scholarly journals Computed tomography total airway count predicts progression to COPD in at risk smokers

2021 ◽  
pp. 00307-2021
Author(s):  
Miranda Kirby ◽  
Benjamin M. Smith ◽  
Naoya Tanabe ◽  
James C. Hogg ◽  
Harvey O. Coxson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
At Risk ◽  
Structural Changes ◽  
Population Based ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Wall Area ◽  
Ct Measurements ◽  
Airway Tree

There is limited understanding of how to identify people at high risk of developing chronic obstructive pulmonary disease (COPD). Our objective was to investigate the association between computed tomography (CT) total airway count (TAC) and incident COPD over 3-years among ever-smokers from the population-based Canadian Cohort Obstructive Lung Disease (CanCOLD) study.CT and spirometry were acquired in ever-smokers at baseline; spirometry was repeated at 3-year follow-up. CT TAC was generated by summing all airway segments in the segmented airway tree (VIDA Diagnostics, Inc.). CT airway wall area, wall thickness for a theoretical airway with 10 mm perimeter (Pi10), and low attenuation areas below −856HU (LAA856) were also measured. Logistic and mixed effects regression models were constructed to determine the association for CT measurements with development of COPD and FEV1/FVC decline, respectively.Among 316 at risk participants evaluated at baseline (65±9 years, 40% female, 18±19 pack-years), incident COPD was detected in 56 participants (18%) over a median 3.1±0.6 years of follow-up. Among CT measurements, only TAC was associated with incident COPD (p=0.03), where a 1-sd decrement in TAC increased the odds ratio for incident COPD by a factor of two. In a multivariable linear regression model, reduced TAC was significantly associated with greater longitudinal FEV1/FVC decline (p=0.03), but no other measurements were significant.CT TAC predicts incident COPD in at risk smokers, indicating that smokers exhibit early structural changes associated with COPD prior to abnormal spirometry.

scholarly journals Lung function, forced expiratory volume in 1 s decline and COPD hospitalisations over 44 years of follow-up

2015 ◽  
Vol 47 (3) ◽  
pp. 742-750 ◽  
Author(s):  
Suneela Zaigham ◽  
Per Wollmer ◽  
Gunnar Engström
Keyword(s):  
Lung Function ◽  
Airflow Obstruction ◽  
Fixed Ratio ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Lung Function Decline ◽  
Obstructive Pulmonary Disease ◽  
Hazard Ratios

The use of baseline lung function in the prediction of chronic obstructive pulmonary disease (COPD) hospitalisations, all-cause mortality and lung function decline was assessed in the population-based “Men Born in 1914” cohort.Spirometry was assessed at age 55 years in 689 subjects, of whom 392 had spirometry reassessed at age 68  years. The cohort was divided into three groups using fixed ratio (FR) and lower limit of normal (LLN) criterion: forced expiratory volume in 1 s (FEV1)/vital capacity (VC) ≥70%, FEV1/VC <70% but ≥LLN (FR+LLN−), and FEV1/VC <70% and <LLN (FR+LLN+).Over 44 years of follow-up, 88 men were hospitalised due to COPD and 686 died. Hazard ratios (95% CI) for incident COPD hospitalisation were 4.15 (2.24–7.69) for FR+LLN− and 7.88 (4.82–12.87) for FR+LLN+ (reference FEV1/VC ≥70%). Hazard ratios for death were 1.30 (0.98–1.72) for FR+LLN− and 1.58 (1.25–2.00) for FR+LLN+. The adjusted FEV1 decline between 55 and 68 years of age was higher for FR+LLN− and FR+LLN+ relative to the reference. Of those with FR+LLN− at 55 years, 53% had progressed to the FR+LLN+ group at 68 years.Airflow obstruction at age 55 years is a powerful risk factor for future COPD hospitalisations. The FR+LLN− group should be carefully evaluated in clinical practice in relation to future risks and potential benefit from early intervention. This is reinforced by the increased FEV1 decline in this group.

scholarly journals A homological approach to a mathematical definition of pulmonary fibrosis and emphysema on computed tomography

2021 ◽  
Author(s):  
Naoya Tanabe ◽  
Shizuo Kaji ◽  
Susumu Sato ◽  
Tomoo Yokoyama ◽  
Tsuyoshi Oguma ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Fibrosis ◽  
Structural Changes ◽  
Persistent Homology ◽  
Three Dimensional ◽  
Connected Components ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Definition Of

