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Day 1 - Thursday - 1550 PM - Raul San Jose Estepar
Day 1 - Thursday - 1550 PM - Raul San Jose Estepar
CT Im a g in g Ph e n ot yp e s in COPD
Causes:
Disease in Images
Airway Diseases
Emphysema Diseases
Quantitative CT
Airway
Phenotypes
Size
Effective Linear Attenuation Coefficient
CT
Edge Detection
Dynamic
Emphysema MSCT (INSP EXP)
Phenotypes
Registration
Gas trapping
Deformation
Parenchyma interdependence
Wall thickness
Emphysema phenotypes
Cluster-based analysis
Shape-based analysis
Size
Density
Histogram-based
analysis
Histogram-based measurements
• Low Attenuation Areas % (LAA%)
– Conceptually more appealing
– Histopathologic correlates
• 15th Percentile (Per15th)
– More normally distributed
– More sensitive to early changes
Issues
Shape-based analysis
• Descriptor of diaphragm
curvature
• Correlated with DLCO%
and VA
• Enhance information
provided by
histogram-based
metrics.
Texture-based analysis
• Exploit pixel relations: higher order order statistics
and other image features.
• Require training stage.
• Long processing time.
• It has the potential of being less sensitive to scanner
variability.
Airway Phenotypes
Airway size
Tree morphology
Size
Density
Airway Size
-
-CT measures the linear attenuation coefficient of the underlying
tissue structures. This can be used as a indirect measurement for
density (no without many caveats)
-Hypothesis:
·Airway wall compositions changes due to mural remodeling can be
detectable by CT X-ray attenuation
·Changes in wall X-ray attenuation may correlate with degree of expiratory
airflow obstruction
Preliminary Evidences
-Micro-CT of an hamartoma:
CT Density*
-Wall at t enuat ion shows higher 500 Males
correlat ion wit h FEV1% 400 Female
300
predict ed (R= -0.47, 200
100
P< 0.0001) t han wall t hickness 0
(R= -0.34, P< 0.0001). Normal 1 2 3/4
GOLD Stage
-
CT Imaging Phenotypes in COPD
Introduction Emphysema Airways Airway Power Lung Cancer Workshop VII
-Developm ent of a new phenot ype t hat has as prim ary goal t o be
precise while capturing the main airway components: morphology and
composition
-
CT (h(x))
mass mass
Airway Power
COPDGene Phantom
-
CTP666-4 CTP666-3 CTP666-2
CTP666-1
CTP666-5 CTP666-6
Conclusions