Quantitative CT Scoring for Local COPD SeverityWassim W Labaki, Sundaresh Ram, Ali Namvar, Alexander J Bell, Benjamin A Hoff, Ella A Kazerooni, Stefanie Galban, Fernando J Martinez, Charles R Hatt, Susan Murray, Evgeny M Mirkes, Alexander N Gorban, Andrei Zinovyev, MeiLan K Han, Craig J GalbanmedRxiv 2025.04.09.25324951; doi: https://doi.org/10.1101/2025.04.09.25324951
Abstract: Chronic obstructive pulmonary disease (COPD) is complex, and its course is difficult to predict due to its diverse pathophysiology. Small airway disease (SAD), a key component of COPD and potential target for emerging therapeutics, may be reversible in mild COPD, but left unchecked, may worsen, leading to airway loss and emphysema. The dual nature of SAD complicates clinical management of COPD patients, necessitating more accurate monitoring methods. To meet this need, we developed elastic Parametric Response Mapping (ePRM), a tiered scoring system that classifies local lung volumes by the degree of PRM-derived SAD, normal, and emphysematous tissue. In individuals with or at risk for COPD, we demonstrate that chest CT ePRM can categorize local lung tissue into distinct tiers of disease severity that distinguish between tissue characterized by early reversible SAD and progressive destruction. This level of characterization is crucial to developing personalized treatment strategies for COPD.
To summarize, ePRM is an innovative quantitative CT scoring technique for precisely and reliably monitoring local COPD progression. This imaging biomarker provides a method for detecting and characterizing COPD earlier in its course, when altering the natural trajectory of the disease may still be possible.
https://www.medrxiv.org/content/10.1101/2025.04.09.25324951v3
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