Association of Lung Quantitative CT Scan Textures With Systemic Inflammation and Mortality in COPD

Area of Science:

• Pulmonary Medicine
• Radiology
• Biomarkers

Background:

• Chronic Obstructive Pulmonary Disease (COPD) involves persistent lung inflammation, leading to bronchovascular bundle (BVB) remodeling and reduced quality of life.
• Quantitative CT (QCT) scan textures offer insights into local inflammation patterns and respiratory morbidity.

Purpose of the Study:

• To investigate the association between BVB and CT scan density gradient (CTDG) textures, derived from QCT scans using an adaptive multiple feature method, with systemic inflammation, morbidity, and mortality in COPD.
• To determine if QCT scan textures predict COPD progression, specifically FEV1 decline and all-cause mortality.

Main Methods:

• Analysis of data from two large cohorts: SPIROMICS (n=2,981) and COPDGene (n=10,305).
• QCT scan biomarkers (BVB and CTDG textures) were assessed alongside clinical covariates, emphysema, and airway parameters (Pi10).
• Outcomes included plasma inflammatory biomarkers, CBC counts, lung function (FEV1, FEV1/FVC), quality of life (SGRQ), exercise capacity (6MWD), and dyspnea (mMRC).

Main Results:

• Increased BVB texture correlated with higher neutrophil and monocyte counts and neutrophil-to-lymphocyte ratio (NLR), independent of other factors.
• Elevated CTDG texture was associated with increased neutrophils, NLR, and tumor necrosis factor-α.
• Both BVB and CTDG textures showed significant associations with lower FEV1, reduced 6-minute walk distance (6MWD), and importantly, increased all-cause mortality risk in both cohorts.

Conclusions:

• QCT scan textures, including BVB and CTDG, serve as valuable imaging biomarkers reflecting the spatial heterogeneity of lung inflammation and overall disease burden in COPD.
• These imaging biomarkers demonstrate prognostic value, predicting both disease progression and mortality in COPD patients.