Environmental Health Sciences Research Center

University of Iowa College of Public Health

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Sean B. Fain, PhD

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The Fain lab is dedicated to developing functional imaging of the lungs using magnetic resonance imaging (MRI). Multiple methods are in development and are actively in use for clinical research. Most prominently, ultra-short time to echo (UTE) pulmonary MRI and hyperpolarized xenon gas MRI are actively being used to study long COVID, interstitial lung disease, cystic fibrosis, lung transplant rejection and asthma. Our work has applications in understanding of environmental population health given our ability to measure ventilation and gas exchange regionally with sufficient sensitivity to detect subclinical changes not detected by conventional pulmonary function tests. The MRI techniques developed in the Fain lab are furthermore complementary to quantitative CT methods by providing functional information without using ionizing radiation.

Selected Publications:

  1. Theeler J, Comellas AP, Gehl C, Garvin L, Garg A, Fain SB, Hoth KF. Clinical neuropsychological evaluation of patients referred from a post-COVID subspeciality clinic. Clin Neuropsychol. 2026 Jul;40(5):1339-1358. doi: 10.1080/13854046.2025.2536700. Epub 2025 Jul 26. PMID: 42411649.
  2. Staab KR, McIntosh MJ, Puliyakote ASK, Hahn AD, AlArab N, Percy JL, Lanning T, Theeler J, Linkenmeyer C, Wharff CJ, Bruening E, Sieren JC, Hoffman EA, Comellas AP, Hoth KF, Fain SB. Long COVID: lung pathophysiology and its relationship with cognitive dysfunction. Sci Rep. 2025 Nov 24;15(1):42595. doi: 10.1038/s41598-025-26568-y. PMID: 41286257; PMCID: PMC12663264.
  3. Winkler T, Fain SB. Mucus Plugs and Remodeling in the Small Airways: Considerations for Complex Airway Behavior and Instability in Asthma. Am J Respir Crit Care Med. 2025 Oct 24. doi: 10.1164/rccm.202508-1859ED. Epub ahead of print. PMID: 41135034.
  4. AlArab N, McIntosh MJ, Guo J, Atha J, Kizhakke Puliyakote AS, Sieren JC, Hoffman E, Abadi E, Fain SB. Comparison of quantitative lung measures in low dose energy-integrating detector and photon-counting detector chest CT with an anthropomorphic phantom. Biomed Phys Eng Express. 2025 Oct 30;11(6). doi: 10.1088/2057-1976/ae0e27. PMID: 41033329.
  5. Sieren JC, Schroeder KE, Kitzmann J, Knoernschild K, Atha J, Alarab N, Guo J, Fain SB, Hoffman EA. Ultra-high Resolution Photon Counting Detector Computed Tomography Imaging for Quantitative Lung Assessment: An Anthropomorphic Phantom Study. Invest Radiol. 2025 Aug 1. doi: 10.1097/RLI.0000000000001227. Epub ahead of print. PMID: 40747833.
  6. Zhang X, Rajaraman PK, Li F, Choi S, Comellas AP, Hoffman EA, Fain SB, Kaczka DW, Smith BM, Choi J, Castro M, Wenzel SE, Jarjour NN, Schiebler ML, Israel E, Levy BD, Fahy JV, Erzurum SC, Babiskin A, Kinjo M, Walenga R, Lin CL. Assessment of ventilation heterogeneity and particle deposition in asthmatics using combined SPECT/CT imaging and computational modeling approaches. Eur J Pharm Sci. 2025 Jun 1;209:107093. doi: 10.1016/j.ejps.2025.107093. Epub 2025 Apr 2. PMID: 40185289; PMCID: PMC12145795.
  7. San José Estépar R, Barr RG, Fain SB, Grenier PA, Hoffman EA, Humphries SM, Kirby M, Obuchowski N, Ryerson CJ, Seo JB, Tal-Singer R, Ash SY, Bankier AA, Crapo J, Han MK, Kellermeyer L, Goldin J, McCollough CH, Newell JD Jr, Miller BE, Nordenmark LH, Remy-Jardin M, Prokop M, Ohno Y, Silverman EK, Strange C, Washko GR, Lynch DA. The Use of Computed Tomography Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society. Am J Respir Crit Care Med. 2025 May;211(5):709-728. doi: 10.1164/rccm.202410-2012SO. PMID: 40126404; PMCID: PMC12091028.
  8. Nadeem SA, Comellas AP, Chan KS, Hoffman EA, Fain SB, Saha PK. Automated CT-based measurements of radial and longitudinal expansion of airways due to breathing-related lung volume change. Med Phys. 2025 Apr;52(4):2316-2329. doi: 10.1002/mp.17592. Epub 2024 Dec 20. PMID: 39704489; PMCID: PMC11972036.
