... AbstractText: To determine if the total number of airways quantified in vivo using computed tomography (CT) reflects early airway-related disease changes and is associated with lung-function decline independent of emphysema in COPD ... CT total-airway-count (TAC) was measured as well as airway inner diameter and wall area using anatomically ...
Chronic Obstructive Pulmonary Disease (10), Emphysema (3), more mentions
BACKGROUND: Assessing functional impairment, therapeutic response and disease progression in patients with idiopathic pulmonary fibrosis (IPF) continues to be challenging. Hyperpolarized (129)Xe MRI can address this gap through its unique capability to image gas transfer three-dimensionally from airspaces to interstitial barrier tissues to red blood cells (RBCs). This must be validated by testing the degree to which it correlates with pulmonary function tests (PFTs) and CT scores, and its spatial distribution reflects known physiology and patterns of disease.
METHODS: 13 healthy individuals (33.6±15.7 years) and 12 patients with IPF (66.0±6.4 years) underwent (129)Xe MRI to generate three-dimensional quantitative maps depicting the (129)Xe ventilation distribution, its uptake in interstitial barrier tissues and its transfer to RBCs. For each map, mean values were correlated with PFTs and CT fibrosis scores, and their patterns were tested for the ability to depict functional gravitational gradients in healthy lung and to detect the known basal and peripheral predominance of disease in IPF.
RESULTS: (129)Xe MRI depicted functional impairment in patients with IPF, whose mean barrier uptake increased by 188% compared with the healthy reference population. (129)Xe MRI metrics correlated poorly and insignificantly with CT fibrosis scores but strongly with PFTs. Barrier uptake and RBC transfer both correlated significantly with diffusing capacity of the lungs for carbon monoxide (r=-0.75, p<0.01 and r=0.72, p<0.01), while their ratio (RBC/barrier) correlated most strongly (r=0.94, p<0.01). RBC transfer exhibited significant anterior-posterior gravitational gradients in healthy volunteers, but not in IPF, where it was significantly impaired in the basal (p=0.02) and subpleural (p<0.01) lung.
CONCLUSIONS: Hyperpolarized(129)Xe MRI is a rapid and well-tolerated exam that provides region-specific quantification of interstitial barrier thickness and RBC transfer efficiency. With further development, it could become a robust tool for measuring disease progression and therapeutic response in patients with IPF, sensitively and non-invasively.
In adult patients with cystic fibrosis (CF), the lung clearance index (LCI) derived from the multiple breath washout relates to both acinar and conductive ventilation heterogeneity. The latter component predicts an association between LCI and the number of bronchial segments affected by bronchiectasis. Here, we experimentally demonstrated this association in patients with CF, and also examined an ancillary group of patients with non-CF bronchiectasis. We conclude that lung disease severity in terms of number of bronchial segments results in an associated LCI increase, likely constituting a portion of LCI that cannot be reversed by treatment in patients with CF lung disease.
Bronchiectasis (4), Cystic Fibrosis (2), Lung Diseases (2), more mentions
We therefore assessed the prevalence of positive computed tomography (CT) images and lung cancers in PLWHIV AbstractText: The Copenhagen comorbidity in HIV infection (COCOMO) study is an observational, longitudinal cohort study. Single-round LDCT was performed with subsequent clinical follow-up (NCT02382822) AbstractText: Outcomes included histology-proven lung cancer identified by LDCT and positive CT images (noncalcified nodules) in the ...
Oncology (5) Lung Neoplasms (5), HIV Infections (1), more mentions
OBJECTIVE: The purposes of this study were to investigate dual-energy CT findings predictive of clinical outcome and to determine the incremental risk stratification benefit of dual-energy CT findings compared with CT ventricular diameter ratio in patients with acute pulmonary embolism.
MATERIALS AND METHODS: A retrospective evaluation was conducted of the cases of 172 patients with acute pulmonary embolism who underwent dual-energy CT. Ventricular diameter ratio and relative perfusion defect volume were measured. The primary endpoints were death within 30 days and pulmonary embolism-related death.
RESULTS: A ventricular diameter ratio of 1 or greater was associated with increased risk of death within 30 days (hazard ratio, 3.822; p = 0.002) and pulmonary embolism-related death (hazard ratio, 18.051; p < 0.001). Relative perfusion defect volume was also associated with increased risk of death of any cause within 30 days (hazard ratio, 1.044; p = 0.014) and pulmonary embolism-related death (hazard ratio, 1.046; p = 0.017). However, the addition of relative perfusion defect volume to ventricular diameter ratio had no added benefit for prediction of death of any cause within 30 days (concordance statistic, 0.833 vs 0.815; p = 0.187) or pulmonary embolism-related death (concordance statistic, 0.873 vs 0.874; p = 0.866).
CONCLUSION: Compared with ventricular diameter ratio alone, lung perfusion defect volume had no statistically significant added benefit for prediction of death of any cause within 30 days or of pulmonary embolism-related death among patients with acute PE.
As low-dose CT (LDCT) lung cancer screening moves into routine clinical practice, evaluation of nodules identified as new becomes critical. We examine the frequency and clinical outcomes of new lung nodules reported at the two postbaseline annual screening examinations (hereafter referred to as postbaseline time 1 [T1] and time 2 [T2]), compared with those detected at baseline in the ...