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New CT Technique Shows Stages of COPD

October 8, 2012
Written by: , Filed in: Chest Radiology, Diagnostic Imaging
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A new computerized method of analyzing CT scans of the lungs can distinguish whether—and how far—chronic obstructive pulmonary disease has advanced in the small airways of the lungs.

A University of Michigan Medical School team developed the technique, known as parametric response mapping (PRM). Computer software exactly overlays two CT scans, one taken at full inhalation and the other at full exhalation.

Between the two images, the density of healthy lungs differs more than that of diseased lungs. PRM breaks the lung scans into voxels (3-D versions of pixels) and assigns a color to each voxel: green for healthy tissue with a large difference in density, yellow for tissue that shows moderately reduced ability to push air out of the small sacs in the lung, and red for tissue with greatly reduced ability.

The resulting display provides an at-a-glance assessment of lung health, ranging from great (almost all green) through not so good (patches of yellow) to dire (lots of red).

A study published online Sunday in Nature Medicine explains the PRM system. Brian Ross, PhD, senior author, summarized the implications:

Essentially, with the PRM technique, we’ve been able to tell subtypes of COPD apart, distinguishing functional small airway disease, or fSAD, from emphysema and normal lung function. We believe this offers a new path to more precise diagnosis and treatment planning, and a useful tool for precisely assessing the impact of new medications and other treatments.

Dr. Ross is a professor of biological chemistry. He was quoted in a University of Michigan Health System news release.

The team originally developed the PRM technique to show the response of brain tumors to treatment. A university spin-off company, Imbio, has licensed the university’s PRM patents and has already been working on early prediction of treatment response to brain tumors and other cancers. It has now expanded into the COPD arena.

Ella Kazerooni, MD, a study co-author who heads Michigan’s lung-imaging program, said:

In the last decade, CT scan techniques for imaging COPD have improved steadily, but PRM is the missing link, giving us a robust way to see small-airway disease and personalize treatment.

Dr. Kazerooni is a professor of thoracic radiology and cardiovascular radiology.

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