Longitudinal Study of Xenon-129 MRI Imaging Effects of Cannabis Smoking
Longitudinal Study of Xenon-129 MRI Imaging Effects of Cannabis Smoking
This is a longitudinal study of the long-term health impact of cannabis smoking on the lungs.
 Participants will be followed over a period of 10 years, and impacts of cannabis smoking on
 the lungs will be measured with magnetic resonance imaging (MRI) using hyperpolarized
 xenon-129 gas, pulmonary function tests, exercise capacity, computed tomography images and
 questionnaires.
This is a longitudinal study of the long-term lung health impact of cannabis smoking in
 adults using xenon-129 (129Xe) MRI over ten years.

 Males and females between the ages of 18 to 85 years with a history of cannabis smoking will
 be screened, and those who satisfy all inclusion and exclusion criteria will undergo study
 visits for up to 10 years, with visits every 24 ± 6 months, for a total of up to six study
 visits. Each study visit will include collection of patient smoking history and vital signs.
 129Xe MRI, spirometry, plethysmography for airways resistance (Raw) and lung volumes, forced
 oscillation technique (FOT) and multiple breath nitrogen washout (MBNW) for the lung
 clearance index (LCI) will all be performed pre- and post-bronchodilator. Blood will be drawn
 for blood eosinophil count, and sputum induction will be done to measure sputum eosinophils.
 At baseline, 6 year follow-up and 10 year follow-up, a CT will also be done at University
 Hospital, London Health Sciences Centre.

 Participants 35 years of age or older will complete a six minute walk test (6MWT) for the
 distance walked (6MWD), pre and post oxygen saturation, perceived dyspnea (Modified Borg
 Scale) and perceived exertion (Borg's rating of perceived exertion). These participants will
 complete the St. George's Respiratory Questionnaire (SGRQ).

 Participants under the age of 35 will complete Cardio Pulmonary Exercise Testing to assess
 exercise capacity, and the American Thoracic Society Questionnaire (ATSQ).
Inclusion Criteria:

 -  Patient understands study procedures and is willing to participate in the study as
 indicated by the patient's signature

 -  Provision of written, informed consent prior to any study specific procedures

 -  Males and females aged 18-85

 -  Current or former cannabis smoker (medicinal or recreational) with or without
 concurrent tobacco smoking history

 -  Participant is able to perform reproducible pulmonary function testing (i.e. the 3
 best acceptable spirograms have Forced Expiratory Volume in 1 second (FEV1) values
 that do not vary more than 150 millilitres)

 -  Participant is able to perform a breathhold for 16s

 -  FEV1 > 25% predicted

 -  Forced Vital Capacity (FVC) > 25% predicted and >0.5 litres

 Exclusion Criteria:

 -  Participant is, in the opinion of the investigator, mentally or legally incapacitated,
 preventing informed consent from being obtained, or cannot read or understand written
 material

 -  Participant is medically unstable in the opinion of the Principal Investigator

 -  Participant has a daytime room air oxygen saturation <90% while lying supine

 -  Participant is unable to perform spirometry or plethysmography maneuvers

 -  Patient is pregnant at time of enrolment

 -  In the opinion of the investigator, patient suffers from any physical, psychological
 or other condition(s) that might prevent performance of the MRI, such as severe
 claustrophobia

 -  Patient has implanted mechanically, electrically or magnetically activated device or
 any metal in their body, which cannot be removed, including but not limited to
 pacemakers, neurostimulators, biostimulators, implanted insulin pumps, aneurysm clips,
 bioprosthesis, artificial limb, metallic fragment or foreign body, shunt, surgical
 staples (including clips or metallic sutures and/or ear implants) - at the discretion
 of the MRI Technologist.