Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging

IntroductionThe aim of this research is to elucidate chronic obstructive pulmonary disease (COPD) progression by quantifying lung ventilation heterogeneities using single-photon emission computed tomography (SPECT) images and establishing correlations with quantitative computed tomography (qCT) imag...

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Main Authors: Frank Li, Xuan Zhang, Alejandro P. Comellas, Eric A. Hoffman, Michael M. Graham, Ching-Long Lin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Physiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2025.1555230/full
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author Frank Li
Frank Li
Xuan Zhang
Xuan Zhang
Alejandro P. Comellas
Eric A. Hoffman
Eric A. Hoffman
Michael M. Graham
Ching-Long Lin
Ching-Long Lin
Ching-Long Lin
Ching-Long Lin
author_facet Frank Li
Frank Li
Xuan Zhang
Xuan Zhang
Alejandro P. Comellas
Eric A. Hoffman
Eric A. Hoffman
Michael M. Graham
Ching-Long Lin
Ching-Long Lin
Ching-Long Lin
Ching-Long Lin
author_sort Frank Li
collection DOAJ
description IntroductionThe aim of this research is to elucidate chronic obstructive pulmonary disease (COPD) progression by quantifying lung ventilation heterogeneities using single-photon emission computed tomography (SPECT) images and establishing correlations with quantitative computed tomography (qCT) imaging-based metrics. This approach seeks to enhance our understanding of how structural and functional changes influence ventilation heterogeneity in COPD.MethodsEight COPD subjects completed a longitudinal study with three visits, spaced about a year apart. CT scans were performed at each visit and qCT-based variables were derived to measure the structural and functional characteristics of the lungs, while the SPECT-based variables were used to quantify lung ventilation heterogeneity. The correlations between key qCT-based variables and SPECT-based variables were examined.ResultsThe SPECT-based ventilation heterogeneity (CVTotal) showed strong correlations with the qCT-based functional small airway disease percentage (fSAD%Total) and emphysematous tissue percentage (Emph%Total) in the total lung, based on cross-sectional data. Over the 2-year period, changes in SPECT-based hot spots (TCMax) exhibited strong negative correlations with changes in fSAD%Total, Emph%Total, and the average airway diameter in the left upper lobe, as well as a strong positive correlation with alternations in airflow distribution between the upper and lower lobes.DiscussionIn conclusion, this study found strong positive cross-sectional correlations between CVTotal and both fSAD% and Emph%, suggesting that these markers primarily reflect static disease severity at a single time point. In contrast, longitudinal correlations between changes in TCMax and other variables over 2 years may capture the dynamic process of hot spot formation, independent of disease severity. These findings suggest that changes in TCMax may serve as a more sensitive biomarker than changes in CVTotal for tracking the underlying mechanisms of COPD progression.
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spelling doaj-art-ec002d3d222944ff920d1c75cf4e2f3d2025-08-20T03:14:20ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-04-011610.3389/fphys.2025.15552301555230Longitudinal study of COPD phenotypes using integrated SPECT and qCT imagingFrank Li0Frank Li1Xuan Zhang2Xuan Zhang3Alejandro P. Comellas4Eric A. Hoffman5Eric A. Hoffman6Michael M. Graham7Ching-Long Lin8Ching-Long Lin9Ching-Long Lin10Ching-Long Lin11Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United StatesIIHR-Hydroscience and Engineering, University of Iowa, Iowa City, IA, United StatesIIHR-Hydroscience and Engineering, University of Iowa, Iowa City, IA, United StatesDepartment of Mechanical Engineering, University of Iowa, Iowa City, IA, United StatesDepartment of Internal Medicine, University of Iowa, Iowa City, IA, United StatesRoy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United StatesDepartment of Radiology, University of Iowa, Iowa City, IA, United StatesDepartment of Radiology, University of Iowa, Iowa City, IA, United StatesRoy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United StatesIIHR-Hydroscience and Engineering, University of Iowa, Iowa City, IA, United StatesDepartment of Mechanical Engineering, University of Iowa, Iowa City, IA, United StatesDepartment of Radiology, University of Iowa, Iowa City, IA, United StatesIntroductionThe aim of this research is to elucidate chronic obstructive pulmonary disease (COPD) progression by quantifying lung ventilation heterogeneities using single-photon emission computed tomography (SPECT) images and establishing correlations with quantitative computed tomography (qCT) imaging-based metrics. This approach seeks to enhance our understanding of how structural and functional changes influence ventilation heterogeneity in COPD.MethodsEight COPD subjects completed a longitudinal study with three visits, spaced about a year apart. CT scans were performed at each visit and qCT-based variables were derived to measure the structural and functional characteristics of the lungs, while the SPECT-based variables were used to quantify lung ventilation heterogeneity. The correlations between key qCT-based variables and SPECT-based variables were examined.ResultsThe SPECT-based ventilation heterogeneity (CVTotal) showed strong correlations with the qCT-based functional small airway disease percentage (fSAD%Total) and emphysematous tissue percentage (Emph%Total) in the total lung, based on cross-sectional data. Over the 2-year period, changes in SPECT-based hot spots (TCMax) exhibited strong negative correlations with changes in fSAD%Total, Emph%Total, and the average airway diameter in the left upper lobe, as well as a strong positive correlation with alternations in airflow distribution between the upper and lower lobes.DiscussionIn conclusion, this study found strong positive cross-sectional correlations between CVTotal and both fSAD% and Emph%, suggesting that these markers primarily reflect static disease severity at a single time point. In contrast, longitudinal correlations between changes in TCMax and other variables over 2 years may capture the dynamic process of hot spot formation, independent of disease severity. These findings suggest that changes in TCMax may serve as a more sensitive biomarker than changes in CVTotal for tracking the underlying mechanisms of COPD progression.https://www.frontiersin.org/articles/10.3389/fphys.2025.1555230/fullCTSPECTCOPDventilationsmall airway disease
spellingShingle Frank Li
Frank Li
Xuan Zhang
Xuan Zhang
Alejandro P. Comellas
Eric A. Hoffman
Eric A. Hoffman
Michael M. Graham
Ching-Long Lin
Ching-Long Lin
Ching-Long Lin
Ching-Long Lin
Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging
Frontiers in Physiology
CT
SPECT
COPD
ventilation
small airway disease
title Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging
title_full Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging
title_fullStr Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging
title_full_unstemmed Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging
title_short Longitudinal study of COPD phenotypes using integrated SPECT and qCT imaging
title_sort longitudinal study of copd phenotypes using integrated spect and qct imaging
topic CT
SPECT
COPD
ventilation
small airway disease
url https://www.frontiersin.org/articles/10.3389/fphys.2025.1555230/full
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