Three-dimensional imaging is essential to evaluate local abnormalities and understand structure-function relationships in an organ. However, quantifiable and interpretable methods to localize abnormalities remain unestablished. Visual assessments are prone to bias, machine learning methods depend on training images, and the underlying decision principle is usually difficult to interpret. Here, we developed a homological approach to mathematically define emphysema and fibrosis in the lungs on computed tomography (CT). Using persistent homology, the density of homological features, including connected components, tunnels, and voids, was extracted from the volumetric CT scans of lung diseases. A pair of CT values at which each homological feature appeared (birth) and disappeared (death) was computed by sweeping the threshold levels from higher to lower CT values. Consequently, fibrosis and emphysema were defined as voxels with dense voids having a longer lifetime (birth-death difference) and voxels with dense connected components having a lower birth, respectively. In an independent dataset including subjects with idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and combined pulmonary fibrosis and emphysema (CPFE), the proposed definition enabled accurate segmentation with comparable quality to deep learning in terms of Dice coefficients. Persistent homology-defined fibrosis was closely associated with physiological abnormalities such as impaired diffusion capacity and long-term mortality in subjects with IPF and CPFE, and persistent homology-defined emphysema was associated with impaired diffusion capacity in subjects with COPD. The present persistent homology-based evaluation of structural abnormalities could help explore the clinical and physiological impacts of structural changes and morphological mechanisms of disease progression.

Evaluation of cigarette smoke-induced emphysema in mice using quantitative micro-computed tomography

2015 ◽  
Vol 308 (10) ◽  
pp. L1039-L1045 ◽  
Author(s):  
Mamoru Sasaki ◽  
Shotaro Chubachi ◽  
Naofumi Kameyama ◽  
Minako Sato ◽  
Mizuha Haraguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cigarette Smoke ◽  
Structural Changes ◽  
Chronic Obstructive ◽  
Micro Ct ◽  
Micro Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Calculated Volume ◽  
Lung Ct ◽  
Time Point

Chronic cigarette smoke (CS) exposure provokes variable changes in the lungs, and emphysema is an important feature of chronic obstructive pulmonary disease. The usefulness of micro-computed tomography (CT) to assess emphysema in different mouse models has been investigated, but few studies evaluated the dynamic structural changes in a CS-induced emphysema mouse model. A novel micro-CT technique with respiratory and cardiac gating has resulted in high-quality images that enable processing for further quantitative and qualitative analyses. Adult female C57BL/6J mice were repeatedly exposed to mainstream CS, and micro-CT scans were performed at 0, 4, 12, and 20 wk. Emphysema was also histologically quantified at each time point. Air-exposed mice and mice treated with intratracheal elastase served as controls and comparisons, respectively. End-expiratory lung volume, corresponding to functional residual volume, was defined as the calculated volume at the phase of end-expiration, and it evaluated air trapping. The end-expiratory lung volumes of CS-exposed mice were significantly larger than those of air controls at 12 and 20 wk, which was in line with alveolar enlargement and destruction by histological quantification. However, CS exposure neither increased low attenuation volume nor decreased the average lung CT value at any time point, unlike the elastase-instilled emphysema model. CS-exposed mice had rather higher average lung CT values at 4 and 12 wk. This is the first study characterizing a CS-induced emphysema model on micro-CT over time in mice. Moreover, these findings extend our understanding of the distinct pathophysiology of CS-induced emphysema in mice.

scholarly journals Incidence of chronic obstructive pulmonary disease based on three spirometric diagnostic criteria in Sao Paulo, Brazil: a nine-year follow-up since the PLATINO prevalence study

2015 ◽  
Vol 133 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Graciane Laender Moreira ◽  
Mariana Rodrigues Gazzotti ◽  
Beatriz Martins Manzano ◽  
Oliver Nascimento ◽  
Rogelio Perez-Padilla ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Diagnostic Criteria ◽  
Population Based ◽  
Sao Paulo ◽  
Chronic Obstructive ◽  
São Paulo ◽  
Obstructive Pulmonary Disease ◽  
Significance Level

CONTEXT AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a respiratory disease of high prevalence and socioeconomic impact worldwide. It affects approximately 16% of the population of São Paulo. The incidence of COPD is still unknown in Brazil. The aim of this study was to estimate new cases of COPD in a population-based sample in São Paulo, Brazil, using three different spirometric diagnostic criteria, and to assess the concordance between these criteria.DESIGN AND SETTING: Prospective cohort study, in the city of São Paulo, Brazil.METHODS: A questionnaire was applied and anthropometry and pre and post-bronchodilator spirometry were performed on the same subjects as in the initial PLATINO study (2003) in São Paulo. Data from this follow-up study were added to the original database of the initial phase. Incident COPD cases refer to subjects who developed the disease in accordance with each spirometric criterion during the nine-year follow-up period. The Statistical Package for the Social Sciences, version 17.0 (SPSS Inc., Chicago, IL, USA) was used in the analysis and the significance level was set at P < 0.05.RESULTS: 613 subjects participated in the follow-up. New COPD cases ranged in frequency from 1.4% to 4.0%, depending on the diagnostic criterion used. The concordance between the criteria ranged from 35% to 60%.CONCLUSION: The incidence of COPD after a nine-year follow-up was high, but varied according to the spirometric criterion used. The agreement between the criteria for identifying new cases of the disease ranged from 35% to 60%.

scholarly journals Differences in regional air trapping in current smokers with normal spirometry

