ArticleChest2018
Lobar Emphysema Distribution Is Associated With 5-Year Radiological Disease Progression.
Article in Chest, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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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
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- DSP variants may be associated with longitudinal change in quantitative emphysema.Respiratory research · 2019Trial
- Imaging endpoints for biologic therapy in chronic obstructive pulmonary disease.The British journal of radiology · 2026Review
- HighERJ open research · 2026Article
- Molecular determinants of lung function decline: a multi-level analysis of gene expression.Respiratory research · 2025Article
- Deep learning based CT images for lung function prediction in patients with chronic obstructive pulmonary disease.BMC pulmonary medicine · 2025Article
- GOLD grade-specific characterization of COPD in the COSYCONET multi-center trial: comparison of semiquantitative MRI and quantitative CT.European radiology · 2025Article
- Association between age and lung cancer risk: evidence from lung lobar radiomics.BMC medical imaging · 2025Article
- Upper-lobe CT imaging features improve prediction of lung function decline in COPD.ERJ open research · 2025Article
- Novel Lobe-based Transformer model (LobTe) to predict emphysema progression in Alpha-1 Antitrypsin Deficiency.Computers in biology and medicine · 2025Article
- Computed Tomography Radiomics Features Predict Change in Lung Density and Rate of Emphysema Progression.Annals of the American Thoracic Society · 2025Article
- Computed tomography (CT) quantitative assessment of single lobe emphysema correlates with chronic obstructive pulmonary disease (COPD) severity: a cross-sectional study with retrospective data collection.Quantitative imaging in medicine and surgery · 2024Article
- Deep Learning Integration of Chest Computed Tomography Imaging and Gene Expression Identifies Novel Aspects of COPD.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2023Article
- Heterogeneity and Progression of Chronic Obstructive Pulmonary Disease: Emphysema-Predominant and Non-Emphysema-Predominant Disease.American journal of epidemiology · 2023Article
- Quantifying the spatial clustering characteristics of radiographic emphysema explains variability in pulmonary function.Scientific reports · 2023Article
- GOLD stage-specific phenotyping of emphysema and airway disease using quantitative computed tomography.Frontiers in medicine · 2023Article
- Clustering-based COPD subtypes have distinct longitudinal outcomes and multi-omics biomarkers.BMJ open respiratory research · 2022Observational
- Basilar Predominant Emphysema: Thinking beyond Alpha-1-Antitrypsin Deficiency.Case reports in medicine · 2022Article
- CT-Based Commercial Software Applications: Improving Patient Care Through Accurate COPD Subtyping.International journal of chronic obstructive pulmonary disease · 2022Review
- Phenotyping COPD Patients with Emphysema Distribution Using Quantitative CT Measurement; More Severe Airway Involvement in Lower Dominant Emphysema.International journal of chronic obstructive pulmonary disease · 2022Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundEmphysema has considerable variability in its regional distribution. Craniocaudal emphysema distribution is an important predictor of the response to lung volume reduction. However, there is little consensus regarding how to define upper lobe-predominant and lower lobe-predominant emphysema subtypes. Consequently, the clinical and genetic associations with these subtypes are poorly characterized.
methodsWe sought to identify subgroups characterized by upper-lobe or lower-lobe emphysema predominance and comparable amounts of total emphysema by analyzing data from 9,210 smokers without alpha-1-antitrypsin deficiency in the Genetic Epidemiology of COPD (COPDGene) cohort. CT densitometric emphysema was measured in each lung lobe. Random forest clustering was applied to lobar emphysema variables after regressing out the effects of total emphysema. Clusters were tested for association with clinical and imaging outcomes at baseline and at 5-year follow-up. Their associations with genetic variants were also compared.
resultsThree clusters were identified: minimal emphysema (n = 1,312), upper lobe-predominant emphysema (n = 905), and lower lobe-predominant emphysema (n = 796). Despite a similar amount of total emphysema, the lower-lobe group had more severe airflow obstruction at baseline and higher rates of metabolic syndrome compared with subjects with upper-lobe predominance. The group with upper-lobe predominance had greater 5-year progression of emphysema, gas trapping, and dyspnea. Differential associations with known COPD genetic risk variants were noted.
conclusionsSubgroups of smokers defined by upper-lobe or lower-lobe emphysema predominance exhibit different functional and radiological disease progression rates, and the upper-lobe predominant subtype shows evidence of association with known COPD genetic risk variants. These subgroups may be useful in the development of personalized treatments for COPD.
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