CT Assessment of Lung Fissures: Anatomy and Correlated Function

肺裂的 CT 评估：解剖结构和相关功能

基本信息

批准号：
9204412
负责人：
Jiantao Pu
金额：
$ 26.95万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-05-01 至 2019-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9204412
关键词：
3-Dimensional Affect Age Air Sacs Algorithmic Analysis Anatomy Attention Breathing Bronchodilator Agents Cause of Death Cessation of life Characteristics Chronic Obstructive Airway Disease Clinical Collaborations Complex Computational Geometry Computers Data Databases Development Diagnostic radiologic examination Dimensions Disease Early Intervention Elasticity Environmental air flow Fissural Geometry Goals Grant Image Image Analysis Individual Interlobar Investigation Left Lobe Longitudinal cohort Lung Lung Volume Reductions Lung volume reduction surgery Modeling Molecular Morphology Obesity Operative Surgical Procedures Oxygen Pathogenicity Pathway interactions Patient Selection Patients Pattern Physiological Physiology Play Practice Management Process Pulmonary Emphysema Quality of life Research Personnel Respiratory physiology Risk stratification Role Scanning Severities Shortness of Breath Smoker Smoking History Structure of parenchyma of lung Symptoms Techniques Therapeutic Intervention United States Universities Unnecessary Procedures Walking Work X-Ray Computed Tomography chest computed tomography cohort cost demographics disability experience functional decline geometric methodologies imaging biomarker improved innovation minimally invasive patient subsets public health relevance reduce symptoms response smoking cessation spatial integration spatial relationship targeted treatment tool treatment trial

项目摘要

DESCRIPTION (provided by applicant): Emphysema is a leading cause of disability and death in the United States and worldwide. Millions of people suffer from this disease, which often goes undiagnosed for many years and irreversibly destroys lung parenchyma. It is unclear how the disease progresses, but there are emerging investigations indicating that the development and extent of emphysema may follow certain pathogenic pathways. In recent years, bronchoscopic lung volume reduction therapy has been gaining significant attention as a treatment for emphysema to reduce hyperinflation, improve lung function, and relieve symptoms (e.g., short of breath) because of its minimally invasive characteristic. However, it is difficult to determine which patients could actually benefit from this bronchoscopic therapy. The primary challenge is the lack of an accurate, quantitative, and non-invasive way to assess an individual's inter-lobar collateral ventilation (CV). Preliminarily studies by some investigators and us revealed that pulmonary fissure integrity (completeness) depicted on CT images may play a crucial role in interlobar CV, but the exact contribution to the interlobar CV remains unclear. We propose to advance our previous work to comprehensively investigate pulmonary fissure morphology, emphysema distribution patterns, and their 3D spatial integration. Our ultimate goal is to develop a risk stratification model for assessing function decline, COPD progression, and responses to endobronchial valve (EBV) therapy. Our assumption is that the interlobar CV is affected by multiple factors, such as the existence of incomplete fissures surrounded by emphysema, and not simply fissure integrity. Therefore the current approaches to assess interlobar CV by fissure integrity on CT images may be insufficient. If successful, the developed computer tool may not only aid in assessing COPD progression and possible developing optimal patient management practices, but also significantly simplify pre-operative work-up in identifying patients for EBV therapy. We have the following specific aims: (1) continue to populate our chest CT examination database, (2) further develop our 3D fissure and lung models to integrates fissure morphology and emphysema severity and distribution, (3) evaluate the functional implications of features morphology, emphysema distribution patterns, and integrative lung model, and (4) develop and validate a risk stratification model for function decline, COPD progression, and responses to EBV therapy.

描述（由申请人提供）：肺气肿是美国和世界范围内导致残疾和死亡的主要原因。数百万人患有这种疾病，这种疾病往往多年来未被诊断出来，并且会不可逆转地破坏肺实质。目前尚不清楚这种疾病是如何发生的。进展，但新的研究表明，肺气肿的发展和程度可能遵循某些致病途径，表明近年来，支气管镜肺减容疗法作为一种治疗方法已受到广泛关注。由于其微创特性，可以减少过度充气、改善肺功能并缓解症状（例如呼吸短促）。然而，很难确定哪些患者实际上可以从这种支气管镜治疗中受益。一些研究人员和我们的初步研究表明，CT 图像上描绘的肺裂完整性（完整性）可能会发挥重要作用，这是一种准确、定量和非侵入性的方法来评估个体的肺叶间侧支通气（CV）。在叶间 CV 中发挥着至关重要的作用，但对叶间 CV 的确切贡献仍不清楚。我们建议推进我们之前的工作，全面研究肺裂形态、肺气肿分布模式及其 3D 空间整合。用于评估功能下降、COPD 进展和支气管内瓣膜 (EBV) 治疗反应的模型我们的假设是叶间 CV 受到多种因素的影响，例如存在不完整的裂隙。因此，目前通过 CT 图像上的裂隙完整性评估叶间 CV 的方法可能还不够，如果成功，开发的计算机工具不仅可以帮助评估 COPD 进展并可能制定最佳的患者管理实践。还简化了识别 EBV 治疗患者的术前检查。我们有以下重要的具体目标：(1) 继续充实我们的胸部 CT 检查数据库，(2) 进一步开发我们的 3D 裂隙和肺模型以整合裂隙。形态和肺气肿的严重程度和分布，(3) 评估特征形态、肺气肿分布模式和综合肺模型的功能影响，以及 (4) 开发和验证功能下降、COPD 进展和对 EBV 治疗反应的风险分层模型。