Lumen area change (Delta Lumen) between inspiratory and expiratory multidetector computed tomography as a measure of severe outcomes in asthmatic patients

Quantitative computed tomographic (QCT) biomarkers of airway morphology hold potential for understanding and monitoring regional airway remodeling in asthmatic patients. We sought to determine whether the change in airway lumen area between total lung capacity (TLC) and functional residual capacity...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2018-12, Vol.142 (6), p.1773-1780.e9
Main Authors: Shim, Sung Shine, Schiebler, Mark L., Evans, Michael D., Jarjour, Nizar, Sorkness, Ron L., Denlinger, Loren C., Rodriguez, Alfonso, Wenzel, Sally, Hoffman, Eric A., Lin, Ching-Long, Gierada, David S., Castro, Mario, Fain, Sean B.
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Adult
air trapping
Airway Remodeling
asthma
Asthma - diagnostic imaging
Asthma - drug therapy
Asthma - pathology
Asthma - physiopathology
Female
Humans
Male
Middle Aged
Multidetector Computed Tomography
Quantitative computed tomography
Respiration
Respiratory Function Tests
Respiratory System - diagnostic imaging
Respiratory System - pathology
Respiratory System - physiopathology
severe asthma
Young Adult
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Summary:Quantitative computed tomographic (QCT) biomarkers of airway morphology hold potential for understanding and monitoring regional airway remodeling in asthmatic patients. We sought to determine whether the change in airway lumen area between total lung capacity (TLC) and functional residual capacity (FRC) lung volumes measured from CT imaging data was correlated with severe outcomes in asthmatic patients. We studied 152 asthmatic patients (90 female and 62 male patients) and 33 healthy subjects (12 female and 21 male subjects) using QCT. Postprocessing of airways at generations 1 to 5 (1 = trachea) was performed for wall area percentage, wall thickness percentage (WT%), lumen area at baseline total lung capacity (LATLC), lumen area at baseline functional residual capacity (LAFRC), and low attenuation area at FRC. A new metric (reflecting remodeling, distal air trapping, or both), Delta Lumen, was determined as follows: Percentage difference in lumen area (LATLC − LAFRC)/LATLC × 100. Postprocessing of 4501 airway segments was performed (3681 segments in the 152 patients with asthma and 820 segments in the 33 healthy subjects; range, 17-28 segments per subject). Delta Lumen values were negatively correlated with WT% and low attenuation area (P 
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2017.12.1004