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Quantifying heterogeneity in emphysema from high-resolution computed tomography: a lung tissue research consortium
Cuneyt Yilmaz1, Dan M Dane, Nova C Patel
1Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9034, USA. Cuneyt.yilmaz@utsouthwestern.edu
High-resolution CT analysis reveals emphysema alters lung tissue and air volumes, with distinct spatial patterns differentiating it from interstitial lung disease. Early disease shows increased tissue volume and fractional tissue volume.
Area of Science:
- Pulmonary Medicine
- Radiology
- Medical Imaging
Background:
- Emphysema is a progressive lung disease characterized by destruction of alveoli.
- Accurate quantification of emphysema's spatial distribution is crucial for understanding disease progression and heterogeneity.
- High-resolution computed tomography (HRCT) offers detailed imaging of lung parenchyma.
Purpose of the Study:
- To quantify the spatial distribution of emphysema using HRCT.
- To measure regional air volume, tissue volume, and fractional tissue volume (FTV).
- To differentiate emphysema patterns from interstitial lung disease (ILD).
Main Methods:
- Semiautomated HRCT analysis with internal attenuation calibration was applied.
- Measurements included air volume, tissue volume, and FTV (tissue/[air + tissue] volume).
- Analysis was performed on lobar data from 31 emphysema patients (stages II-V) and 20 healthy controls, assessing FTV heterogeneity via coefficients of variation, kurtosis, and skewness.
Main Results:
- Lobar air volume increased significantly in emphysema, while lobar tissue volume increased in mild-moderate stages then normalized.
- Normally, FTV was higher in lower than upper lobes; in mild-moderate emphysema, lobar FTV increased.
- Severe emphysema showed FTV decline correlated with pulmonary function; heterogeneity markers increased with disease stage, distinct from ILD patterns.
Conclusions:
- CT-derived biomarkers effectively differentiate spatial patterns of emphysema from ILD.
- Early emphysema is associated with elevated tissue volume and FTV, potentially indicating hyperemia, inflammation, or atelectasis.
- Semiautomated HRCT analysis provides valuable insights into emphysema's spatial characteristics and heterogeneity.
