Airway Inspector: a chest imaging biomarker software platform for COPD

描述（由申请人提供）：慢性阻塞性肺疾病在美国影响多达2400万人，预计到2020年将成为全球第三大死亡原因。慢性阻塞性肺病传统上被分为肺气肿和慢性支气管炎的临床表型。尽管肺活量测定法对慢性阻塞性肺病的诊断至关重要，但FEV1在旨在阐明个体之间疾病机制差异的分类方案中可能价值有限。”肺部计算机断层扫描（CT）成像是一种工具，可以满足新的生物标志物的需求：促进新疗法的创建和测试，作为临床试验的替代终点，并为研究人员提供减少COPD受试者队列异质性的能力，使其成为更均匀的亚组，以协助监测研究终点。x由布莱根妇女医院开发，用于分析胸部CT扫描，以分析肺气肿和气道疾病。该工具旨在分析低分辨率CT扫描，从而弥补回顾性数据与新兴CT技术之间的差距。该工具在COPD临床社区的成功得到了一系列同行评审出版物的支持，这些出版物使用该工具来定义疾病指标，从而实现假设驱动的研究。除了存在其他商业应用之外，Airway Inspector是COPD研究中唯一可免费获得的维护平台。尽管它的成功，气道检查员仅限于一个停产版本的切片器。该提案的总体目标是支持气道检查员作为基于图像的COPD研究平台的重构和开发。这一目标将通过创建胸部成像生物标志物平台（CIBP）库来实现，该库集成了我们实验室开发的肺图像分析的新算法解决方案。这些解决方案包括：鲁棒肺提取、基于局部密度的实质组织分类、基于尺度空间粒子的气道、裂隙和肺血管提取以及基于隐马尔可夫模型的气道标记。该软件平台将用于创建工作流，这些工作流将集成到Slicer 4中，以便在临床社区中部署。Slicer 4是NIH支持的开放软件通用成像软件平台，专门设计用于集成气道检查器等解决方案。该工作流程将为临床提供端到端的解决方案，以获得表征肺气肿、气道疾病和肺血管重塑的表型。

DESCRIPTION (provided by applicant): Chronic Obstructive Pulmonary Disease affects up to 24 million people in the United States and is projected to be the 3rd leading cause of death worldwide by 2020. COPD has been traditionally dichotomized into the clinical phenotypes of emphysema and chronic bronchitis. Although spirometry is critical for diagnosis of COPD, FEV1 may be of limited value in a classification scheme designed to illuminate differences in disease mechanism among individuals." Computed tomographic (CT) imaging of the lung is a tool that may fulfill the need of new biomarkers to: facilitate the creation and testing of novel therapies, act as surrogate endpoints for clinical trials and provide researchers with the ability to reduce the heterogeneity of a cohort of subjects with COPD into more homogeneous subgroups to assist in monitoring study endpoints Airway Inspector is a open source software tool based on Slicer 2.x developed at Brigham and Women's Hospital for the analysis of chest CT scans for the analysis of emphysema and airway disease. The tool was conceived to analysis low resolution CT scans bringing the gap between retrospective data and new emerging CT technologies. The success of the tool in the COPD clinical community is supported by the array of peer- review publications that have used the tool to define metrics of disease that enable hypothesis driven research. Beside the existence of alternative commercial applications, Airway Inspector is the only freely available maintained platform for COPD research. In spite of its success, Airway Inspector is limited to a discontinued version of Slicer. The broad objective of this proposal is to support the refactoring and development of Airway Inspector as a platform for image-based COPD research. This goal will be achieved by the creation of the Chest Imaging Biomarker Platform (CIBP) library that integrates novel algorithm solutions to lung image analysis that have been developed in our laboratory. Those solutions include: robust lung extraction, parenchymal tissue classification based on local density, airway, fissure and pulmonary vascular extraction based on scale-space particles and airway labeling based on Hidden Markov Models. That software platform will be used to create workflows that will be integrated in Slicer 4 for their deployment in the clinical community. Slicer 4 is a NIH supported open software general purpose imaging software platform that is specifically designed to integrate solutions like Airway Inspector. The workflows will provide an end-to-end solution for the clinical to obtain phenotypes to characterize emphysema, airway disease and pulmonary vascular remodeling.