Journal article
One-year progression of CT emphysema subtypes predict lung function decline: SPIROMICS
American journal of respiratory and critical care medicine
09/25/2026
DOI: 10.1093/ajrccm/aamag497
PMID: 42788667
Abstract
Intermediate endpoints that predict lung function decline are needed to improve the efficiency of clinical trials in chronic obstructive pulmonary disease (COPD).
To test if one-year progression of quantitative computed tomography (QCT) measures predicts subsequent FEV₁ decline.
SPIROMICS recruited individuals with ≥ 20 pack-years smoking history with or without COPD and nonsmoking controls who underwent four annual and a later fifth visit. We analyzed chest CT scans at visits one and two for machine-learned CT emphysema subtypes (combined bronchitic-apical emphysema [CBaE], diffuse emphysema) and standard QCT measures of emphysema (percent emphysema-950HU, 15th percentile HU, volume-adjusted lung density), airways, functional small airways, hyperinflation, parenchymal texture and vasculature. Linear mixed-effects models evaluated associations between one-year QCT measure changes and FEV₁ decline from visits two through five, adjusting for demographics, site, enrollment group, baseline QCT value, and time-varying anthropometrics and smoking.
Among 880 participants (43% mild/moderate COPD, 17% severe COPD, 29% smoking controls, 11% nonsmoking controls), FEV₁ declined -30.4mL/year (95% CI: -34.5, -26.3). A standard deviation (SD) one-year increase in CBaE and diffuse emphysema predicted an accelerated decline in FEV1 of - 4.2 mL/year (95% CI: -8.3, -0.2) and -6.2 mL/year (95% CI: -10.7, -1.8), respectively. Changes in standard QCT emphysema measures also predicted change in FEV1 decline, but only CBaE and diffuse emphysema remained independently predictive of accelerated FEV1 decline when all were considered together.
One-year progression of CT emphysema subtypes predicted accelerated FEV₁ decline, supporting their potential use as intermediate endpoints in COPD trials.
Details
- Title: Subtitle
- One-year progression of CT emphysema subtypes predict lung function decline: SPIROMICS
- Creators
- Emilia A Hermann - Columbia University Irving Medical CenterEric A Hoffman - University of Iowa, RadiologyElsa D Angelini - Institut Polytechnique de ParisIgor Barjaktarevic - University of California, Los AngelesJessica Bon - Wake Forest UniversityAlejandro Comellas - University of IowaChristopher B Cooper - University of California, Los AngelesDavid Couper - University of North Carolina at Chapel HillJeffrey L Curtis - University of MichiganGerard Criner - Temple UniversityJ Michael Wells - University of Alabama at BirminghamRobert Paine III - University of UtahJerry A Krishnan - University of Illinois ChicagoWassim Labaki - University of MichiganAndrew F Laine - Columbia UniversityDavid A Lynch - National Jewish HealthMeiLan K Han - University of MichiganNadia N Hansel - Johns Hopkins UniversityFernando J Martinez - Weill Cornell MedicineVictor Ortega - Mayo ClinicBenjamin Smith - Columbia University Irving Medical CenterYifei Sun - Columbia UniversityPrescott Woodruff - University of California, San FranciscoR Graham Barr - Columbia University Irving Medical Center
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine
- DOI
- 10.1093/ajrccm/aamag497
- PMID
- 42788667
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1535-4970
- eISSN
- 1535-4970
- Publisher
- Oxford University Press
- Language
- English
- Electronic publication date
- 09/25/2026
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9985236348702771
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