Intrapulmonary vascular remodeling: MSCT-based evaluation in COPD and alpha-1 antitrypsin deficient subjects

Adeline Crosnier; Catalin Fetita; Gabriel Thabut; Pierre-Yves Brillet

doi:10.1117/12.2216522

24 March 2016 Intrapulmonary vascular remodeling: MSCT-based evaluation in COPD and alpha-1 antitrypsin deficient subjects

Adeline Crosnier, Catalin Fetita, Gabriel Thabut, Pierre-Yves Brillet

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Proceedings Volume 9785, Medical Imaging 2016: Computer-Aided Diagnosis; 978516 (2016) https://doi.org/10.1117/12.2216522
Event: SPIE Medical Imaging, 2016, San Diego, California, United States

Abstract

Whether COPD is generally known as a small airway disease, recent investigations suggest that vascular remodeling could play a key role in disease progression. This paper develops a specific investigation framework in order to evaluate the remodeling of the intrapulmonary vascular network and its correlation with other image or clinical parameters (emphysema score or FEV₁) in patients with smoking- or genetic- (alpha-1 antitrypsin deficiency - AATD) related COPD. The developed approach evaluates the vessel caliber distribution per lung or lung region (upper, lower, 10%- and 20%- periphery) in relation with the severity of the disease and computes a remodeling marker given by the area under the caliber distribution curve for radii less than 1.6mm, AUC16. It exploits a medial axis analysis in relation with local caliber information computed in the segmented vascular network, with values normalized with respect to the lung volume (for which a robust segmentation is developed). The first results obtained on a 34-patient database (13 COPD, 13 AATD and 8 controls) showed significant vascular remodeling for COPD and AATD versus controls, with a negative correlation with the emphysema degree for COPD, but not for AATD. Significant vascular remodeling at 20% lung periphery was found both for the severe COPD and AATD patients, but not for the moderate groups. Also the vascular remodeling in AATD did not correlate with the FEV₁, nor with DLCO, which might suggest independent mechanisms for bronchial and vascular remodeling in the lung.

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Adeline Crosnier, Catalin Fetita, Gabriel Thabut, and Pierre-Yves Brillet "Intrapulmonary vascular remodeling: MSCT-based evaluation in COPD and alpha-1 antitrypsin deficient subjects", Proc. SPIE 9785, Medical Imaging 2016: Computer-Aided Diagnosis, 978516 (24 March 2016); https://doi.org/10.1117/12.2216522

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KEYWORDS

Lung

Chronic obstructive pulmonary disease

Emphysema

Image segmentation

Image resolution

Blood vessels

Genetics

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