2017 ◽  
Vol 49 (1) ◽  
pp. 1600345 ◽  
Author(s):  
Reza Karimi ◽  
Göran Tornling ◽  
Helena Forsslund ◽  
Mikael Mikko ◽  
Åsa M. Wheelock ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Structural Changes ◽  
Forced Expiratory Volume ◽  
Wall Thickening ◽  
Chronic Obstructive ◽  
Air Trapping ◽  
Obstructive Pulmonary Disease ◽  
Never Smokers ◽  
Detection Of Smoking ◽  
Specific Manifestation

We investigated regional air trapping on computed tomography in current smokers with normal spirometry. It was hypothesised that presence of regional air trapping may indicate a specific manifestation of smoking-related changes.40 current smokers, 40 patients with chronic obstructive pulmonary disease (COPD), and 40 healthy never- smokers underwent computed tomography scans. Regional air trapping was assessed on end-expiratory scans and emphysema, micronodules and bronchial wall thickening on inspiratory scans. The ratio of expiratory and inspiratory mean lung attenuation (E/I) was calculated as a measure of static (fixed) air trapping.Regional air trapping was present in 63% of current smokers, in 45% of never smokers and in 8% of COPD patients (p<0.001). Current smokers with and without regional air trapping had E/I ratio of 0.81 and 0.91, respectively (p<0.001). Forced expiratory volume in 1 s (FEV1) was significantly higher and emphysema less frequent in current smokers with regional air trapping.Current smokers with regional air trapping had higher FEV1 and less emphysema on computed tomography. In contrast, current smokers without regional air trapping resembled COPD. Our results highlight heterogeneity among smokers with normal spirometry and may contribute to early detection of smoking related structural changes in the lungs.

scholarly journals Quantitative Assessment the Longitudinal Changes of Pulmonary Vascular Counts in Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Sang Won Park ◽  
Myoung-Nam Lim ◽  
Woo Jin Kim ◽  
So Hyeon Bak
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Longitudinal Changes ◽  
Severe Emphysema ◽  
Copd Patients

Abstract BackgroundChest computed tomography(CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. However, there are few studies of changes in vascular during longitudinal follow-up in COPD patients. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.Materials and MethodsA total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856exp). Total number of vessels (Ntotal) and total number of vessels with area less than 5 mm2 (N<5mm) per 1 cm2 of lung surface area (LSA) were measured at 6 mm from the pleural surface.ResultsNtotal/LSA and N<5mm/LSA changed from 1.16±0.27 to 0.87±0.2 and from 1.02±0.22 to 0.78±0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39±0.21 to 0.74±0.17 and from 1.18±0.19 to 0.67±0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with Ntotal/LSA (r=-0.738, -0.529) and N<5mm /LSA (r=-0.729, -0.497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with Ntotal/LSA and N<5mm/LSA (r=0.205, 0.210). The depth in CT subtypes for longitudinal change both Ntotal/LSA and N<5mm/LSA was (-0.032, -0.023) and (-0.027) in normal and SAD, respectively.ConclusionsQuantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.Trial registrationWe obtained the written informed consent from all participants in this study and the approval for all processes by our institution Institutional Review Board.

Grip strength changes over 27 yr in Japanese-American men

1998 ◽  
Vol 85 (6) ◽  
pp. 2047-2053 ◽  
Author(s):  
T. Rantanen ◽  
K. Masaki ◽  
D. Foley ◽  
G. Izmirlian ◽  
L. White ◽  
...  
Keyword(s):  
Grip Strength ◽  
Chronic Conditions ◽  
Population Based ◽  
Chronic Obstructive ◽  
Japanese American ◽  
Obstructive Pulmonary Disease ◽  
Strength Change ◽  
Weight Decrease ◽  
Age Range

The aim of this study was to describe changes in grip strength over a follow-up period of ∼27 yr and to study the associations of rate of strength decline with weight change and chronic conditions. The data are from the Honolulu Heart Program, a prospective population-based study established in 1965. Participants at exam 1 were 8,006 men (ages 45–68 yr) who were of Japanese ancestry and living in Hawaii. At follow-up, 3,741 men (age range, 71–96 yr) participated. Those who died before the follow-up showed significantly lower grip-strength values at baseline than did the survivors. The average annualized strength change among the survivors was −1.0%. Steeper decline (>1.5%/yr) was associated with older age at baseline, greater weight decrease, and chronic conditions such as stroke, diabetes, arthritis, coronary heart disease, and chronic obstructive pulmonary disease. The risk factors for having very low hand-grip strength at follow-up, here termed grip-strength disability (≤21 kg, the lowest 10th percentile), were largely same as those for steep strength decline. However, the age-adjusted correlation between baseline and follow-up strength was strong ( r = 0.557, P < 0.001); i.e., those who showed greater grip strength at baseline were also likely to do so 27 yr later. Consequently, those in the lowest grip-strength tertile at baseline had about eight times greater risk of grip-strength disability than those in the highest tertile because of their lower reserve of strength. In old age, maintenance of optimal body mass may help prevent steep strength decrease and poor absolute strength.

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