Journal article
Automated CT-based Decoupling of the Effects of Airway Narrowing and Wall Thinning on Airway Counts in Chronic Obstructive Pulmonary Disease
British journal of radiology, Vol.98(1165), pp.150-159
01/01/2025
DOI: 10.1093/bjr/tqae211
PMCID: PMC11652725
PMID: 39447037
Appears in UI Libraries Support Open Access
Abstract
We examine pathways of airway alteration due to wall thinning, narrowing, and obliteration at different COPD severity stages using CT-derived airway metrics.OBJECTIVEWe examine pathways of airway alteration due to wall thinning, narrowing, and obliteration at different COPD severity stages using CT-derived airway metrics.Ex-smokers (N = 649; age mean±std: 69 ± 6years; 52% male) from the COPDGene Iowa cohort (September 2013-July 2017) were studied. Total airway count (TAC), peripheral TAC beyond 7th generation (TACp), and airway wall thickness (WT) were computed from chest CT scans using previously validated automated methods. Causal relationships among demographic, smoking, spirometry, COPD severity, airway counts, WT, and scanner variables were analyzed using causal inference techniques including direct acyclic graphs (DAGs) to quantitatively assess multi-pathway alterations of airways in COPD.METHODSEx-smokers (N = 649; age mean±std: 69 ± 6years; 52% male) from the COPDGene Iowa cohort (September 2013-July 2017) were studied. Total airway count (TAC), peripheral TAC beyond 7th generation (TACp), and airway wall thickness (WT) were computed from chest CT scans using previously validated automated methods. Causal relationships among demographic, smoking, spirometry, COPD severity, airway counts, WT, and scanner variables were analyzed using causal inference techniques including direct acyclic graphs (DAGs) to quantitatively assess multi-pathway alterations of airways in COPD.TAC, TACp, and WT were significantly lower (p < 0.0001) in mild, moderate, and severe COPD compared to the preserved lung function group. TAC (TACp) losses attributed to narrowing and obliteration of small airways were 4.59, 13.29, and 32.58% (4.64, 17.82, and 45.51%) in mild, moderate, and severe COPD, while the losses attributed to wall thinning were 8.24, 17.01, and 22.95% (12.79, 25.66, and 33.95%) in respective groups.RESULTSTAC, TACp, and WT were significantly lower (p < 0.0001) in mild, moderate, and severe COPD compared to the preserved lung function group. TAC (TACp) losses attributed to narrowing and obliteration of small airways were 4.59, 13.29, and 32.58% (4.64, 17.82, and 45.51%) in mild, moderate, and severe COPD, while the losses attributed to wall thinning were 8.24, 17.01, and 22.95% (12.79, 25.66, and 33.95%) in respective groups.Different pathways of airway alteration in COPD are observed using CT-derived automated airway metrics. Wall thinning is a dominant contributor to both TAC and TACp loss in mild and moderate COPD while narrowing and obliteration of small airways is dominant in severe COPD.CONCLUSIONSDifferent pathways of airway alteration in COPD are observed using CT-derived automated airway metrics. Wall thinning is a dominant contributor to both TAC and TACp loss in mild and moderate COPD while narrowing and obliteration of small airways is dominant in severe COPD.This automated CT-based study shows that wall thinning dominates airway alteration in mild and moderate COPD while narrowing and obliteration of small airways leads the alteration process in severe COPD.ADVANCES IN KNOWLEDGEThis automated CT-based study shows that wall thinning dominates airway alteration in mild and moderate COPD while narrowing and obliteration of small airways leads the alteration process in severe COPD.
Details
- Title: Subtitle
- Automated CT-based Decoupling of the Effects of Airway Narrowing and Wall Thinning on Airway Counts in Chronic Obstructive Pulmonary Disease
- Creators
- Syed Ahmed Nadeem - University of IowaXinyu Zhang - University of Iowa, Statistics and Actuarial SciencePrashant Nagpal - University of Wisconsin–MadisonEric A Hoffman - University of Iowa, RadiologyKung-Sik Chan - University of Iowa, Statistics and Actuarial ScienceAlejandro P Comellas - University of IowaPunam K Saha - University of Iowa
- Resource Type
- Journal article
- Publication Details
- British journal of radiology, Vol.98(1165), pp.150-159
- DOI
- 10.1093/bjr/tqae211
- PMID
- 39447037
- PMCID
- PMC11652725
- NLM abbreviation
- Br J Radiol
- ISSN
- 1748-880X
- eISSN
- 1748-880X
- Publisher
- Oxford University Press; OXFORD
- Grant note
- National Institutes of HealthNational Heart, Lung, and Blood Institute: R01 HL142042, 5U01 HL089897, S10 OD018526 Bowers Emphysema Research Fund at the University of Iowa
This work was supported by National Institutes of Health and the National Heart, Lung, and Blood Institute (R01 HL142042, 5U01 HL089897, and S10 OD018526) and the Bowers Emphysema Research Fund at the University of Iowa.
- Language
- English
- Electronic publication date
- 10/24/2024
- Date published
- 01/01/2025
- Academic Unit
- Statistics and Actuarial Science; Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984738165802771
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