BACKGROUND: Disease accumulates in the small airways without being detected by conventional measurements. OBJECTIVES: To quantify small airway disease using a novel computed tomography (CT) inspiratory-to-expiratory approach called the disease probability measure (DPM) and to investigate the association with pulmonary function measurements. METHODS: Participants from the population-based CanCOLD study were evaluated using full-inspiration/full-expiration CT and pulmonary function measurements. Full-inspiration and full-expiration CT images were registered, and each voxel was classified as emphysema, gas trapping (GasTrap) related to functional small airway disease, or normal using two classification approaches: parametric response map (PRM) and DPM (VIDA Diagnostics, Inc., Coralville, IA, USA). RESULTS: The participants included never-smokers (n = 135), at risk (n = 97), Global Initiative for Chronic Obstructive Lung Disease I (GOLD I) (n = 140), and GOLD II chronic obstructive pulmonary disease (n = 96). PRMGasTrap and DPMGasTrap measurements were significantly elevated in GOLD II compared to never-smokers (p < 0.01) and at risk (p < 0.01), and for GOLD I compared to at risk (p < 0.05). Gas trapping measurements were significantly elevated in GOLD II compared to GOLD I (p < 0.0001) using the DPM classification only. Overall, DPM classified significantly more voxels as gas trapping than PRM (p < 0.0001); a spatial comparison revealed that the expiratory CT Hounsfield units (HU) for voxels classified as DPMGasTrap but PRMNormal (PRMNormal- DPMGasTrap = -785 ± 72 HU) were significantly reduced compared to voxels classified normal by both approaches (PRMNormal-DPMNormal = -722 ± 89 HU; p < 0.0001). DPM and PRMGasTrap measurements showed similar, significantly associations with forced expiratory volume in 1 s (FEV1) (p < 0.01), FEV1/forced vital capacity (p < 0.0001), residual volume/total lung capacity (p < 0.0001), bronchodilator response (p < 0.0001), and dyspnea (p < 0.05). CONCLUSION: CT inspiratory-to-expiratory gas trapping measurements are significantly associated with pulmonary function and symptoms. There are quantitative and spatial differences between PRM and DPM classification that need pathological investigation.
BACKGROUND: Disease accumulates in the small airways without being detected by conventional measurements. OBJECTIVES: To quantify small airway disease using a novel computed tomography (CT) inspiratory-to-expiratory approach called the disease probability measure (DPM) and to investigate the association with pulmonary function measurements. METHODS:Participants from the population-based CanCOLD study were evaluated using full-inspiration/full-expiration CT and pulmonary function measurements. Full-inspiration and full-expiration CT images were registered, and each voxel was classified as emphysema, gas trapping (GasTrap) related to functional small airway disease, or normal using two classification approaches: parametric response map (PRM) and DPM (VIDA Diagnostics, Inc., Coralville, IA, USA). RESULTS: The participants included never-smokers (n = 135), at risk (n = 97), Global Initiative for Chronic Obstructive Lung Disease I (GOLD I) (n = 140), and GOLD II chronic obstructive pulmonary disease (n = 96). PRMGasTrap and DPMGasTrap measurements were significantly elevated in GOLD II compared to never-smokers (p < 0.01) and at risk (p < 0.01), and for GOLD I compared to at risk (p < 0.05). Gas trapping measurements were significantly elevated in GOLD II compared to GOLD I (p < 0.0001) using the DPM classification only. Overall, DPM classified significantly more voxels as gas trapping than PRM (p < 0.0001); a spatial comparison revealed that the expiratory CT Hounsfield units (HU) for voxels classified as DPMGasTrap but PRMNormal (PRMNormal- DPMGasTrap = -785 ± 72 HU) were significantly reduced compared to voxels classified normal by both approaches (PRMNormal-DPMNormal = -722 ± 89 HU; p < 0.0001). DPM and PRMGasTrap measurements showed similar, significantly associations with forced expiratory volume in 1 s (FEV1) (p < 0.01), FEV1/forced vital capacity (p < 0.0001), residual volume/total lung capacity (p < 0.0001), bronchodilator response (p < 0.0001), and dyspnea (p < 0.05). CONCLUSION: CT inspiratory-to-expiratory gas trapping measurements are significantly associated with pulmonary function and symptoms. There are quantitative and spatial differences between PRM and DPM classification that need pathological investigation.
