Related Experiment Video
Updated: Dec 29, 2025
Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models
Published on: November 11, 2020
Airway tapering: an objective image biomarker for bronchiectasis
Wieying Kuo1,2, Adria Perez-Rovira1,3, Harm Tiddens1,2
1Department of Paediatric Pulmonology and Allergology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Airway tapering, a novel imaging biomarker, is significantly reduced in children with bronchiectasis. This method offers a promising, objective tool for diagnosing pediatric bronchiectasis without needing to measure pulmonary arteries.
Area of Science:
- Pulmonary imaging
- Medical diagnostics
- Pediatric respiratory diseases
Background:
- Bronchiectasis is a chronic lung condition characterized by irreversible airway dilation.
- Accurate and objective biomarkers are needed for early diagnosis and management of pediatric bronchiectasis.
- Current diagnostic methods may have limitations in sensitivity and specificity.
Purpose of the Study:
- To establish normal airway tapering values in healthy children.
- To evaluate airway tapering as a potential imaging biomarker for pediatric bronchiectasis.
- To compare airway tapering with the airway-artery ratio in differentiating bronchiectasis.
Main Methods:
- Semi-automatic quantification of intra-branch and inter-branch airway tapering using CT scans from 156 healthy children.
- Assessment of airway tapering and airway-artery ratios in 12 children with bronchiectasis and 12 matched controls.
- Stratification of biomarkers by small, medium, and large airway sizes based on vessel diameter.
Main Results:
- Healthy children exhibited intra-branch tapering of 1% and inter-branch tapering of 24-39%.
- Children with bronchiectasis showed significantly reduced intra-branch (0.8%) and inter-branch tapering (19-32%) and increased airway-artery ratios (p < 0.01).
- Tapering differences were significant across all airway sizes; airway-artery ratio differences were significant only in small airways.
Conclusions:
- Normal pediatric airway tapering values were established.
- Airway tapering is a promising, objective imaging biomarker for pediatric bronchiectasis, detectable across all airway sizes.
- This novel biomarker does not require pulmonary artery measurements, potentially simplifying diagnosis and allowing for earlier detection, even in central airways.
Purpose:
To estimate airway tapering in control subjects and to assess the usability of tapering as a bronchiectasis biomarker in paediatric populations.
Methods:
Airway tapering values were semi-automatically quantified in 156 children with control CTs collected in the Normal Chest CT Study Group. Airway tapering as a biomarker for bronchiectasis was assessed on spirometer-guided inspiratory CTs from 12 patients with bronchiectasis and 12 age- and sex-matched controls. Semi-automatic image analysis software was used to quantify intra-branch tapering (reduction in airway diameter along the branch), inter-branch tapering (reduction in airway diameter before and after bifurcation) and airway-artery ratios on chest CTs. Biomarkers were further stratified in small, medium and large airways based on three equal groups of the accompanying vessel size.
Results:
Control subjects showed intra-branch tapering of 1% and inter-branch tapering of 24-39%. Subjects with bronchiectasis showed significantly reduced intra-branch of 0.8% and inter-branch tapering of 19-32% and increased airway-artery ratios compared with controls (p < 0.01). Tapering measurements were significantly different between diseased and controls across all airway sizes. Difference in airway-artery ratio was only significant in small airways.
Conclusion:
Paediatric normal values for airway tapering were established in control subjects. Tapering showed to be a promising biomarker for bronchiectasis as subjects with bronchiectasis show significantly less airway tapering across all airway sizes compared with controls. Detecting less tapering in larger airways could potentially lead to earlier diagnosis of bronchiectasis. Additionally, compared with the conventional airway-artery ratio, this novel biomarker has the advantage that it does not require pairing with pulmonary arteries.
Key Points:
• Tapering is a promising objective image biomarker for bronchiectasis that can be extracted semi-automatically and has good correlation with validated visual scoring methods. • Less airway tapering was observed in patients with bronchiectasis and can be observed sensitively throughout the bronchial tree, even in the more central airways. • Tapering values seemed to be less influenced by variety in scanning protocols and lung volume making it a more robust biomarker for bronchiectasis detection.
More Related Videos
02:09Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
10:37Automated Measurement of Pulmonary Emphysema and Small Airway Remodeling in Cigarette Smoke-exposed Mice
Published on: January 16, 2015
