Vascular leak is a cardinal response to tissue injury [1, 2]. When dysregulated, vascular leak has been shown to contribute to the development of pulmonary fibrosis in the bleomycin mouse model . Specifically targeting vascular endothelial growth factor, initially described as vascular permeability factor  and a key mediator regulating capillary permeability, attenuates the development of pulmonary fibrosis in vivo . Gadofosveset (Ablavar; Lantheus Medical Imaging Inc., North Billerica, MA, USA) is a US Food and Drug Administration-approved, gadolinium-based, albumin-binding contrast agent. Gadofosveset has been used to detect vascular permeability in mouse models  and to perform vascular imaging clinically. We hypothesised that gadofosveset-enhanced lung magnetic resonance imaging (MRI) could detect albumin extravasation in subjects with pulmonary fibrosis and demonstrate the location of ongoing tissue injury.
We would like to gratefully acknowledge the important contributions from Mary O'Hara and Larry White of the Athinoula A. Martinos Center for Biomedical Imaging (Massachusetts General Hospital, Charlestown, MA, USA).
Conflict of interest: S.B. Montesi reports receiving grants from the Parker B. Francis Foundation, the National Institutes of Health, Harvard Catalyst and the Chest Foundation, during the conduct of the study.
Conflict of interest: B.S. Shea reports receiving grants from the National Institutes of Health/NHLBI during the conduct of the study; and consulting fees from Boehringer Ingelheim and Roche-Genentech, and grants from Biogen, outside the submitted work.
Conflict of interest: R.T. Seethamraju is an employee of Siemens Healthineers, the manufacturer of MRI machines on which this study was performed. In addition, he has two patents, “Free-breathing Radial-MR Angiography with No Contrast (FRANC)” and “Non-contrast Breath Held MR Perfusion of the Lungs from Time Series Analysis”, pending to Siemens and Brigham and Women's Hospital.
Conflict of interest: P. Caravan reports receiving grants from the National Institutes of Health during the conduct of the study; and personal fees and nonfinancial support from Collagen Medical LLC, nonfinancial support from Factor 1A LLC and Reveal Pharmaceuticals, grants from Pfizer and Pliant, and personal fees from Bayer and Guerbet, outside the submitted work.
Support statement: This work was conducted with support from Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102), and financial contributions from Harvard University and its affiliated academic healthcare centres. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health centres, or the National Institutes of Health. This work was also supported in part by grants from the National Institutes of Health (F32HL129789 to S.B. Montesi, K08HL105656 to B.S. Shea, and R01HL131907 to P. Caravan and A.M. Tager) and the Parker B. Francis Foundation (S.B. Montesi). Funding information for this article has been deposited with the Crossref Funder Registry.