<i>This</i> is what <scp>COPD</scp> looks like

Sheikh, Khadija; Coxson, Harvey O.; Párraga, Grace

doi:10.1111/resp.12611

Cited by 53 publications

(19 citation statements)

References 85 publications

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“…Magnetic resonance imaging (MRI) is another modality that can provide functional images of the lungs in COPD [123,124]. There are a number of challenges in using MR to image the lungs including the low concentrations of protons, multiple air tissue interfaces and relatively poor spatial resolution.…”

Section: Other Imaging Modalitiesmentioning

confidence: 99%

“…Uptake is significantly increased in COPD [121] and is associated with FEV1 and emphysema severity [121,122]. With SPECT, perfusion and ventilation imaging can be performed with either a vascular or inhaled tracer.Magnetic resonance imaging (MRI) is another modality that can provide functional images of the lungs in COPD [123,124]. There are a number of challenges in using MR to image the lungs including the low concentrations of protons, multiple air tissue interfaces and relatively poor spatial resolution.…”

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confidence: 99%

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Present and future utility of computed tomography scanning in the assessment and management of COPD

Ostridge

Wilkinson

2016

Eur Respir J

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likely to have important implications for understanding disease progression and the future management of this condition [2]. There are currently no significant diseasemodifying medications for COPD and there have not been the improvements in outcome seen in other chronic diseases. Other tools are required in addition to spirometry to help explain the heterogeneity and provide further insights into approaches to study and treat COPD. CT has current practical applications in the routine management and investigation of the disease and with the development of novel analysis techniques has the potential to provide further details about the pulmonary and extra-pulmonary manifestations of COPD. Computed Tomography in Current Clinical PractisePrior to the 1970s histological and post mortem studies were required to study structural changes of the lung. The introduction of CT made it possible to visualise the thorax and assess lung structure non-invasively. In COPD CT can identify key morphological features, including emphysema, bronchial wall thickening and gas trapping. These pathologies contribute directly to airflow obstruction and therefore CT has the potential to provide vital insights into the underlying pathophysiological changes of COPD. Despite this, routine CT imaging has not necessarily been widely adopted in clinical practise and its place in the management and investigation of COPD has not been firmly established. The GOLD guidelines do not routinely recommend CT scanning in COPD and only advise that it may be helpful in differential diagnosis or when surgical options are being considered [3]. This general ambivalence is highlighted by a study of attitudes in respiratory physicians and surgeons in the UK where only 32% thought it necessary for patients with severe COPD to have a CT scan [4].There are a number of reasons why the use of CT has not become routine in COPD. One of the most important is the perceived notion that using CT does not alter management, although this is not strictly true. The National Emphysema Treatment Trial (NETT) demonstrated that patients with advanced upper lobe emphysema and limited exercise ability improved after lung volume reduction surgery [5]. There has also been considerable progress and experience in using endobronchial treatments for severe emphysema including coils, valves, sealant and airway bypass. In the correct patients with severe heterogeneous emphysema these treatments can lead to significant improvement in pulmonary physiology and functional capacity [6, 7]. CT imaging can also identify bullous disease, which may be amenable to surgery and bullectomy can lead to improved health status [8]. It therefore seems clear that patients with severe COPD require CT imaging to determine which patients are appropriate for these techniques.CT imaging can also detect concomitant pulmonary pathology in COPD. Bronchiectasis is particularly prevalent, with studies demonstrating 50% of COPD patients having CT evidence of the disease [9][10][11]. When present bronchiectasis is asso...

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Section: Other Imaging Modalitiesmentioning

confidence: 99%

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confidence: 99%

Present and future utility of computed tomography scanning in the assessment and management of COPD

Ostridge

Wilkinson

2016

Eur Respir J

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“…According to the World Health Organization, by 2030, COPD will be the third most common global cause of death [1]. Cigarette smoking (CS) is the main risk factor for the development of COPD, which is a chronic inflammatory disease characterized by progressive, partially reversible airflow limitation [2].…”

Section: Introductionmentioning

confidence: 99%

Human primary airway epithelial cells isolated from active smokers have epigenetically impaired antiviral responses

