other pulmonary imaging methods in patients who are ex-smokers, they are able to show the areas of the lung where the disease is present, and distinguish between disease of the airway versus disease of the air sacs or alveoli. This is critical for disease management because the course of treatment can be different depending on which area of the lung is affected.

"We want to better understand the different components of smoking-related lung disease so that treatments can be designed that are specific to the type of disease," she said.

However, Parraga said there has to be a shift in thinking in order for early detection to become part of the system that we have in place right now.

"We are at a critical junction," she said. "We have to think about the cost-advantage. Does it make sense to detect early or treat patients later when they are in the end-stages of disease?"
Parraga attributes much of the progress that she has had in her lab to the students, fellows and residents who carry out the day-to-day work. The eleven trainees from across a range of disciplines from Medical Biophysics to Respirology, have to be both independent and interdisciplinary in their work.

"If you want to go fast, go alone," she said, quoting an African Proverb. "If you want to go far, go together." She stresses that in their lab they want to both go fast and far so they are working to find that balance between being independent and working together. And if the progress that they have made in their lab so far is any indication, the balance that they have struck is definitely working.