Spatial heterogeneity and distribution of CT-Based pulmonary vascular volumes in chronic thromboembolic pulmonary hypertension.

Rationale/objectives: Image-based vascular biomarkers may help expedite evaluation of chronic thromboembolic pulmonary hypertension (CTEPH), which remains difficult to diagnose despite available effective therapies. We sought to determine if vascular heterogeneity and central redistribution on chest CT differed between CTEPH, pulmonary arterial hypertension (PAH), and control groups.

Materials/methods: We retrospectively included 108 patients who underwent right heart catheterization and chest CT (2011-2018).

Emphysema progression risk in COPD using a localized foundational model of density evolution.

Emphysema progression in chronic obstructive pulmonary disease (COPD) presents a notable challenge due to its significant variability among individuals and the current lack of reliable prognostic markers. Given the limited therapeutic options available for emphysema, there is a critical need for early detection and intervention strategies. Identifying individuals at risk of rapid progression is essential to effectively halt or slow the disease's advancement.

Pulmonary vascular morphology in cystic fibrosis.

Background: Morphological changes of the pulmonary vasculature in cystic fibrosis (CF) with advancing age, disease progression and modulator therapy are not fully understood.

Methods: Sixty-five subjects with CF and baseline pulmonary function underwent a high-resolution CT scan, exercise testing, diffusion capacity and lung clearance index. The ratio of small blood vessel volume (vessels< 5mm or BV5") to total blood vessel volume (TBV) was estimated from CT scans (BV5/TBV%).

Visual and Quantitative Interstitial Lung Abnormality Progression in COPDGene.

Rationale: Interstitial lung abnormalities (ILA) are visually identified changes on chest computed tomography (CT) scans that may represent early/mild pulmonary fibrosis. Quantitative interstitial abnormalities (QIA) measure potential parenchymal lung injury on chest CT scans using an automated algorithm. It is not known if combining these visual and quantitative assessments improves prediction of imaging progression.

Opportunistic Screening on Chest CT, From the Special Series on Screening.

The increase in chest CT volumes affords radiologists the opportunity to systematically assess imaging biomarkers including coronary and thoracic arterial calcification, emphysema, airway dysanapsis, adipose tissue in various compartments, skeletal muscle (in terms of both quantity and quality), and vertebral body bone attenuation (as a measure of bone mineral density), extending from the T1 through T12 vertebral body levels (1). These biomarkers represent a spectrum of disease-induced changes or increases in risk for developing disease. This Special Series review provides an overview of these established and emerging imaging biomarkers on chest CT scans, aiming to serve as a reference for practicing radiologists.

Cluster analysis identifies quantitative CT imaging-based subgroups in COPD subjects with pulmonary artery enlargement.

https://bit.ly/4jEy5RT

Associations of Prepandemic Lung Function and Structure with COVID-19 Outcomes: The C4R Study.

Increased risk of coronavirus disease (COVID-19) hospitalization and death has been reported among patients with clinical lung disease. To test the association of objective measures of prepandemic lung function and structure with COVID-19 outcomes in U.S.

The Use of CT Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society.

Emphysema's significant morbidity and mortality underscore the need for reliable outcome metrics in clinical trials. However, commonly accepted COPD outcome measures do not adequately capture emphysema severity or progression. Computed tomography (CT) metrics have been validated as accurate indicators of pathological emphysema and predictors of COPD progression, exacerbations, and mortality.

Polygenic risk scores for rheumatoid arthritis and idiopathic pulmonary fibrosis and associations with RA, interstitial lung abnormalities, and quantitative interstitial abnormalities among smokers.

Objective: Genome-wide association studies (GWAS) facilitate construction of polygenic risk scores (PRSs) for rheumatoid arthritis (RA) and idiopathic pulmonary fibrosis (IPF). We investigated associations of RA and IPF PRSs with RA and high-resolution chest computed tomography (HRCT) parenchymal lung abnormalities.

Methods: Participants in COPDGene, a prospective multicenter cohort of current/former smokers, had chest HRCT at study enrollment.

