Development and Analysis of Patient-Based Complete Conducting Airways Models.

The analysis of high-resolution computed tomography (CT) images of the lung is dependent on inter-subject differences in airway geometry. The application of computational models in understanding the significance of these differences has previously been shown to be a useful tool in biomedical researc...

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Main Authors: Rafel Bordas, Christophe Lefevre, Bart Veeckmans, Joe Pitt-Francis, Catalin Fetita, Christopher E Brightling, David Kay, Salman Siddiqui, Kelly S Burrowes
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0144105&type=printable
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author Rafel Bordas
Christophe Lefevre
Bart Veeckmans
Joe Pitt-Francis
Catalin Fetita
Christopher E Brightling
David Kay
Salman Siddiqui
Kelly S Burrowes
author_facet Rafel Bordas
Christophe Lefevre
Bart Veeckmans
Joe Pitt-Francis
Catalin Fetita
Christopher E Brightling
David Kay
Salman Siddiqui
Kelly S Burrowes
author_sort Rafel Bordas
collection DOAJ
description The analysis of high-resolution computed tomography (CT) images of the lung is dependent on inter-subject differences in airway geometry. The application of computational models in understanding the significance of these differences has previously been shown to be a useful tool in biomedical research. Studies using image-based geometries alone are limited to the analysis of the central airways, down to generation 6-10, as other airways are not visible on high-resolution CT. However, airways distal to this, often termed the small airways, are known to play a crucial role in common airway diseases such as asthma and chronic obstructive pulmonary disease (COPD). Other studies have incorporated an algorithmic approach to extrapolate CT segmented airways in order to obtain a complete conducting airway tree down to the level of the acinus. These models have typically been used for mechanistic studies, but also have the potential to be used in a patient-specific setting. In the current study, an image analysis and modelling pipeline was developed and applied to a number of healthy (n = 11) and asthmatic (n = 24) CT patient scans to produce complete patient-based airway models to the acinar level (mean terminal generation 15.8 ± 0.47). The resulting models are analysed in terms of morphometric properties and seen to be consistent with previous work. A number of global clinical lung function measures are compared to resistance predictions in the models to assess their suitability for use in a patient-specific setting. We show a significant difference (p < 0.01) in airways resistance at all tested flow rates in complete airway trees built using CT data from severe asthmatics (GINA 3-5) versus healthy subjects. Further, model predictions of airways resistance at all flow rates are shown to correlate with patient forced expiratory volume in one second (FEV1) (Spearman ρ = -0.65, p < 0.001) and, at low flow rates (0.00017 L/s), FEV1 over forced vital capacity (FEV1/FVC) (ρ = -0.58, p < 0.001). We conclude that the pipeline and anatomical models can be used directly in mechanistic modelling studies and can form the basis for future patient-based modelling studies.
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spelling doaj-art-4af44b6fc07b44ac89b72b6be2197cbf2025-08-20T02:15:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-011012e014410510.1371/journal.pone.0144105Development and Analysis of Patient-Based Complete Conducting Airways Models.Rafel BordasChristophe LefevreBart VeeckmansJoe Pitt-FrancisCatalin FetitaChristopher E BrightlingDavid KaySalman SiddiquiKelly S BurrowesThe analysis of high-resolution computed tomography (CT) images of the lung is dependent on inter-subject differences in airway geometry. The application of computational models in understanding the significance of these differences has previously been shown to be a useful tool in biomedical research. Studies using image-based geometries alone are limited to the analysis of the central airways, down to generation 6-10, as other airways are not visible on high-resolution CT. However, airways distal to this, often termed the small airways, are known to play a crucial role in common airway diseases such as asthma and chronic obstructive pulmonary disease (COPD). Other studies have incorporated an algorithmic approach to extrapolate CT segmented airways in order to obtain a complete conducting airway tree down to the level of the acinus. These models have typically been used for mechanistic studies, but also have the potential to be used in a patient-specific setting. In the current study, an image analysis and modelling pipeline was developed and applied to a number of healthy (n = 11) and asthmatic (n = 24) CT patient scans to produce complete patient-based airway models to the acinar level (mean terminal generation 15.8 ± 0.47). The resulting models are analysed in terms of morphometric properties and seen to be consistent with previous work. A number of global clinical lung function measures are compared to resistance predictions in the models to assess their suitability for use in a patient-specific setting. We show a significant difference (p < 0.01) in airways resistance at all tested flow rates in complete airway trees built using CT data from severe asthmatics (GINA 3-5) versus healthy subjects. Further, model predictions of airways resistance at all flow rates are shown to correlate with patient forced expiratory volume in one second (FEV1) (Spearman ρ = -0.65, p < 0.001) and, at low flow rates (0.00017 L/s), FEV1 over forced vital capacity (FEV1/FVC) (ρ = -0.58, p < 0.001). We conclude that the pipeline and anatomical models can be used directly in mechanistic modelling studies and can form the basis for future patient-based modelling studies.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0144105&type=printable
spellingShingle Rafel Bordas
Christophe Lefevre
Bart Veeckmans
Joe Pitt-Francis
Catalin Fetita
Christopher E Brightling
David Kay
Salman Siddiqui
Kelly S Burrowes
Development and Analysis of Patient-Based Complete Conducting Airways Models.
PLoS ONE
title Development and Analysis of Patient-Based Complete Conducting Airways Models.
title_full Development and Analysis of Patient-Based Complete Conducting Airways Models.
title_fullStr Development and Analysis of Patient-Based Complete Conducting Airways Models.
title_full_unstemmed Development and Analysis of Patient-Based Complete Conducting Airways Models.
title_short Development and Analysis of Patient-Based Complete Conducting Airways Models.
title_sort development and analysis of patient based complete conducting airways models
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0144105&type=printable
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