  9. Walkup LL, Roach DJ, Plummer JW, Willmering MM, Zanette B, Santyr G, Fain SB, Rock MJ, Mata J, Froh D, Stanojevic S, Cleveland ZI, Ratjen F, Woods JC. Same-Day Repeatability and 28-Day Reproducibility of Xenon MRI Ventilation in Children With Cystic Fibrosis in a Multi-Site Trial. J Magn Reson Imaging. 2025 Apr;61(4):1664-1674. doi: 10.1002/jmri.29605. Epub 2024 Sep 11. PMID: 39257323; PMCID: PMC11896927.
  10. Comellas AP, Fain SB. Lung MRI identifies potentially treatable subtypes of long COVID. Eur Respir J. 2024 Mar 28;63(3):2400381. doi: 10.1183/13993003.00381-2024. PMID: 38548274.
  11. Fain SB, McIntosh MJ. A new approach to computed tomography measurement of airway remodelling in paediatric asthma. ERJ Open Res. 2024 Jan 15;10(1):00763-2023. doi: 10.1183/23120541.00763-2023. PMID: 38226062; PMCID: PMC10789253.
  12. Huang BK, Elicker BM, Henry TS, Kallianos KG, Hahn LD, Tang M, Heng F, McCulloch CE, Bhakta NR, Majumdar S, Choi J, Denlinger LC, Fain SB, Hastie AT, Hoffman EA, Israel E, Jarjour NN, Levy BD, Mauger DT, Sumino K, Wenzel SE, Castro M, Woodruff PG, Fahy JV, Sarp FTNSARP. Persistent mucus plugs in proximal airways are consequential for airflow limitation in asthma. JCI Insight. 2024 Feb 8;9(3):e174124. doi: 10.1172/jci.insight.174124. PMID: 38127464; PMCID: PMC10967478.
  13. Leung C, Tang M, Huang BK, Fain SB, Hoffman EA, Choi J, Dunican EM, Mauger DT, Denlinger LC, Jarjour NN, Israel E, Levy BD, Wenzel SE, Sumino K, Hastie AT, Schirm J, McCulloch CE, Peters MC, Woodruff PG, Sorkness RL, Castro M, Fahy JV. A Novel Air Trapping Segment Score Identifies Opposing Effects of Obesity and Eosinophilia on Air Trapping in Asthma. Am J Respir Crit Care Med. 2024 May 15;209(10):1196-1207. doi: 10.1164/rccm.202305-0802OC. PMID: 38113166; PMCID: PMC11146546.
  14. Carey KJ, Hotvedt P, Mummy DG, Lee KE, Denlinger LC, Schiebler ML, Sorkness RL, Jarjour NN, Hatt CR, Galban CJ, Fain SB. Comparison of hyperpolarized 3He-MRI, CT based parametric response mapping, and mucus scores in asthmatics. Front Physiol. 2023 Aug 1;14:1178339. doi: 10.3389/fphys.2023.1178339. PMID: 37593238; PMCID: PMC10431597.
  15. Fain SB, Comellas AP. Monitoring Biologic Therapy in Asthma Using Functional Imaging. Chest. 2023 Jul;164(1):3-5. doi: 10.1016/j.chest.2023.04.004. PMID: 37423697.
  16. Fain SB, Schiebler ML. Using Functional Lung MRI to Predict Chronic Lung Allograft Dysfunction. Radiology. 2023 May;307(4):e230636. doi: 10.1148/radiol.230636. Epub 2023 Apr 18. PMID: 37070992; PMCID: PMC10323287.
  17. Hahn AD, Carey KJ, Barton GP, Torres LA, Kammerman J, Cadman RV, Lee KE, Schiebler ML, Sandbo N, Fain SB. Hyperpolarized 129Xe MR Spectroscopy in the Lung Shows 1-year Reduced Function in Idiopathic Pulmonary Fibrosis. Radiology. 2022 Dec;305(3):688-696. doi: 10.1148/radiol.211433. Epub 2022 Jul 26. PMID: 35880982; PMCID: PMC9713448.
  18. Torres LA, Lee KE, Barton GP, Hahn AD, Sandbo N, Schiebler ML, Fain SB. Dynamic Contrast Enhanced MRI for the Evaluation of Lung Perfusion in Idiopathic Pulmonary Fibrosis. Eur Respir J. 2022 Mar 10:2102058. doi:10.1183/13993003.02058-2021. Epub ahead of print. PMID: 35273033.
  19. Mummy DG, Dunican EM, Carey KJ, Evans MD, Elicker BM, Newell JD Jr, Gierada DS, Nagle SK, Schiebler ML, Sorkness RL, Jarjour NN, Denlinger LC, Fahy JV, Fain SB. Mucus Plugs in Asthma at CT Associated with Regional Ventilation Defects at 3He MRI. Radiology. 2022 Apr;303(1):184-190. doi: 10.1148/radiol.2021204616. Epub 2021 Dec 21. PMID: 34931858; PMCID: PMC8962781.
  20. Avila RS, Fain SB, Hatt C, Armato SG 3rd, Mulshine JL, Gierada D, Silva M, Lynch DA, Hoffman EA, Ranallo FN, Mayo JR, Yankelevitz D, Estepar RSJ, Subramaniam R, Henschke CI, Guimaraes A, Sullivan DC. QIBA guidance: Computed tomography imaging for COVID-19 quantitative imaging applications. Clin Imaging. 2021 Sep;77:151-157. doi: 10.1016/j.clinimag.2021.02.017. Epub 2021 Feb 25. PMID: 33684789; PMCID: PMC7906537.