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COPD: Phenotypes from CT analysis. Raul San Jose Estepar, Ph.D. Clinical relevance. COPD is characterized by: Airway narrowing/remodeling. Parenchymal destruction.
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COPD: Phenotypes from CT analysis Raul San Jose Estepar, Ph.D.
Clinical relevance • COPD is characterized by: • Airway narrowing/remodeling. • Parenchymal destruction. • Hypothesis: Improve diagnosis and therapeutic strategies by better understanding the mechanisms leading to airflow obstruction. This means that we can provide the therapy that is best suited for a given phenotype. • Goal: • Development of robust automated tool for analysis of CT chest scans. • Definition of COPD phenotypes.
Challenges for the Phenotype quest • Definition of lung mask • Airway analysis: • Lumen segmentation • Wall segmentation Quantitative analysis
Lung mask Definition of a lung mask is the first step of the processing pipeline. Mask extraction allows lung mask density analysis. Lung mask extraction for a High Resolution CT scan
Airways: From the brain to the lungs Migration of methods originally developed for brain segmentation and vascular segmentation Vessel segmentation: Lorigo et al. , 2001. Brain segmentation: Pichon et al, 2003 Sponsored by NAC
Airway centerlines Airway centerlines serve as a tree representation of the airway structure Segmented airway and extracted centerline.
Airway inspection Focusing on the airway wall by traveling along the airway. New CT view in planes orthogonal to the airway.
Airway wall Development of new methods for the segmentation of airway wall. Challenge: wall not always visible due to occlusion with pulmonary vessels.
Quantitative analysis Lung mask density. Wall thickness. Percentage of wall area. Geometric measures: curvature of airway lumen. Rate of change across airway generations.
Collaborators • SPL: • S. Haker, Ph.D. • C-F. Westin, Ph.D. • Channing Lab: • E. Silverman, M.D. • Pulmonary division: • G. Washko, M.D. • J.J. Reilly, M.D.