Association analysis of SNPs with CT image-based phenotype of emphysema progression in heavy smokers

Chronic obstructive pulmonary disease (COPD) is predicted to become the third leading cause of death worldwide by 2030. Smoking is a well-known risk factor in the development of COPD. Association between COPD genes and smoking have been studied. This paper presents an association analysis of single nucleotide polymorphisms (SNPs) with a CT image-based phenotype of emphysema progression in heavy smokers. The emphysema progression was quantitatively represented by the annual increment of low attenuation volume (LAV) on CT scans for five years. 10 candidate SNPs were selected from 316 SNPs in 125 papers of genetic studies of COPD and lung cancer. The genotypes were determined by real-time polymerase chain reaction (PCR) using deoxyribonucleic acid (DNA) extracted from saliva samples. The association analysis was performed by Fisher's exact test and logistic regression analysis. This method was applied to a dataset with 144 participants (71 smokers, 61 past smokers, and 12 non-smokers). The results showed that the genotypes of rs3923564 and rs13180 SNPs were candidate SNPs associated with the CT image based-emphysema progression

Visualization and unsupervised clustering of emphysema progression using t-SNE analysis of longitudinal CT images and SNPs

Chronic obstructive pulmonary disease (COPD) is predicted to become the third leading cause of death worldwide by 2030. A longitudinal study using CT scans of COPD is useful to assess the changes in structural abnormalities. In this study, we performed visualization and unsupervised clustering of emphysema progression using t-distributed stochastic neighbor embedding (t-SNE) analysis of longitudinal CT images, smoking history, and SNPs. The procedure of this analysis is as follows: (1) automatic segmentation of lung lobes using 3D U-Net, (2) quantitative image analysis of emphysema progression in lung lobes, and (3) visualization and unsupervised clustering of emphysema progression using t-SNE. Nine explanatory variables were used for the clustering: genotypes at two SNPs (rs13180 and rs3923564), smoking history (smoking years, number of cigarettes per day, pack-year), and LAV distribution (LAV size and density in upper lobes, LAV size, and density in lower lobes). The objective variable was emphysema progression which was defined as the annual change in low attenuation volume (LAV%/year) using linear regression. The nine-dimensional space was transformed to two-dimensional space by t-SNE, and divided into three clusters by Gaussian mixture model. This method was applied to 37 smokers with 68.2 pack-years and 97 past smokers with 51.1 pack-years. The results demonstrated that this method could be effective for quantitative assessment of emphysema progression by SNPs, smoking history, and imaging features

Annual change in bone mineral density in COPD

Background: Osteoporosis is a well-known comorbidity in COPD. It is associated with poor health status and prognosis. Although the exact pathomechanisms are unclear, osteoporosis is suggested to be either a comorbidity due to shared risk factors with COPD or a systematic effect of COPD with a cause–effect relationship. This study aimed to evaluate whether progression of osteoporosis is synchronized with that of COPD. Materials and methods: Data from 103 patients with COPD included in the Hokkaido COPD cohort study were analyzed. Computed tomography (CT) attenuation values of thoracic vertebrae 4, 7, and 10 were measured using custom software, and the average value (average bone density; ABD4,7,10) was calculated. The percentage of low attenuation volume (LAV%) for each patient was also calculated for evaluation of emphysematous lesions. Annual change in thoracic vertebral CT attenuation, which is strongly correlated with dual-energy X-ray absorptiometry-measured bone mineral density, was compared with that in FEV1.0 or emphysematous lesions. Results: In the first CT data set, ABD4,7,10 was significantly correlated with age (ρ=–0.331; p=0.0006), body mass index (BMI; ρ=0.246; p=0.0136), St George’s Respiratory Questionnaire (SGRQ) activity score (ρ=–0.248; p=0.0115), eosinophil count (ρ=0.229; p=0.0198), and LAV% (ρ=–0.372; p=0.0001). However, ABD4,7,10 was not associated with FEV1.0. After adjustment for age, BMI, SGRQ activity score, and eosinophil count, no significant relationship was found between ABD4,7,10 and LAV%. Annual change in ABD4,7,10 was not associated with annual change in LAV% or FEV1.0. Conclusion: Progression of osteoporosis and that of COPD are not directly related or synchronized with each other

Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis

For effective clinical management of cystic fibrosis (CF) lung disease it is important to closely monitor the start and progression of lung damage. The aim of this study was to investigate the ability of high-resolution computed tomography (HRCT) scoring systems and pulmonary function tests (PFT) to detect changes in lung disease. CF children (n=48) had two H

Management of COPD:Is there a role for quantitative imaging?

