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Title: Voxel-Wise Longitudinal Parametric Response Mapping Analysis of Chest Computed Tomography in Smokers.

Authors: Labaki, Wassim W; Gu, Tian; Murray, Susan; Hatt, Charles R; Galbán, Craig J; Ross, Brian D; Martinez, Carlos H; Curtis, Jeffrey L; Hoffman, Eric A; Pompe, Esther; Lynch, David A; Kazerooni, Ella A; Martinez, Fernando J; Han, MeiLan K

Published In Acad Radiol, (2019 02)

Abstract: Chronic obstructive pulmonary disease is a heterogeneous disease characterized by small airway abnormality and emphysema. We hypothesized that a voxel-wise computed tomography analytic approach would identify patterns of disease progression in smokers.We analyzed 725 smokers in spirometric GOLD stages 0-4 with two chest CTs 5 years apart. Baseline inspiration, follow-up inspiration and follow-up expiration images were spatially registered to baseline expiration so that each voxel had correspondences across all time points and respiratory phases. Voxel-wise Parametric Response Mapping (PRM) was then generated for the baseline and follow-up scans. PRM classifies lung as normal, functional small airway disease (PRMfSAD), and emphysema (PRMEMPH).Subjects with low baseline PRMfSAD and PRMEMPH predominantly had an increase in PRMfSAD on follow-up; those with higher baseline PRMfSAD and PRMEMPH mostly had increases in PRMEMPH. For GOLD 0 participants (n = 419), mean 5-year increases in PRMfSAD and PRMEMPH were 0.3% for both; for GOLD 1-4 participants (n = 306), they were 0.6% and 1.6%, respectively. Eighty GOLD 0 subjects (19.1%) had overall radiologic progression (30.0% to PRMfSAD, 52.5% to PRMEMPH, and 17.5% to both); 153 GOLD 1-4 subjects (50.0%) experienced progression (17.6% to PRMfSAD, 48.4% to PRMEMPH, and 34.0% to both). In a multivariable model, both baseline PRMfSAD and PRMEMPH were associated with development of PRMEMPH on follow-up, although this relationship was diminished at higher levels of baseline PRMEMPH.A voxel-wise longitudinal PRM analytic approach can identify patterns of disease progression in smokers with and without chronic obstructive pulmonary disease.

PubMed ID: 30055897 Exiting the NIEHS site

MeSH Terms: Aged; Disease Progression; Female; Humans; Lung*/diagnostic imaging; Lung*/physiopathology; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive*/complications; Pulmonary Disease, Chronic Obstructive*/diagnosis; Pulmonary Disease, Chronic Obstructive*/physiopathology; Pulmonary Emphysema*/diagnosis; Pulmonary Emphysema*/etiology; Radiography, Thoracic/methods*; Reproducibility of Results; Smokers*; Tomography, X-Ray Computed/methods*

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