Robust Detection of Early Small Airway Disease

早期小气道疾病的稳健检测

基本信息

批准号：
10360612
负责人：
Gonzalo Vegas Sanchez-Ferrero
金额：
$ 13.43万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-03-01 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10360612
关键词：
Address Affect Air Air Movements Airway Disease Award Base Pairing Body Size Bronchioles Cause of Death Characteristics Chronic Obstructive Pulmonary Disease Clinical Clinical Trials Cohort Studies Cross-Sectional Studies Data Data Set Detection Development Devices Diagnosis Dimensions Disease Disease Progression Dose Early Diagnosis Early identification Error Sources Gases Goals Histology Image Impairment Inflammatory Response Lead Longitudinal Studies Lung Measurement Measures Methodology Methods Modeling Morbidity - disease rate Names Noise Onset of illness Pathogenesis Patients Pattern Physics Process Protocols documentation Publishing Pulmonary Emphysema Radiation exposure Research Resolution Role Scanning Sensitivity and Specificity Site Smoking Somatotype Standardization Statistical Methods Techniques Terminal Bronchiole Therapeutic Intervention Tissues Validation Vendor X-Ray Computed Tomography airway obstruction base biomarker performance chronic airflow obstruction cigarette smoke clinically relevant density dosage drug discovery early onset follow-up functional decline high risk histological studies image processing imaging biomarker imaging modality improved in vivo interest lung volume microCT mortality particle pulmonary function pulmonary function decline radiological imaging reconstruction response small airways disease success

项目摘要

Project Summary Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality. Despite declines in smoking, mortality from COPD continues to increase and is now the 3rd leading cause of death in the US. The chronic airflow limitation of COPD is caused by a mixture of small airway disease and parenchymal destruction (emphysema). Recent studies have suggested a central role of small airway destruction in the pathogenesis of COPD. This evidence has sparked the interest in in-vivo assessment of small airway disease overall at the early onset of the disease. Early identification of small airway disease could lead to better patient diagnosis, early therapeutic intervention and provide more sensitive markers to elucidate the pathogenesis of the disease and its biomolecular basis that could inform much-needed drug discovery. Computed Tomography (CT) is an imaging modality that has proven to be effective in the quantification of parenchymal destruction. However, the imaging resolution required to obtain direct measures from small airways is beyond the limits of CT scans. A recent technique called parametric response mapping (PRM) proposes to distinguish gas trapping due to small airway disease from emphysema by matching inspiratory and expiratory CT scans and applying density thresholds to distinguish functional small airway disease (FSAD) and emphysema. Despite its success, the PRM shows some limitations that are precluding the accuracy, robustness and interpretation of its results in early disease: The CT density values highly depend on acquisition parameters (dosage, reconstruction kernel, changes in body size) that introduce subject- and scanner-dependent confounders. Although clinical trials use well defined acquisition protocols and phantom-calibrated acquisitions, the biases and noise patterns still are subject-dependent. In particular, many studies using PRM employ inspiratory and expiratory images that are obtained at different dose levels. This project will take full advantage of our most recent developments in image-driven statistical characterization of tissues to reduce the harmful effects of the main factors affecting PRM. The harmonization of CT scans in a statistical framework will enable robust PRM metrics in cross-sectional and longitudinal studies. The statistical characterization will also lead to define adaptive thresholds to detect the emphysema and FSAD minimizing type I and II error trade-off. We will validate the robustness of harmonized PRM metrics in multiparametric acquisitions and study its clinical relevance by studying associations with lung function. Our preliminary data shows that we can obtain harmonized images that minimize the scanner and subject- dependent confounders. Our tissue characterization in CT images also has proved its suitability to provide a statistical framework to define robust adaptive thresholds. Together, the research proposed in the aims of this award will take full advantage of the comprehensive dataset available through the COPDGene study.

项目摘要慢性阻塞性肺疾病（COPD）是发病率和死亡率的主要原因。尽管吸烟的下降，COPD的死亡率继续增加，现在是第三主要死亡原因美国。 COPD的慢性气流限制是由小型气道疾病和实质破坏（肺气肿）。最近的研究表明，小气道的核心作用 COPD发病机理的破坏。这些证据激发了对体内评估的兴趣疾病早期开始时，小气道疾病总体上。早期鉴定小气道疾病可能导致更好的患者诊断，早期治疗干预并提供更敏感的标记以阐明该疾病的发病机理及其生物分子基础，可以为急需的药物发现提供信息。计算机断层扫描（CT）是一种成像方式，已证明在定量中有效实质破坏。但是，从小获得直接度量所需的成像分辨率气道超出了CT扫描的限制。一种称为参数响应映射（PRM）的技术建议通过匹配灵感和呼气CT扫描和应用密度阈值以区分功能性小气道疾病（FSAD）和气肿。尽管取得了成功，但PRM表现出一些局限性，这些局限性排除了准确性，鲁棒性和在早期疾病中的结果解释：CT密度值高度取决于获取参数（剂量，重建内核，体型变化）引入主题和扫描仪的依赖性混淆者。尽管临床试验使用明确定义的采集方案和幻影校准的采集，但偏见和噪声模式仍然依赖于主体。特别是，许多使用PRM的研究在不同剂量水平上获得的灵感和呼气图像。该项目将充分利用我们在图像驱动的统计方面的最新发展组织的表征以减少影响PRM的主要因素的有害作用。协调在统计框架中的CT扫描将使横截面和纵向的强大PRM指标能够实现研究。统计表征还将导致定义自适应阈值以检测肺气肿 FSAD最小化I型和II型错误权衡。我们将验证协调的PRM指标的鲁棒性在多参数采集中，并通过研究与肺功能的关联来研究其临床相关性。我们的初步数据表明，我们可以获得统一的图像，以最大程度地减少扫描仪和受试者 - 依赖的混杂因素。我们在CT图像中的组织表征也证明了其适用性统计框架以定义强大的自适应阈值。共同提出的研究目的奖项将充分利用通过COPDGENE研究获得的综合数据集。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Statistical characterization of the linear attenuation coefficient in polychromatic CT scans.

DOI：
10.1002/mp.14384
发表时间：
2020-11
期刊：
Medical physics
影响因子：
3.8
作者：
Vegas G;San José Estépar R
通讯作者：
San José Estépar R

The Value of Virtual Clinical Trials for the Assessment of the Effect of Acquisition Protocols in Emphysema Quantification.

虚拟临床试验对于评估采集协议在肺气肿量化中的效果的价值。

DOI：
10.1016/j.chest.2023.02.011
发表时间：
2023
期刊：
Chest
影响因子：
9.6
作者：
VegasSanchez-Ferrero,Gonzalo;SanJoséEstépar,Raúl
通讯作者：
SanJoséEstépar,Raúl

Quantitative CT Evaluation of Emphysema Progression over 10 Years in the COPDGene Study.

COPDGene 研究中 10 年来肺气肿进展的定量 CT 评估。

DOI：
10.1148/radiol.222786
发表时间：
2023
期刊：
Radiology
影响因子：
19.7
作者：
Baraghoshi,David;Strand,Matthew;Humphries,StephenM;SanJoséEstépar,Raúl;VegasSanchez-Ferrero,Gonzalo;Charbonnier,Jean-Paul;Latisenko,Rudolfs;Silverman,EdwinK;Crapo,JamesD;Lynch,DavidA
通讯作者：
Lynch,DavidA

Harmonization of in-plane resolution in CT using multiple reconstructions from single acquisitions.