Bronchial Measurements in Patients with Asthma: Comparison of Quantitative Thin-Section CT Findings with Those in Healthy Subjects and Correlation with Pathologic Findings

Montaudon, Michel; Léderlin, Mathieu; Reich, Stéphanie; Bégueret, Hugues; Tunon-de-Lara, José-Manuel; Marthan, Roger; Berger, Patrick; Laurent, François

doi:10.1148/radiol.2533090303

Cited by 101 publications

(107 citation statements)

References 38 publications

(64 reference statements)

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“…In cases of asthma, there was a strong trend for the mean lower asymptote of the PL-Ai curve (constant a of the Venegas equation 5 Ai when the airway is fully deflated) to be less than in the control group (P 5 0.06), and this was statistically significant in the subgroup with more severe asthma (P 5 0.006) ( Table 4, Figure 4, Table E2). Some studies have also reported smaller airway caliber in patients with asthma (10,31,32), although others have observed minimal change (33,34). Potential mechanisms for a smaller airway size include encroachment on the lumen by thickened airway walls, reduced tethering from surrounding parenchyma, or possibly increased smooth muscle contractility (although the latter is unlikely in this study).…”

Section: Elastic Properties In Obstructive Lung Diseasementioning

confidence: 59%

Elastic Properties of the Central Airways in Obstructive Lung Diseases Measured Using Anatomical Optical Coherence Tomography

Williamson¹,

McLaughlin²,

Noffsinger³

et al. 2011

Am J Respir Crit Care Med

102

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Rationale: Our understanding of how airway remodeling affects regional airway elastic properties is limited due to technical difficulties in quantitatively measuring dynamic, in vivo airway dimensions. Such knowledge could help elucidate mechanisms of excessive airway narrowing. Objectives: To use anatomical optical coherence tomography (aOCT) to compare central airway elastic properties in control subjects and those with obstructive lung diseases. Methods: After bronchodilation, airway lumen area (Ai) was measured using aOCT during bronchoscopy in control subjects (n 5 10) and those with asthma (n 5 16), chronic obstructive pulmonary disease (COPD) (n 5 9), and bronchiectasis (n 5 8). Ai was measured in each of generations 0 to 5 while airway pressure was increased from 210 to 20 cm H 2 O. Airway compliance (Caw) and specific compliance (sCaw) were derived from the transpulmonary pressure (PL) versus Ai curves. Measurements and Main Results: Caw decreased progressively as airway generation increased, but sCaw did not differ appreciably across the generations. In subjects with asthma and bronchiectasis, Caw and sCaw were similar to control subjects and the PL-Ai curves were left-shifted. No significant differences were observed between control and COPD groups. Conclusions: Proximal airway elastic properties are altered in obstructive lung diseases. Although central airway compliance does not differ from control subjects in asthma, bronchiectasis, or COPD, Ai is lower in asthma and the PL-Ai relationship is left-shifted in both asthma and bronchiectasis, suggesting that airways are maximally distended at lower inflating pressures. Such changes reflect alteration in the balance between airway wall distensibility and radial traction exerted on airways by surrounding lung parenchyma favoring airway narrowing. Clinical trial registered with Australian New Zealand Clinical Trials Registry (ACTRN12607000624482).

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Section: Elastic Properties In Obstructive Lung Diseasementioning

confidence: 59%

Elastic Properties of the Central Airways in Obstructive Lung Diseases Measured Using Anatomical Optical Coherence Tomography

Williamson¹,

McLaughlin²,

Noffsinger³

et al. 2011

Am J Respir Crit Care Med

102

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“…Some pathologies affect the tree structure; in asthma for instance, airways can be constricted. This goes from frequent moderate constrictions throughout the tree with airway radii reductions of 10 to 25% on average [18], [2] up to, in a low proportion of cases, complete closure [10], [8]. These latter severe constrictions will be designated as plugs.…”

Section: Global Methodologymentioning

confidence: 99%

“…The pressure drop and the flow in an airway are linked through a non linear coefficient ( ) , called resistance, by = ( ) . This coefficient is defined as in [21] by the Pedley model [22]: Remark 1: note that equation (2) has been designed for inspiration and for one bifurcation angle only.…”

Section: Direct Ventilation Problemmentioning

confidence: 99%

See 1 more Smart Citation

Predicted airway obstruction distribution based on dynamical lung ventilation data: A coupled modeling‐machine learning methodology

Pozin

Montesantos

Katz

et al. 2018

Numer Methods Biomed Eng

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In asthma and COPD, some airways of the tracheo-bronchial tree can be constricted, from moderate narrowing up to closure. Those pathological patterns of obstructions affect the lung ventilation distribution. While some imaging techniques enable visualization and quantification of constrictions in proximal generations, no non-invasive technique exists to provide the airway morphology and obstruction distribution in distal areas. In this work, we propose a method that exploits lung ventilation measures to access positions of airways obstructions (restrictions and closures) in the tree. This identification approach combines a lung ventilation model, in which a 0 tree is strongly coupled to a 3 parenchyma description, along with a machine learning approach. Based on synthetic data generated with typical temporal and spatial resolutions as well as reconstruction errors, we obtain very encouraging results of the obstruction distribution, with a detection rate higher than 85%.

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“…2a and b). By using this technique in asthmatic patients, it has been shown that the strongest correlation with airflow obstruction was found through airway wall measurements of the more distal airways [66]. Although current evidence indicates that small airways obstruction could be routinely assessed using CT scanning, this technique does have some limitations, including lack of standardization of the technical parameters of the CT scanner, lack of consensus on the best index for small-airways disease assessment, and exposure of subjects to ionizing radiation.…”

Section: Imaging Assessment Of Peripheral Airwaysmentioning

confidence: 99%

Assessing and accessing the small airways; implications for asthma management

Scichilone

Contoli

Paleari

et al. 2013

Pulmonary Pharmacology & Therapeutics

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a b s t r a c tDespite the wealth of experience in the management of asthma, the disease remains inadequately controlled in some patients, who face long-term respiratory impairment and disability. The disease has been characterised as an inflammatory condition affecting first the larger airways and eventually the smaller airways, but there is evidence that peripheral airway involvement defines a particular and more severe phenotype of asthma. For this reason, assessing functional and biological parameters reflective of small airways involvement is important prognostically. No assessment method is universally and directly representative of peripheral airway function, but the traditional spirometric tests, including vital capacity, residual volume and forced vital capacity, are somewhat correlated with this function; useful methods for further assessment include the single-breath nitrogen wash-out test, impulse oscillometry, nitrous oxide and exhaled breath concentrate measurements, as well as computed tomography to reflect air trapping and response to treatment. Formulation advancements have made for easier treatment access to the smaller airways, with the new extrafine formulations resulting in better asthma control compared with non-extrafine formulations.

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Bronchial Measurements in Patients with Asthma: Comparison of Quantitative Thin-Section CT Findings with Those in Healthy Subjects and Correlation with Pathologic Findings

Cited by 101 publications

References 38 publications

Elastic Properties of the Central Airways in Obstructive Lung Diseases Measured Using Anatomical Optical Coherence Tomography

Elastic Properties of the Central Airways in Obstructive Lung Diseases Measured Using Anatomical Optical Coherence Tomography

Predicted airway obstruction distribution based on dynamical lung ventilation data: A coupled modeling‐machine learning methodology

Assessing and accessing the small airways; implications for asthma management

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