While the recent development of quantitative imaging methods have led to their increased use in the diagnosis and management of many chronic diseases, medical imaging still plays a limited role in the management of chronic obstructive pulmonary disease (COPD). In this review we highlight three pulmonary imaging modalities: computed tomography (CT), magnetic resonance imaging (MRI) and optical coherence tomography (OCT) imaging and the COPD biomarkers that may be helpful for managing COPD patients. We discussed the current role imaging plays in COPD management as well as the potential role quantitative imaging will play by identifying imaging phenotypes to enable more effective COPD management and improved outcomes

Improvement of acid resistance of Zn-doped dentin by newly generated chemical bonds

Dental caries, the world's most prevalent infectious disease, is caused by the diffusion of hydroxyl ions into tooth structures. To prevent dental caries, the application of fluoride (F) and zinc (Zn) ions to teeth surfaces are potential effective measures. In this study, The ionic influence, especially the chemical bond of F and Zn, on the acid resistance of dentin were investigated by particle induced X-ray / gamma-ray emission, X-ray diffraction, X-ray photoelectron spectroscopy and X-ray absorption spectroscopy. The results showed Zn was distributed in the limited surface layer of dentin without altering its crystal structure. From the Zn K edge extended X-ray absorption fine structure, Zn incorporated into dentin was surrounded by oxygen and demonstrated four-fold coordination. The bond length and chemical state of Zn–O in Zn doped dentin suggested newly generated Zn–O covalent bond, which may improve acid resistance of dentin. This study showed that the atomic and molecular structures, such as the molecular distances and chemical state, influenced acid resistance of teeth, emphasizing the validity of chemical state analysis for understanding properties in biomaterials.Naito K., Kuwahara Y., Yamamoto H., et al. Improvement of acid resistance of Zn-doped dentin by newly generated chemical bonds. Materials and Design, 215, 110412. https://doi.org/10.1016/j.matdes.2022.110412

Estimation of lung growth using computed tomography

Anatomical studies suggest that normal lungs grow by rapid alveolar addition until about 2 yrs of age followed by a gradual increase in alveolar dimensions. The aim of this study was to examine the hypothesis that normal lung growth can be monitored by computed tomography (CT). Therefore, the gas volume per gram of lung tissue was estimated from measurements of lung density obtained from CT scans performed on children throughout the growth period. CT scans were performed on 17 males and 18 females, ranging in age from 15 days-17.6 yrs. CT-measured lung weight was correlated with predicted post mortem values and CT measured gas volume with predicted values of functional residual capacity. The median value for lung expansion was 1.86 mL x g(-1) at 15 days, decreased to 0.79 mL x g(-1) by 2 yrs and then increased steadily to 5.07 mL x g(-1) at 17 yrs. Computed tomography scans can be used to estimate lung weight, gas volume and expansion of normal lungs during the growth period. The increase in the lung expansion after the age of 2 yrs suggests progressive alveolar expansion with increasing lung volume

1-Year Results of the ZEPHYR Registry (Zilver PTX for the Femoral Artery and Proximal Popliteal Artery) Predictors of Restenosis

AbstractObjectivesThis study sought to assess the rate and predictors of 1-year restenosis after drug-eluting stent implantation for femoropopliteal (FP) lesions in patients with peripheral arterial disease.BackgroundZilver PTX, a paclitaxel-eluting stent for FP lesions, provides superior outcomes to angioplasty and bare-metal stents in clinical trials. However, its real-world outcomes and the associated features remain unclear.MethodsThis was a prospective multicenter study enrolling 831 FP lesions (797 limbs, 690 patients) treated by Zilver PTX implantation. The primary endpoint was 1-year restenosis. Secondary endpoints included major adverse limb event and stent thrombosis.ResultsMean lesion length was 17 ± 10 cm. One-year restenosis, major adverse limb event, and stent thrombosis rates were 37%, 22%, and 2%, respectively. The generalized linear mixed model showed that lesion length ≥16 cm assessed by angiography and distal external elastic membrane area ≤27 mm2 and minimum stent area ≤12 mm2 assessed by intravascular ultrasound were independent risk factors for restenosis. One-year restenosis rates were 15% in cases with none of these risk factors and 50% in those with ≥2 risk factors.ConclusionsThe current study demonstrated 1-year real-world outcomes after drug-eluting stent treatment for FP lesions, including challenging ones in clinical practice. Lesion length, external elastic membrane area, and minimum stent area were independent predictors for restenosis. (Zilver PTX for the Femoral Artery and Proximal Popliteal Artery—Prospective Multicenter Registry [ZEPHYR]; UMIN000008433