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Comparison of Pi10 and PiSlope calculation methods and association with lung function
Razieh Enjilela1, Sukhraj Virdee1, Jason Bartlett1
1Physics Department, Toronto Metropolitan University, Toronto, ON, Canada.
European Radiology
|December 21, 2025
Summary
This study found that calculation methods for CT airway remodeling biomarkers (Pi10 and PiSlope) that include more airways are more reliable. PiSlope showed stronger associations with lung function in COPD patients.
Area of Science:
- Pulmonary Medicine
- Radiology
- Biomarker Discovery
Background:
- Computed tomography (CT) derived Pi10 and PiSlope are biomarkers for airway remodeling in chronic obstructive pulmonary disease (COPD).
- Variability in calculation methods for Pi10 leads to inconsistent results across studies.
Purpose of the Study:
- To evaluate the reliability of 10 different methodologies for calculating Pi10 and PiSlope.
- To assess the association of these methodologies with lung function in COPD patients.
Main Methods:
- Ten literature-based methods were used to calculate Pi10 and PiSlope from CT scans of 1351 COPD participants.
- Reliability was assessed using intraclass correlation (ICC).
- Associations with lung function (FEV1, FEV1/FVC, FEF25-75%) were evaluated using regression analysis.
Main Results:
- Methods incorporating a higher number of airways demonstrated excellent reliability (ICC > 0.90).
- PiSlope consistently showed stronger negative associations with lung function parameters compared to Pi10 across all methods.
- These associations were particularly pronounced in participants with fewer analyzed airways.
Conclusions:
- CT-derived Pi10/PiSlope calculation methods that include more airways offer greater reliability.
- PiSlope may serve as a more comprehensive and reliable biomarker for assessing airway remodeling in COPD.
- Findings aid in standardizing interpretations and support PiSlope's clinical utility.
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