Voxel-Wise Longitudinal Parametric Response Mapping Analysis of Chest Computed Tomography in Smokers
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 sta...
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Published in | Academic radiology Vol. 26; no. 2; p. 217 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.02.2019
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Subjects | |
Online Access | Get more information |
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Summary: | 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 (PRM
), and emphysema (PRM
).
Subjects with low baseline PRM
and PRM
predominantly had an increase in PRM
on follow-up; those with higher baseline PRM
and PRM
mostly had increases in PRM
. For GOLD 0 participants (n = 419), mean 5-year increases in PRM
and PRM
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 PRM
, 52.5% to PRM
, and 17.5% to both); 153 GOLD 1-4 subjects (50.0%) experienced progression (17.6% to PRM
, 48.4% to PRM
, and 34.0% to both). In a multivariable model, both baseline PRM
and PRM
were associated with development of PRM
on follow-up, although this relationship was diminished at higher levels of baseline PRM
.
A voxel-wise longitudinal PRM analytic approach can identify patterns of disease progression in smokers with and without chronic obstructive pulmonary disease. |
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ISSN: | 1878-4046 |
DOI: | 10.1016/j.acra.2018.05.024 |