A computed tomography imaging-based subject-specific whole-lung deposition model

Zhang, Xuan; Li, Frank; Rajaraman, Prathish K.; Choi, Jiwoong; Comellas, A.P.; Hoffman, Eric A.; Smith, Benjamin M.; Lin, Ching‐Long

doi:10.1016/j.ejps.2022.106272

Cited by 10 publications

(5 citation statements)

References 54 publications

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“…C1 and C2 subjects demonstrated a significant reduction in lung deformation when contrasted with C0 subjects. This feature was evident in the lung size at TLC ( Table S1 ), being in agreement with Zhang et al (2022) . The size reduction at TLC signifying a decline in respiratory muscle strength within both clusters ( McNarry et al, 2022 ).…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Investigating distributions of inhaled aerosols in the lungs of post-COVID-19 clusters through a unified imaging and modeling approach

Zhang,

Li,

Rajaraman

et al. 2024

European Journal of Pharmaceutical Sciences

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Section: Discussionsupporting

confidence: 81%

“…While C0 and C2 subjects did not differ significantly in CV, C1 subjects had higher CV values than others (p<0.05). The selection of 0.5 μm particles enabled a comparison with our previous study involving COPD subjects ( Zhang et al, 2022 ), which used Technetium-99 m sulfur colloid (< 1.0 μm) for ventilation SPECT imaging.…”

Section: Resultsmentioning

confidence: 99%

Investigating distributions of inhaled aerosols in the lungs of post-COVID-19 clusters through a unified imaging and modeling approach

Zhang,

Li,

Rajaraman

et al. 2024

European Journal of Pharmaceutical Sciences

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“…on the wall of the trachea and main bronchi 17 . Similar results on the movement of particles in a study on a respiratory tract model, which excluded the mouth-throat region were confirmed by Zhang et al They confirmed that large particles of around 10.0 µm were retained in the central airways, trachea and main bronchi by sedimentation 18 .…”

Section: Discussionsupporting

confidence: 75%

Tracheobronchial Morphometry Correlates with Demographic Characteristics and Infections in Critically Ill Patients

Šantić

2023

ACC

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SUMMARY Tracheal measurements in the intensive care unit (ICU) are important for the choice of endotracheal tube and may correlate with patient demographic characteristics and infections. The study included 42 surgical patients, age 60 [48-71] years, who underwent diagnostic chest computed tomography (CT) scans during treatment in the ICU, Osijek University Hospital, in 2019 and 2020. CT scans were analyzed using AW Server 3.2. Measurement analysis showed that the diameters of the tracheobronchial tree, the length of the trachea and left main bronchus were significantly larger in men compared to women (p<0.05 all). The smallest tracheal upper diameter was 15.25 [IQR 11.8-18.8] mm vs. 17.95 [13.55-20.05] mm in septic and nonseptic patients, respectively (p=0.028). A total of 26 patients who underwent CT scans developed nosocomial pneumonia. It was right-sided in 15, left-sided in 6 and bilateral in 5 patients, and correlated significantly with the left main bronchus length (ρ=0.515, p=0.007). No correlation was observed between tracheobronchial measurements and length of ICU treatment, number of hours spent on mechanical ventilation, or survival. A larger study could provide better data on the importance of tracheobronchial tree measurements in ICU patients.

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“…It is not possible to fully replicate real-life settings, for example physiological factors including lung surface features and airway humidity [19,38], and the complex process of aerosolization [19,39]. However, CT scanning and modeling is increasingly being used to assess lung deposition [40]. In silico FRI has demonstrated consistency with SPECT/CT under similar conditions in patients with asthma [21] and consistency with scintigraphy in different populations [41][42][43], including patients with COPD; thus, in silico FRI has become an accepted estimate of lung deposition.…”

Section: Discussionmentioning

confidence: 99%

Modeled small airways lung deposition of two fixed-dose triple therapy combinations assessed with in silico functional respiratory imaging

Usmani,

Li,

De Backer

et al. 2023

Respir Res

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Background Small airways disease plays a key role in the pathogenesis of chronic obstructive pulmonary disease (COPD) and is a major cause of obstruction; therefore, it is a critical pharmacotherapy target. This study evaluated lung deposition of two inhaled corticosteroid (ICS)/long-acting β2-agonist/long-acting muscarinic antagonist single-inhaler triple therapies using in silico functional respiratory imaging (FRI). Deposition was assessed using real-world inhalation profiles simulating everyday use where optimal inhalation may be compromised. Methods Three-dimensional airway models were produced from 20 patients with moderate-to-very severe COPD. Total, central, and regional small airways deposition as a percentage of delivered dose of budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) 160/7.2/5 µg per actuation and fluticasone furoate/umeclidinium/vilanterol (FF/UM/VI) 100/62.5/25 µg were evaluated using in silico FRI based on in vitro aerodynamic particle size distributions of each device. Simulations were performed using multiple inhalation profiles of varying durations and flow rates representing patterns suited for a pressurized metered-dose inhaler or dry-powder inhaler (four for BGF, two for FF/UM/VI, with one common profile). For the common profile, deposition for BGF versus FF/UM/VI was compared post-hoc using paired t-tests. Results Across inhalation profiles, mean total lung deposition was consistently higher with BGF (47.0–54.1%) versus FF/UM/VI (20.8–22.7%) and for each treatment component, with greater deposition for BGF also seen in the central large airways. Mean regional small airways deposition was also greater across inhalation profiles with BGF (16.9–23.6%) versus FF/UM/VI (6.8–8.7%) and for each treatment component. For the common profile, total, central, and regional small airways deposition were significantly greater for BGF versus FF/UM/VI (nominal p < 0.001), overall and for treatment components; notably, regional small airways deposition of the ICS components was approximately five-fold greater with budesonide versus fluticasone furoate (16.1% vs. 3.3%). Conclusions BGF was associated with greater total, central, and small airways deposition for all components versus FF/UM/VI. Importantly, using an identical inhalation profile, there was an approximately five-fold difference in small airways deposition for the ICS components, with only a small percentage of the ICS from FF/UM/VI reaching the small airways. Further research is needed to understand if the enhanced delivery of BGF translates to clinical benefits. Graphical Abstract

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A computed tomography imaging-based subject-specific whole-lung deposition model

Cited by 10 publications

References 54 publications

Investigating distributions of inhaled aerosols in the lungs of post-COVID-19 clusters through a unified imaging and modeling approach

Investigating distributions of inhaled aerosols in the lungs of post-COVID-19 clusters through a unified imaging and modeling approach

Tracheobronchial Morphometry Correlates with Demographic Characteristics and Infections in Critically Ill Patients

Modeled small airways lung deposition of two fixed-dose triple therapy combinations assessed with in silico functional respiratory imaging

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