Journal article
Association of Lung Quantitative CT Scan Textures With Systemic Inflammation and Mortality in COPD
Chest, Vol.168(5), pp.1107-1119
11/2025
DOI: 10.1016/j.chest.2025.04.017
PMCID: PMC12410363
PMID: 40268239
Abstract
Background
COPD is characterized by persistent inflammation that is responsible for remodeling the bronchovascular bundles (BVBs), which may lead to poor quality of life. Quantitative CT (QCT) scan textures of the lung can capture local disease patterns of inflammation and related respiratory morbidity.
Research Question
Are BVB textures, obtained from the adaptive multiple feature method, associated with systemic inflammation, morbidity, and mortality in COPD?
Study Design and Methods
We analyzed data from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS; n = 2,981) and the Genetic Epidemiology of COPD (COPDGene) study (n = 10,305). The predictors included 2 QCT scan biomarkers, the BVB and CT density gradient (CTDG) textures, age, sex, BMI, race, smoking status, pack-years of smoking, CT scan-detected emphysema, and square root of the wall area of a hypothetical airway with a 10-mm lumen perimeter (Pi10). Outcomes included plasma biomarker concentrations from Meso Scale Discovery proteomics assays and CBC counts, both as markers of inflammation, along with FEV1, FEV1 to FVC ratio, St. George’s Respiratory Questionnaire score, 6-minute walk distance, and modified Medical Research Council dyspnea scale score. Associations of these QCT scan textures with FEV1 decline and all-cause mortality also were investigated.
Results
Increased BVB texture was associated significantly with elevated neutrophil and monocyte counts and the neutrophil to lymphocyte ratio, independent of clinical covariates, CT scan-detected emphysema, and Pi10. Elevated CTDG was associated with increased neutrophil count, NLR, and tumor necrosis factor α. Increased CTDG and BVB textures also were associated with a lower FEV1 and 6-minute walk distance. CTDG at baseline was also associated with decline in FEV1 at the 5-year follow-up in the COPDGene study. We observed a significant association of both BVB texture (SPIROMICS: hazard ratio [HR], 1.084 [95% CI, 1.035-1.135; P < .001]; COPDGene: HR, 1.106 [95% CI, 1.080-1.131; P < .001]) and CTDG texture (SPIROMICS: HR, 1.033 [95% CI, 1.003-1.064; P = .03]; COPDGene: HR, 1.079 [95% CI, 1.061-1.096; P < .001]) with all-cause mortality independent of CT scan-detected emphysema and Pi10.
Interpretation
QCT scan textures may provide imaging evidence of the spatial heterogeneity of lung inflammation and overall disease burden in COPD.
Details
- Title: Subtitle
- Association of Lung Quantitative CT Scan Textures With Systemic Inflammation and Mortality in COPD
- Creators
- Hira A Awan - University of IowaMuhammad F A ChaudharyAnthony D El-Sokkary - Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USAEric A HoffmanAlejandro P Comellas - University of IowaJunfeng GuoIgor Z Barjaktarevic - David Geffen School of Medicine at UCLAR Graham Barr - Columbia UniversitySurya P Bhatt - University of Alabama at BirminghamSandeep Bodduluri - University of Alabama at BirminghamRussell P Bowler - Cleveland ClinicLuis G Vargas Buonfiglio - University of UtahChristopher B Cooper - David Geffen School of Medicine at UCLAAshraf Fawzy - Johns Hopkins UniversityAnnette T Hastie - Wake Forest UniversityWassim W Labaki - University of MichiganFernando J Martinez - Weill Cornell MedicineMartha G Menchaca - University of Illinois ChicagoWanda O'Neal - University of North Carolina at Chapel HillRobert Paine III - University of UtahJoyce D Schroeder - Mayo ClinicPrescott G Woodruff - University of California, San FranciscoJeffrey L CurtisJoseph M Reinhardt
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.168(5), pp.1107-1119
- DOI
- 10.1016/j.chest.2025.04.017
- PMID
- 40268239
- PMCID
- PMC12410363
- NLM abbreviation
- Chest
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Alternative title
- Lung Quantitative Computed Tomography Textures are Associated with Systemic Inflammation and Mortality in COPD
- Language
- English
- Electronic publication date
- 04/22/2025
- Date published
- 11/2025
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984813284202771
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