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Predictive Modelling of Lung Function using Emphysematous Density Distribution.


ABSTRACT: Target lung tissue selection remains a challenging task to perform for treating severe emphysema with lung volume reduction (LVR). In order to target the treatment candidate, the percentage of low attenuation volume (LAV%) representing the proportion of emphysema volume to whole lung volume is measured using computed tomography (CT) images. Although LAV% have shown to have a correlation with lung function in patients with chronic obstructive pulmonary disease (COPD), similar measurements of LAV% in whole lung or lobes may have large variations in lung function due to emphysema heterogeneity. The functional information of regional emphysema destruction is required for supporting the choice of optimal target. The purpose of this study is to develop an emphysema heterogeneity descriptor for the three-dimensional emphysematous bullae according to the size variations of emphysematous density (ED) and their spatial distribution. The second purpose is to derive a predictive model of airflow limitation based on the regional emphysema heterogeneity. Deriving the bullous representation and grouping them into four scales in the upper and lower lobes, a predictive model is computed using the linear model fitting to estimate the severity of lung function. A total of 99 subjects, 87 patients with mild to very severe COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I~IV) and 12 control participants with normal lung functions (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC)?>?0.7) were evaluated. The final model was trained with stratified cross-validation on randomly selected 75% of the dataset (n?=?76) and tested on the remaining dataset (n?=?23). The dispersed cases of LAV% inconsistent with their lung function outcome were evaluated, and the correlation study suggests that comparing to LAV of larger bullae, the widely spread smaller bullae with equivalent LAV has a larger impact on lung function. The testing dataset has the correlation of r?=?-0.76 (p?1/FVC, whereas using two ED % of scales and location-dependent variables to predict the emphysema-associated FEV1/FVC, the results shows their correlation of 0.82 (p?1/FVC.

SUBMITTER: Lor KL 

PROVIDER: S-EPMC6930211 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Predictive Modelling of Lung Function using Emphysematous Density Distribution.

Lor Kuo-Lung KL   Liu Cheng-Pei CP   Chang Yeun-Chung YC   Yu Chong-Jen CJ   Wang Cheng-Yi CY   Chung Ming-Jui MJ   Lin Fan-Ya FY   Chen Chung-Ming CM  

Scientific reports 20191224 1


Target lung tissue selection remains a challenging task to perform for treating severe emphysema with lung volume reduction (LVR). In order to target the treatment candidate, the percentage of low attenuation volume (LAV%) representing the proportion of emphysema volume to whole lung volume is measured using computed tomography (CT) images. Although LAV% have shown to have a correlation with lung function in patients with chronic obstructive pulmonary disease (COPD), similar measurements of LAV%  ...[more]

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