Risk factors for interstitial lung disease in early rheumatoid arthritis and external validation of screening strategies: Baseline results of SAIL-RA.

Background: Risk factors and screening strategies for rheumatoid arthritis-associated interstitial lung disease (RA-ILD) have received limited evaluation in patients with early RA. We investigated RA-ILD prevalence, risk factors, and the performance of proposed RA-ILD screening methodologies in a multicenter, prospective study of patients with early RA.

Methods: Participants with early RA, defined as being within two years of RA diagnosis, were enrolled at five US sites and assessed with high-resolution computed tomography (HRCT) chest imaging, pulmonary function tests, and autoantibodies.

Characterization of Occupational Endotoxin-Related Small Airway Disease With Longitudinal Paired Inspiratory/Expiratory CT Scans.

Background: Although small airway disease (SAD) has been recognized as a major contributor to obstructive respiratory diseases, the association between occupational endotoxin exposure and SAD, as characterized by CT scans, requires further investigation.

Research Question: What is the association between occupational endotoxin exposure and SAD, and which CT imaging biomarkers effectively detect preclinical airway dysfunction?

Study Design And Methods: This study included 404 patients from the Shanghai Textile Workers Cohort. We collected longitudinal inspiratory/expiratory CT scans, spirometry data, and endotoxin levels in 2011 and 2016.

Novel Lobe-based Transformer model (LobTe) to predict emphysema progression in Alpha-1 Antitrypsin Deficiency.

Emphysema, marked by irreversible lung tissue destruction, poses challenges in progression prediction due to its heterogeneity. Early detection is particularly critical for patients with Alpha-1 Antitrypsin Deficiency (AATD), a genetic disorder reducing ATT protein levels. Heterozygous carriers (PiMS and PiMZ) have variable AAT levels thus complicating their prognosis.

Effect of Common Medications on Longitudinal Pectoralis Muscle Area in Smokers.

Background: Cigarette smoke contributes to skeletal muscle wasting. While exercise and nutritional therapies are effective in improving skeletal muscle quantity and quality, the effect of medications on longitudinal muscle loss is unclear. We investigated whether long-term use of common medications affects longitudinal skeletal muscle changes in current and former smokers.

Associations between life-course FEV/FVC trajectories and respiratory symptoms up to middle age: analysis of data from two prospective cohort studies.

Background: Life-course lung function trajectories leading to airflow obstruction, as measured by impaired FEV/FVC (forced vital capacity), precede the onset of chronic obstructive pulmonary disease (COPD). We aimed to investigate whether individuals on impaired FEV/FVC trajectories have an increased burden of respiratory symptoms, including those who do not meet the spirometric criteria for COPD.

Methods: We analysed serial life-course data from two population-based cohort studies separately, which included respiratory symptoms and spirometry: the Tasmanian Longitudinal Health Study (TAHS, Australia) cohort was recruited at age 6-7 years and followed up until middle age (mean age 53 years; range 51-55); and the Coronary Artery Risk Development in Young Adults (CARDIA, USA) cohort was recruited at a mean age of 25 years (range 18-30) and followed up to a mean age of 55 years (range 47-64).

Airway Mucus Plugs on Chest Computed Tomography Are Associated with Exacerbations in COPD.

Unlabelled: Rationale/Objective: Acute exacerbations (AEs) of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity and mortality. Whether mucus plugs are associated with prospective exacerbations has not been examined extensively.

Methods: Mucus plugs were visually-identified on baseline chest computed tomography (CT) scans from smokers with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 2-4 COPD enrolled in two multicenter cohort studies: Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and COPDGene.

CT Radiomics Features Predict Change in Lung Density and Rate of Emphysema Progression.

Rationale Emphysema progression is heterogeneous. Predicting temporal changes in lung density and detecting rapid progressors may facilitate selection of individuals for targeted therapies. Objective To test whether computed tomography (CT) radiomics can be used to predict changes in lung density and detect rapid progressors.