Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression
Abstract Background Small airways disease (SAD) is a major cause of airflow obstruction in COPD patients and has been identified as a precursor to emphysema. Although the amount of SAD in the lungs can be quantified using our Parametric Response Mapping (PRM) approach, the full breadth of this reado...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-024-02729-x |
| _version_ | 1827326454020440064 |
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| author | Alexander J. Bell Ravi Pal Wassim W. Labaki Benjamin A. Hoff Jennifer M. Wang Susan Murray Ella A. Kazerooni Stefanie Galban David A. Lynch Stephen M. Humphries Fernando J. Martinez Charles R. Hatt MeiLan K. Han Sundaresh Ram Craig J. Galban |
| author_facet | Alexander J. Bell Ravi Pal Wassim W. Labaki Benjamin A. Hoff Jennifer M. Wang Susan Murray Ella A. Kazerooni Stefanie Galban David A. Lynch Stephen M. Humphries Fernando J. Martinez Charles R. Hatt MeiLan K. Han Sundaresh Ram Craig J. Galban |
| author_sort | Alexander J. Bell |
| collection | DOAJ |
| description | Abstract Background Small airways disease (SAD) is a major cause of airflow obstruction in COPD patients and has been identified as a precursor to emphysema. Although the amount of SAD in the lungs can be quantified using our Parametric Response Mapping (PRM) approach, the full breadth of this readout as a measure of emphysema and COPD progression has yet to be explored. We evaluated topological features of PRM-derived normal parenchyma and SAD as surrogates of emphysema and predictors of spirometric decline. Methods PRM metrics of normal lung (PRMNorm) and functional SAD (PRMfSAD) were generated from CT scans collected as part of the COPDGene study (n = 8956). Volume density (V) and Euler-Poincaré Characteristic (χ) image maps, measures of the extent and coalescence of pocket formations (i.e., topologies), respectively, were determined for both PRMNorm and PRMfSAD. Association with COPD severity, emphysema, and spirometric measures were assessed via multivariable regression models. Readouts were evaluated as inputs for predicting FEV1 decline using a machine learning model. Results Multivariable cross-sectional analysis of COPD subjects showed that V and χ measures for PRMfSAD and PRMNorm were independently associated with the amount of emphysema. Readouts χfSAD (β of 0.106, p < 0.001) and VfSAD (β of 0.065, p = 0.004) were also independently associated with FEV1% predicted. The machine learning model using PRM topologies as inputs predicted FEV1 decline over five years with an AUC of 0.69. Conclusions We demonstrated that V and χ of fSAD and Norm have independent value when associated with lung function and emphysema. In addition, we demonstrated that these readouts are predictive of spirometric decline when used as inputs in a ML model. Our topological PRM approach using PRMfSAD and PRMNorm may show promise as an early indicator of emphysema onset and COPD progression. |
| first_indexed | 2024-03-07T14:44:47Z |
| format | Article |
| id | doaj.art-7ce7ea7e78a94cbabe467d5df815a259 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-03-07T14:44:47Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-7ce7ea7e78a94cbabe467d5df815a2592024-03-05T20:02:37ZengBMCRespiratory Research1465-993X2024-02-0125111210.1186/s12931-024-02729-xLocal heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progressionAlexander J. Bell0Ravi Pal1Wassim W. Labaki2Benjamin A. Hoff3Jennifer M. Wang4Susan Murray5Ella A. Kazerooni6Stefanie Galban7David A. Lynch8Stephen M. Humphries9Fernando J. Martinez10Charles R. Hatt11MeiLan K. Han12Sundaresh Ram13Craig J. Galban14Department of Radiology, University of MichiganDepartment of Radiology, University of MichiganDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of MichiganDepartment of Radiology, University of MichiganDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of MichiganSchool of Public Health, University of MichiganDepartment of Radiology, University of MichiganDepartment of Radiology, University of MichiganDepartment of Radiology, National Jewish HealthDepartment of Radiology, National Jewish HealthWeill Cornell Medical CollegeImbio, LLCDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of MichiganDepartment of Radiology, University of MichiganDepartment of Radiology, University of MichiganAbstract Background Small airways disease (SAD) is a major cause of airflow obstruction in COPD patients and has been identified as a precursor to emphysema. Although the amount of SAD in the lungs can be quantified using our Parametric Response Mapping (PRM) approach, the full breadth of this readout as a measure of emphysema and COPD progression has yet to be explored. We evaluated topological features of PRM-derived normal parenchyma and SAD as surrogates of emphysema and predictors of spirometric decline. Methods PRM metrics of normal lung (PRMNorm) and functional SAD (PRMfSAD) were generated from CT scans collected as part of the COPDGene study (n = 8956). Volume density (V) and Euler-Poincaré Characteristic (χ) image maps, measures of the extent and coalescence of pocket formations (i.e., topologies), respectively, were determined for both PRMNorm and PRMfSAD. Association with COPD severity, emphysema, and spirometric measures were assessed via multivariable regression models. Readouts were evaluated as inputs for predicting FEV1 decline using a machine learning model. Results Multivariable cross-sectional analysis of COPD subjects showed that V and χ measures for PRMfSAD and PRMNorm were independently associated with the amount of emphysema. Readouts χfSAD (β of 0.106, p < 0.001) and VfSAD (β of 0.065, p = 0.004) were also independently associated with FEV1% predicted. The machine learning model using PRM topologies as inputs predicted FEV1 decline over five years with an AUC of 0.69. Conclusions We demonstrated that V and χ of fSAD and Norm have independent value when associated with lung function and emphysema. In addition, we demonstrated that these readouts are predictive of spirometric decline when used as inputs in a ML model. Our topological PRM approach using PRMfSAD and PRMNorm may show promise as an early indicator of emphysema onset and COPD progression.https://doi.org/10.1186/s12931-024-02729-xChronic obstructive pulmonary diseaseSmall airways diseaseParametric response mappingComputed tomography of the chestMachine learningEmphysema |
| spellingShingle | Alexander J. Bell Ravi Pal Wassim W. Labaki Benjamin A. Hoff Jennifer M. Wang Susan Murray Ella A. Kazerooni Stefanie Galban David A. Lynch Stephen M. Humphries Fernando J. Martinez Charles R. Hatt MeiLan K. Han Sundaresh Ram Craig J. Galban Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression Respiratory Research Chronic obstructive pulmonary disease Small airways disease Parametric response mapping Computed tomography of the chest Machine learning Emphysema |
| title | Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression |
| title_full | Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression |
| title_fullStr | Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression |
| title_full_unstemmed | Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression |
| title_short | Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression |
| title_sort | local heterogeneity of normal lung parenchyma and small airways disease are associated with copd severity and progression |
| topic | Chronic obstructive pulmonary disease Small airways disease Parametric response mapping Computed tomography of the chest Machine learning Emphysema |
| url | https://doi.org/10.1186/s12931-024-02729-x |
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