ArticlePloS one2012
Longitudinal study of spatially heterogeneous emphysema progression in current smokers with chronic obstructive pulmonary disease.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Chest CT in the evaluation of chronic obstructive pulmonary disease: recommendations of Asian Society of Thoracic Radiology.The British journal of radiology · 2026Guideline
- The Use of Computed Tomography Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society.American journal of respiratory and critical care medicine · 2025Pooled it
- Emphysema progression risk in COPD using a localized foundational model of density evolution.NPJ digital medicine · 2025Article
- Leveraging Subjective Parameters and Biomarkers in Machine Learning Models: The Feasibility ofDiagnostics (Basel, Switzerland) · 2025Article
- A Personalized Spring Network Representation of Emphysematous Lungs From CT Images.Frontiers in network physiology · 2022Article
- Airway Hyperresponsiveness, Inflammation, and Pulmonary Emphysema in Rodent Models Designed to Mimic Exposure to Fuel Oil-Derived Volatile Organic Compounds Encountered during an Experimental Oil Spill.Environmental health perspectives · 2020Article
- Quantitative analysis of computed tomography of the lungs in patients with lymphangioleiomyomatosis treated with sirolimus.Heliyon · 2020Article
- Fractal Analysis of Lung Structure in Chronic Obstructive Pulmonary Disease.Frontiers in physiology · 2020Review
- CT Imaging-Based Low-Attenuation Super Clusters in Three Dimensions and the Progression of Emphysema.Chest · 2019Observational
- Low morphometric complexity of emphysematous lesions predicts survival in chronic obstructive pulmonary disease patients.European radiology · 2019Article
- Longitudinal changes in structural lung abnormalities using MDCT in chronic obstructive pulmonary disease with asthma-like features.PloS one · 2019Observational
- Fractal analysis of low attenuation clusters on computed tomography in chronic obstructive pulmonary disease.BMC pulmonary medicine · 2018Observational
- Complementary regional heterogeneity information from COPD patients obtained using oxygen-enhanced MRI and chest CT.PloS one · 2018Article
- Development of digital phantoms based on a finite element model to simulate low-attenuation areas in CT imaging for pulmonary emphysema quantification.International journal of computer assisted radiology and surgery · 2017Article
- Computed Tomography Measure of Lung at Risk and Lung Function Decline in Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2017Article
- Article
- Size variation and collapse of emphysema holes at inspiration and expiration CT scan: evaluation with modified length scale method and image co-registration.International journal of chronic obstructive pulmonary disease · 2017Article
- A size-based emphysema severity index: robust to the breath-hold-level variations and correlated with clinical parameters.International journal of chronic obstructive pulmonary disease · 2016Article
- Computational modeling helps uncover mechanisms related to the progression of emphysema.Drug discovery today. Disease models · 2014Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCigarette smoke is the main risk factor for emphysema, which is a key pathology in chronic obstructive pulmonary disease (COPD). Low attenuation areas (LAA) in computed tomography (CT) images reflect emphysema, and the cumulative size distribution of LAA clusters follows a power law characterized by the exponent D. This property of LAA clusters can be explained by model simulation, where mechanical force breaks alveolar walls causing local heterogeneous lung tissue destruction. However, a longitudinal CT study has not investigated whether continuous smoking causes the spatially heterogeneous progression of emphysema.
methodsWe measured annual changes in ratios of LAA (LAA%), D and numbers of LAA clusters (LAN) in CT images acquired at intervals of ≥ 3 years from 22 current and 31 former smokers with COPD to assess emphysema progression. We constructed model simulations using CT images to morphologically interpret changes in current smokers.
resultsD was decreased in current and former smokers, whereas LAA% and LAN were increased only in current smokers. The annual changes in LAA%, D, and LAN were greater in current, than in former smokers (1.03 vs. 0.37%, p=0.008; -0.045 vs. -0.01, p=0.004; 13.9 vs. 1.1, p=0.007, respectively). When LAA% increased in model simulations, the coalescence of neighboring LAA clusters decreased D, but the combination of changes in D and LAN in current smokers could not be explained by the homogeneous emphysema progression model despite cluster coalescence. Conversely, a model in which LAAs heterogeneously increased and LAA clusters merged somewhat in relatively advanced emphysematous regions could reflect actual changes.
conclusionsSusceptibility to parenchymal destruction induced by continuous smoking is not uniform over the lung, but might be higher in local regions of relatively advanced emphysema. These could result in the spatially heterogeneous progression of emphysema in current smokers.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.