A20-01 One-year Progression in Quantitative CT Parameters Predicts Subsequent Lung Function Decline Over 5 Years: The Subpopulations and Intermediate Outcome Measures in COPD Study (Spiromics)

E A Hermann; E A Hoffman; E Angelini; I Barjaktarevic; J Bon; A P Comellas; C B Cooper; D Couper; J L Curtis; G J Criner; M Wells; R Paine; J A Krishnan; W W Labaki; A Laine; D A Lynch; M K Han; N N Hansel; F J Martinez; B M Smith; Y Sun; P Woodruff; R G Barr

doi:10.1093/ajrccm/aamag162.1595

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A20-01 One-year Progression in Quantitative CT Parameters Predicts Subsequent Lung Function Decline Over 5 Years: The Subpopulations and Intermediate Outcome Measures in COPD Study (Spiromics)

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A20-01 One-year Progression in Quantitative CT Parameters Predicts Subsequent Lung Function Decline Over 5 Years: The Subpopulations and Intermediate Outcome Measures in COPD Study (Spiromics)

E A Hermann, E A Hoffman, E Angelini, I Barjaktarevic, J Bon, A P Comellas, C B Cooper, D Couper, J L Curtis, G J Criner, …

American journal of respiratory and critical care medicine, Vol.212(Supplement_1), aamag1621595

05/01/2026

DOI: 10.1093/ajrccm/aamag162.1595

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Abstract

Background COPD is the fourth leading cause of death worldwide, yet the only approved surrogate endpoints for disease progression are FEV₁ decline and exacerbation rates. SPIROMICS, a multicenter longitudinal study of COPD cases and smoking and non-smoking controls, was designed to identify additional surrogate endpoints of disease progression. Given the high short-term (6-week) reproducibility of quantitative computed tomography (CT) measures, we tested if their 1-year progression predicted subsequent 5-year decline in the FEV₁. Methods SPIROMICS comprised four annual visits and a fifth visit 5-7 years after initial enrollment, all with post-bronchodilator spirometry. At Visits 1 and 2, post-bronchodilator CT scans were acquired at full inspiration and expiration and QC’d following the SPIROMICS CT protocol. Quantitative CT parameters were selected for short-term reproducibility, including novel CT emphysema subtypes (combined bronchitic-apical emphysema [CBaE] and diffuse emphysema), density-based measures (percent emphysema-950HU, volume-adjusted lung density [VALD]), AMFM-derived texture, disease probability measures, pulmonary vascular volume, and segmental airway measures (wall area percent [WA%]). Among participants with acceptable inspiratory scans and 3-4 subsequent valid spirometry tests, we tested associations between progression of CT parameters from Visits 1-2 and subsequent FEV₁ decline in Visits 2-5 using linear mixed-effects models with random intercepts adjusting for demographics, enrollment strata, site, baseline CT measure and time-varying height, weight, smoking status, and pack-years. Results Among 880 participants (43% mild/moderate COPD, 17% severe COPD, 29% smoking control, 11% non-smoking control), one-year increases in CBaE and diffuse emphysema were associated with subsequent accelerated FEV₁ decline over a mean of 4.7 years follow up (SD 0.6) in both unadjusted and adjusted analyses (adjusted: CBaE, −4.7 mL/year/one-year increase SD unit; 95% CI: −8.98, −0.36; diffuse, −5.5 mL/year/one-year increase SD unit; 95% CI: −9.86, −1.19). Percent emphysema-950, VALD, and %WA also predicted FEV₁ decline (all P < 0.05). Comparison of these five parameters demonstrated that only CBaE and diffuse emphysema were independently predictive of FEV₁ decline. Other quantitative CT measures showed limited or no associations. The figure shows one-year change in CBaE, diffuse emphysema and percent emphysema-950 (top vs bottom quartile) and subsequent FEV1 decline in among 375 participants with complete data. Conclusions One-year progression of several quantitative CT parameters, particularly the novel, machine-learned CT emphysema subtypes of CBaE and diffuse emphysema, predict long-term FEV1 decline in COPD. These findings support the potential of quantitative CT parameters to serve as intermediate endpoints in COPD clinical trials. This abstract is funded by: SPIROMICS was supported by contracts from the NIH/NHLBI (HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, HHSN268200900020C, 75N92024D00012), grants from the NIH/NHLBI (U01HL137880, U24HL141762, R01HL182622, R01HL144718, and R01HL093081), and supplemented by contributions made through the Foundation for the NIH and the COPD Foundation from Amgen; AstraZeneca/MedImmune; Bayer; Bellerophon Therapeutics; Boehringer-Ingelheim Pharmaceuticals, Inc.; Bristol Myers Squibb; Chiesi Farmaceutici S.p.A.; Forest Research Institute, Inc.; Genentech; GlaxoSmithKline; Grifols Therapeutics, Inc.; Ikaria, Inc.; MGC Diagnostics; Novartis Pharmaceuticals Corporation; Nycomed GmbH; Polarean; ProterixBio; Regeneron Pharmaceuticals, Inc.; Sanofi; Sunovion; Takeda Pharmaceutical Company; Theravance Biopharma; Verona; and Mylan/Viatris

Bronchodilators

Emphysema

Pharmaceutical industry

Reproducibility

Spirometry

Details

Title: Subtitle: A20-01 One-year Progression in Quantitative CT Parameters Predicts Subsequent Lung Function Decline Over 5 Years: The Subpopulations and Intermediate Outcome Measures in COPD Study (Spiromics)
Creators: E A Hermann - Columbia University Irving Medical Center
E A Hoffman - University of Iowa
E Angelini - Imperial College London
I Barjaktarevic - UCLA Health
J Bon - Wake Forest University
A P Comellas - University of Iowa
C B Cooper - University of California, Los Angeles
D Couper - University of North Carolina at Chapel Hill
J L Curtis - University of Michigan
G J Criner - Temple University
M Wells - University of Alabama at Birmingham
R Paine - University of Utah
J A Krishnan - University of Illinois Chicago
W W Labaki - University of Michigan
A Laine - Columbia University
D A Lynch - National Jewish Health
M K Han - University of Michigan
N N Hansel - Johns Hopkins University
F J Martinez - University of Massachusetts Chan Medical School
B M Smith - McGill University
Y Sun - Columbia University
P Woodruff - University of California, San Francisco
R G Barr - Columbia University Irving Medical Center
Resource Type: Abstract
Publication Details: American journal of respiratory and critical care medicine, Vol.212(Supplement_1), aamag1621595
DOI: 10.1093/ajrccm/aamag162.1595
ISSN: 1535-4970
eISSN: 1535-4970
Publisher: Oxford University Press
Language: English
Date published: 05/01/2026
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
Record Identifier: 9985164603602771

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