ArticleThe British journal of radiology2025
Automated CT-based decoupling of the effects of airway narrowing and wall thinning on airway counts in chronic obstructive pulmonary disease.
Article in The British journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Comorbidity of chronic obstructive pulmonary disease and pulmonary tuberculosis: a bibliometric analysis (2011-2025) with narrative review.Journal of thoracic disease · 2026Article
- Predictive value of quantitative CT-derived emphysema heterogeneity for outcomes following bronchoscopic lung volume reduction.American journal of translational research · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
objectiveWe examine pathways of airway alteration due to wall thinning, narrowing, and obliteration in chronic obstructive pulmonary disease (COPD) using CT-derived airway metrics.
methodsEx-smokers (N = 649; age mean ± std: 69 ± 6 years; 52% male) from the COPDGene Iowa cohort (September 2013-July 2017) were studied. Total airway count (TAC), peripheral TAC beyond 7th generation (TACp), and airway wall thickness (WT) were computed from chest CT scans using previously validated automated methods. Causal relationships among demographic, smoking, spirometry, COPD severity, airway counts, WT, and scanner variables were analysed using causal inference techniques including direct acyclic graphs to assess multi-pathway alterations of airways in COPD.
resultsTAC, TACp, and WT were significantly lower (P < .0001) in mild, moderate, and severe COPD compared to the preserved lung function group. TAC (TACp) losses attributed to narrowing and obliteration of small airways were 4.59%, 13.29%, and 32.58% (4.64%, 17.82%, and 45.51%) in mild, moderate, and severe COPD, while the losses attributed to wall thinning were 8.24%, 17.01%, and 22.95% (12.79%, 25.66%, and 33.95%) in respective groups.
conclusionsDifferent pathways of airway alteration in COPD are observed using CT-derived automated airway metrics. Wall thinning is a dominant contributor to both TAC and TACp loss in mild and moderate COPD while narrowing and obliteration of small airways is dominant in severe COPD. ADVANCES IN KNOWLEDGE: This automated CT-based study shows that wall thinning dominates airway alteration in mild and moderate COPD while narrowing and obliteration of small airways leads the alteration process in severe COPD.
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