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Related Experiment Video

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Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models
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Predictive Modelling of Lung Function using Emphysematous Density Distribution.

Kuo-Lung Lor1, Cheng-Pei Liu1, Yeun-Chung Chang2

  • 1Department of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen - Ai Rd., Taipei City, 100, Taiwan (R.O.C.).

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|December 26, 2019
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This study introduces a new method to assess emphysema heterogeneity, improving predictions of lung function decline in COPD patients. Widely spread smaller emphysematous bullae significantly impact lung function more than larger ones.

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Medical Imaging Analysis

Background:

  • Lung volume reduction (LVR) for severe emphysema is challenged by difficulties in targeting treatment areas.
  • Low attenuation volume percentage (LAV%) from CT scans correlates with lung function in COPD but can vary due to emphysema heterogeneity.
  • Regional emphysema destruction patterns are crucial for selecting optimal LVR targets.

Purpose of the Study:

  • To develop a descriptor for emphysema heterogeneity based on the size and spatial distribution of 3D emphysematous bullae.
  • To create a predictive model for airflow limitation using regional emphysema heterogeneity.

Main Methods:

  • Emphysematous bullae were represented and categorized into four scales across upper and lower lung lobes.
  • A predictive model was computed using linear model fitting to estimate lung function severity.
  • The model was trained and tested on a dataset of 99 subjects (87 COPD patients, 12 controls).

Main Results:

  • Widely spread smaller bullae with equivalent LAV% have a greater impact on lung function compared to larger bullae.
  • The model using whole lung LAV% showed a correlation of r=-0.76 (p<0.01) with FEV1/FVC.
  • Predicting emphysema-associated FEV1/FVC using two ED% scales and location-dependent variables yielded a correlation of r=0.82 (p<0.001).

Conclusions:

  • Regional emphysema heterogeneity significantly influences lung function in COPD patients.
  • The developed descriptor and predictive model offer improved assessment of airflow limitation compared to traditional LAV% measurements.
  • This approach can aid in optimizing treatment targeting for lung volume reduction in severe emphysema.