Journal article
Biomechanical CT metrics are associated with patient outcomes in COPD
Thorax, Vol.72(5), pp.409-414
05/2017
DOI: 10.1136/thoraxjnl-2016-209544
PMCID: PMC5526353
PMID: 28044005
Abstract
BackgroundTraditional metrics of lung disease such as those derived from spirometry and static single-volume CT images are used to explain respiratory morbidity in patients with COPD, but are insufficient. We hypothesised that the mean Jacobian determinant, a measure of local lung expansion and contraction with respiration, would contribute independently to clinically relevant functional outcomes.MethodsWe applied image registration techniques to paired inspiratory-expiratory CT scans and derived the Jacobian determinant of the deformation field between the two lung volumes to map local volume change with respiration. We analysed 490 participants with COPD with multivariable regression models to assess strengths of association between traditional CT metrics of disease and the Jacobian determinant with respiratory morbidity including dyspnoea (modified Medical Research Council), St Georges Respiratory Questionnaire (SGRQ) score, 6-min walk distance (6MWD) and the Body Mass Index, Airflow Obstruction, Dyspnoea and Exercise Capacity (BODE) index, as well as all-cause mortality.ResultsThe Jacobian determinant was significantly associated with SGRQ (adjusted regression coefficient β=−11.75,95% CI −21.6 to −1.7; p=0.020), and with 6MWD (β=321.15, 95% CI 134.1 to 508.1; p<0.001), independent of age, sex, race, body mass index, FEV1, smoking pack-years, CT emphysema, CT gas trapping, airway wall thickness and CT scanner type. The mean Jacobian determinant was also independently associated with the BODE index (β=−0.41, 95% CI −0.80 to −0.02; p=0.039) and mortality on follow-up (adjusted HR=4.26, 95% CI 0.93 to 19.23; p=0.064).ConclusionsBiomechanical metrics representing local lung expansion and contraction improve prediction of respiratory morbidity and mortality and offer additional prognostic information beyond traditional measures of lung function and static single-volume CT metrics.Trial registration numberNCT00608764; Post-results.
Details
- Title: Subtitle
- Biomechanical CT metrics are associated with patient outcomes in COPD
- Creators
- Sandeep Bodduluri - Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USASurya BhattEric A Hoffman - University of Iowa, RadiologyJohn D Newell Jr - University of Iowa, RadiologyCarlos H MartinezMark T DransfieldMeilan K HanJoseph M Reinhardt - University of Iowa, Roy J. Carver Department of Biomedical EngineeringCOPDGene Investigators
- Resource Type
- Journal article
- Publication Details
- Thorax, Vol.72(5), pp.409-414
- DOI
- 10.1136/thoraxjnl-2016-209544
- PMID
- 28044005
- PMCID
- PMC5526353
- ISSN
- 0040-6376
- eISSN
- 1468-3296
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: 1K23HL133438-01, R01 HL079406, R01 HL089856, R01 HL089897, R01 HL112986
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984196997002771
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