Lobar Emphysema Distribution Is Associated With 5-Year Radiological Disease Progression

Abstract

Subgroups of smokers defined by upper-lobe or lower-lobe emphysema predominance exhibit different functional and radiological disease progression rates, and the upper-lobe predominant subtype shows evidence of association with known COPD genetic risk variants. These subgroups may be useful in the development of personalized treatments for COPD.

Voxel-Wise Longitudinal Parametric Response Mapping Analysis of Chest Computed Tomography in Smokers

“…Furthermore, the presence of baseline PRM fSAD and PRM EMPH in the upper lung zones is independently predictive of an increase in upper lung emphysema over time. Similarly, in another study of the COPDGene cohort, Boueiz and colleagues performed a cluster analysis on CT subtypes and found that the cluster most characterized by upperlobe predominant emphysema at baseline experienced faster overall progression of emphysema (28). This differential effect by baseline emphysema distribution may be related to variability in regional perfusion (29), mechanical stress (30) and clearance of smoking metabolites (31) between the upper and lower parts of the lung.…”

Interpretable clustering methods

“…This might imply that the upper-lobe predominant subjects are associated with the most 5-year progression of emphysema, which is worthy of further investigation. Note that this result is consistent with the recent COPD research described in [50]. I predict which cluster a subject belongs to using the trained models.…”

Artificial Intelligence in COPD: New Venues to Study a Complex Disease

“…Advanced clustering of emphysematous region textons in the MESA COPD cohort 49 was used to discerned 12 distinct sLTPs. One interesting aspect of this approach is that integrated spatial information as regional distribution of emphysema has been recognized as an important phenotype 50 . Almost all the sLTPs showed reasonable associations with dyspnea and exercise capacity, but more work is needed to better understand the pathological meaning.…”