CT Assessment of Lung Fissures: Anatomy and Correlated Function

肺裂的 CT 评估：解剖结构和相关功能

• 批准号: 9204412
• 负责人: Jiantao Pu
• 金额: $ 26.95万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9204412
• 关键词: 3-Dimensional; Affect; Age; Air Sacs; Algorithmic Analysis; Anatomy; Attention; Breathing; Bronchodilator Agents; Cause of Death; Cessation of life; Characteristics; Chronic Obstructive Airway Disease; Clinical; Collaborations; Complex; Computational Geometry; Computers; Data; Databases; Development; Diagnostic radiologic examination; Dimensions; Disease; Early Intervention; Elasticity; Environmental air flow; Fissural; Geometry; Goals; Grant; Image; Image Analysis; Individual; Interlobar; Investigation; Left; Lobe; Longitudinal cohort; Lung; Lung Volume Reductions; Lung volume reduction surgery; Modeling; Molecular; Morphology; Obesity; Operative Surgical Procedures; Oxygen; Pathogenicity; Pathway interactions; Patient Selection; Patients; Pattern; Physiological; Physiology; Play; Practice Management; Process; Pulmonary Emphysema; Quality of life; Research Personnel; Respiratory physiology; Risk stratification; Role; Scanning; Severities; Shortness of Breath; Smoker; Smoking History; Structure of parenchyma of lung; Symptoms; Techniques; Therapeutic Intervention; United States; Universities; Unnecessary Procedures; Walking; Work; X-Ray Computed Tomography; chest computed tomography; cohort; cost; demographics; disability; experience; functional decline; geometric methodologies; imaging biomarker; improved; innovation; minimally invasive; patient subsets; public health relevance; reduce symptoms; response; smoking cessation; spatial integration; spatial relationship; targeted treatment; tool; treatment trial

 DESCRIPTION (provided by applicant): Emphysema is a leading cause of disability and death in the United States and worldwide. Millions of people suffer from this disease, which often goes undiagnosed for many years and irreversibly destroys lung parenchyma. It is unclear how the disease progresses, but there are emerging investigations indicating that the development and extent of emphysema may follow certain pathogenic pathways. In recent years, bronchoscopic lung volume reduction therapy has been gaining significant attention as a treatment for emphysema to reduce hyperinflation, improve lung function, and relieve symptoms (e.g., short of breath) because of its minimally invasive characteristic. However, it is difficult to determine which patients could actually benefit from this bronchoscopic therapy. The primary challenge is the lack of an accurate, quantitative, and non-invasive way to assess an individual's inter-lobar collateral ventilation (CV). Preliminarily studies by some investigators and us revealed that pulmonary fissure integrity (completeness) depicted on CT images may play a crucial role in interlobar CV, but the exact contribution to the interlobar CV remains unclear. We propose to advance our previous work to comprehensively investigate pulmonary fissure morphology, emphysema distribution patterns, and their 3D spatial integration. Our ultimate goal is to develop a risk stratification model for assessing function decline, COPD progression, and responses to endobronchial valve (EBV) therapy. Our assumption is that the interlobar CV is affected by multiple factors, such as the existence of incomplete fissures surrounded by emphysema, and not simply fissure integrity. Therefore the current approaches to assess interlobar CV by fissure integrity on CT images may be insufficient. If successful, the developed computer tool may not only aid in assessing COPD progression and possible developing optimal patient management practices, but also significantly simplify pre-operative work-up in identifying patients for EBV therapy. We have the following specific aims: (1) continue to populate our chest CT examination database, (2) further develop our 3D fissure and lung models to integrates fissure morphology and emphysema severity and distribution, (3) evaluate the functional implications of features morphology, emphysema distribution patterns, and integrative lung model, and (4) develop and validate a risk stratification model for function decline, COPD progression, and responses to EBV therapy.

 描述（由申请人提供）：肺气肿是美国和全世界残疾和死亡的主要原因。数百万人患有这种疾病，这种疾病往往多年未被诊断出来，并且会不可逆转地破坏肺实质。目前尚不清楚该疾病如何进展，但新的研究表明，肺气肿的发展和程度可能遵循某些致病途径。近年来，支气管镜肺减容疗法因其微创的特点，作为一种治疗肺气肿以减少过度充气、改善肺功能、缓解症状（例如呼吸短促）的方法而受到广泛关注。然而，很难确定哪些患者实际上可以从这种支气管镜治疗中受益。主要挑战是缺乏准确、定量和非侵入性的方法来评估个体的叶间侧支通气 (CV)。我们和一些研究者的初步研究表明，CT 图像上描绘的肺裂完整性（完整性）可能在叶间 CV 中发挥至关重要的作用，但对叶间 CV 的确切贡献仍不清楚。我们建议推进我们之前的工作，全面研究肺裂形态、肺气肿分布模式及其 3D 空间整合。我们的最终目标是开发一个风险分层模型，用于评估功能下降、COPD 进展以及对支气管内瓣膜 (EBV) 治疗的反应。我们的假设是，叶间CV受到多种因素的影响，例如是否存在被肺气肿包围的不完整裂隙，而不仅仅是裂隙完整性。因此，目前通过 CT 图像上裂隙完整性评估叶间 CV 的方法可能还不够。如果成功，开发的计算机工具不仅可以帮助评估 COPD 进展并可能制定最佳的患者管理实践，而且还可以显着简化识别患者进行 EBV 治疗的术前检查。我们有以下具体目标：(1) 继续充实我们的胸部 CT 检查数据库，(2) 进一步开发我们的 3D 裂隙和肺部模型，以整合裂隙形态和肺气肿严重程度和分布，(3) 评估特征形态、肺气肿分布模式和综合肺模型的功能影响，以及 (4) 开发和验证功能下降、COPD 进展和对 EBV 反应的风险分层模型 治疗。