Authors: Abhaya P Trivedi; Chase Hall; Charles W Goss; Daphne Lew; James G Krings; Mary Clare McGregor; Maanasi Samant; Jered P Sieren; Huashi Li; Ken B Schechtman; Joshua Schirm; Stephen McEleney; Sam Peterson; Wendy C Moore; Eugene R Bleecker; Deborah A Meyers; Elliot Israel; George R Washko; Bruce D Levy; Joseph K Leader; Sally E Wenzel; John V Fahy; Mark L Schiebler; Sean B Fain; Nizar N Jarjour; David T Mauger; Joseph M Reinhardt; John D Newell; Eric A Hoffman; Mario Castro; Ajay Sheshadri Journal: Radiology Date: 2022-04-26 Impact factor: 29.146
Authors: Steve N Georas; Rosalind J Wright; Anastasia Ivanova; Elliot Israel; Lisa M LaVange; Praveen Akuthota; Tara F Carr; Loren C Denlinger; Merritt L Fajt; Rajesh Kumar; Wanda K O'Neal; Wanda Phipatanakul; Stanley J Szefler; Mark A Aronica; Leonard B Bacharier; Allison J Burbank; Mario Castro; Laura Crotty Alexander; Julie Bamdad; Juan Carlos Cardet; Suzy A A Comhair; Ronina A Covar; Emily A DiMango; Kim Erwin; Serpil C Erzurum; John V Fahy; Jonathan M Gaffin; Benjamin Gaston; Lynn B Gerald; Eric A Hoffman; Fernando Holguin; Daniel J Jackson; John James; Nizar N Jarjour; Nicholas J Kenyon; Sumita Khatri; John P Kirwan; Monica Kraft; Jerry A Krishnan; Andrew H Liu; Mark C Liu; M Alison Marquis; Fernando Martinez; Jacob Mey; Wendy C Moore; James N Moy; Victor E Ortega; David B Peden; Emily Pennington; Michael C Peters; Kristie Ross; Maria Sanchez; Lewis J Smith; Ronald L Sorkness; Michael E Wechsler; Sally E Wenzel; Steven R White; Joe Zein; Amir A Zeki; Patricia Noel Journal: J Allergy Clin Immunol Date: 2021-11-29 Impact factor: 14.290
Authors: Kyle A Hasenstab; Nancy Yuan; Tara Retson; Douglas J Conrad; Seth Kligerman; David A Lynch; Albert Hsiao Journal: Radiol Cardiothorac Imaging Date: 2021-04-08
Authors: James G Krings; Charles W Goss; Daphne Lew; Maanasi Samant; Mary Clare McGregor; Jonathan Boomer; Leonard B Bacharier; Ajay Sheshadri; Chase Hall; Joshua Brownell; Ken B Schechtman; Samuel Peterson; Stephen McEleney; David T Mauger; John V Fahy; Sean B Fain; Loren C Denlinger; Elliot Israel; George Washko; Eric Hoffman; Sally E Wenzel; Mario Castro Journal: J Allergy Clin Immunol Date: 2021-02-09 Impact factor: 14.290
Authors: Josalyn L Cho; Raul Villacreses; Prashant Nagpal; Junfeng Guo; Alejandro A Pezzulo; Andrew L Thurman; Nabeel Y Hamzeh; Robert J Blount; Spyridon Fortis; Eric A Hoffman; Joseph Zabner; Alejandro P Comellas Journal: Radiology Date: 2022-03-15 Impact factor: 29.146
Authors: Prashant Nagpal; Amin Motahari; Sarah E Gerard; Junfeng Guo; Joseph M Reinhardt; Alejandro P Comellas; Eric A Hoffman; David W Kaczka Journal: J Appl Physiol (1985) Date: 2021-06-24