Zhang

Booth

et al. 2016

Respir Res

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BackgroundCigarette smoking (CS) is the main risk factor for the development of chronic obstructive pulmonary disease (COPD) and most COPD exacerbations are caused by respiratory infections including influenza. Influenza infections are more severe in smokers. The mechanism of the increased risk and severity of infections in smokers is likely multifactorial, but certainly includes changes in immunologic host defenses.MethodsWe investigated retinoic acid-inducible protein I (RIG-I) and interferon (IFN) induction by influenza A virus (IAV) in human bronchial epithelial cells (HBEC) isolated from smokers or nonsmokers. Subcultured HBEC cells were infected with A/Puerto Rico/8/1934 (PR8) IAV at an MOI of 1. After 24 h of infection, cells and supernatants were collected for qRT-PCR, immunoblot or ELISA to determine RIG-I, Toll-like receptor3 (TLR3) and IFN expression levels.ResultsIAV exposure induced a vigorous IFN-β, IFN-λ 1 and IFN-λ 2/3 antiviral response in HBEC from nonsmokers and significant induction of RIG-I and TLR3. In cells from smokers, viral RIG-I and TLR3 mRNA induction was reduced 87 and 79 % compared to the response from nonsmokers. CS exposure history was associated with inhibition of viral induction of the IFN-β, IFN-λ1 and IFN-λ 2/3 mRNA response by 85, 96 and 95 %, respectively, from that seen in HBEC from nonsmokers. The demethylating agent 5-Aza-2-deoxycytidine reversed the immunosuppressive effects of CS exposure in HBEC since viral induction of all three IFNs was restored. IFN-β induction of RIG-I and TLR3 was also suppressed in the cells from smokers.ConclusionOur results suggest that active smoking reduces expression of antiviral cytokines in primary HBEC cells. This effect likely occurs via downregulation of RIG-I and TLR3 due to smoke-induced epigenetic modifications. Reduction in lung epithelial cell RIG-I and TLR3 responses may be a major mechanism contributing to the increased risk and severity of viral respiratory infections in smokers and to viral-mediated acute exacerbations of COPD.

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“…However, spirometry provides a global measure of airflow obstruction and fails to capture fully the variability in clinical phenotype . In order to improve clinical phenotyping several imaging studies have focused on the assessment of impairment of structural and functional changes to the airways and the lung parenchyma …”

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confidence: 99%

Deep semantic lung segmentation for tracking potential pulmonary perfusion biomarkers in chronic obstructive pulmonary disease (COPD): The multi‐ethnic study of atherosclerosis COPD study

Winther

Gutberlet

Hundt³

et al. 2019

Magnetic Resonance Imaging

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Background Chronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality. Identification of imaging biomarkers for phenotyping is necessary for future treatment and therapy monitoring. However, translation of visual analytic pipelines into clinics or their use in large‐scale studies is significantly slowed by time‐consuming postprocessing steps. Purpose To implement an automated tool chain for regional quantification of pulmonary microvascular blood flow in order to reduce analysis time and user variability. Study Type Prospective. Population In all, 90 MRI scans of 63 patients, of which 31 had a COPD with a mean Global Initiative for Chronic Obstructive Lung Disease status of 1.9 ± 0.64 (μ ± σ). Field Strength/Sequence 1.5T dynamic gadolinium‐enhanced MRI measurement using 4D dynamic contrast material‐enhanced (DCE) time‐resolved angiography acquired in a single breath‐hold in inspiration. [Correction added on August 20, 2019, after first online publication: The field strength in the preceding sentence was corrected.] Assessment We built a 3D convolutional neural network for semantic segmentation using 29 manually segmented perfusion maps. All five lobes of the lung are denoted, including the middle lobe. Evaluation was performed on 61 independent cases from two sites of the Multi‐Ethnic Study of Arteriosclerosis (MESA)‐COPD study. We publish our implementation of a model‐free deconvolution filter according to Sourbron et al for 4D DCE MRI scans as open source. Statistical Test Cross‐validation 29/61 (# training / # testing), intraclass correlation coefficient (ICC), Spearman ρ, Pearson r, Sørensen–Dice coefficient, and overlap. Results Segmentations and derived clinical parameters were processed in ~90 seconds per case on a Xeon E5‐2637v4 workstation with Tesla P40 GPUs. Clinical parameters and predicted segmentations exhibit high concordance with the ground truth regarding median perfusion for all lobes with an ICC of 0.99 and a Sørensen–Dice coefficient of 93.4 ± 2.8 (μ ± σ). Data Conclusion We present a robust end‐to‐end pipeline that allows for the extraction of perfusion‐based biomarkers for all lung lobes in 4D DCE MRI scans by combining model‐free deconvolution with deep learning. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:571–579.

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This is what COPD looks like

Cited by 53 publications

References 85 publications

Present and future utility of computed tomography scanning in the assessment and management of COPD

Present and future utility of computed tomography scanning in the assessment and management of COPD

Human primary airway epithelial cells isolated from active smokers have epigenetically impaired antiviral responses

Deep semantic lung segmentation for tracking potential pulmonary perfusion biomarkers in chronic obstructive pulmonary disease (COPD): The multi‐ethnic study of atherosclerosis COPD study

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