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Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report.

Publication ,  Journal Article
Hsia, CCW; Bates, JHT; Driehuys, B; Fain, SB; Goldin, JG; Hoffman, EA; Hogg, JC; Levin, DL; Lynch, DA; Ochs, M; Parraga, G; Prisk, GK ...
Published in: Ann Am Thorac Soc
February 2023

Multiple thoracic imaging modalities have been developed to link structure to function in the diagnosis and monitoring of lung disease. Volumetric computed tomography (CT) renders three-dimensional maps of lung structures and may be combined with positron emission tomography (PET) to obtain dynamic physiological data. Magnetic resonance imaging (MRI) using ultrashort-echo time (UTE) sequences has improved signal detection from lung parenchyma; contrast agents are used to deduce airway function, ventilation-perfusion-diffusion, and mechanics. Proton MRI can measure regional ventilation-perfusion ratio. Quantitative imaging (QI)-derived endpoints have been developed to identify structure-function phenotypes, including air-blood-tissue volume partition, bronchovascular remodeling, emphysema, fibrosis, and textural patterns indicating architectural alteration. Coregistered landmarks on paired images obtained at different lung volumes are used to infer airway caliber, air trapping, gas and blood transport, compliance, and deformation. This document summarizes fundamental "good practice" stereological principles in QI study design and analysis; evaluates technical capabilities and limitations of common imaging modalities; and assesses major QI endpoints regarding underlying assumptions and limitations, ability to detect and stratify heterogeneous, overlapping pathophysiology, and monitor disease progression and therapeutic response, correlated with and complementary to, functional indices. The goal is to promote unbiased quantification and interpretation of in vivo imaging data, compare metrics obtained using different QI modalities to ensure accurate and reproducible metric derivation, and avoid misrepresentation of inferred physiological processes. The role of imaging-based computational modeling in advancing these goals is emphasized. Fundamental principles outlined herein are critical for all forms of QI irrespective of acquisition modality or disease entity.

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Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

February 2023

Volume

20

Issue

2

Start / End Page

161 / 195

Location

United States

Related Subject Headings

  • Respiration
  • Pulmonary Emphysema
  • Magnetic Resonance Imaging
  • Lung Diseases
  • Lung
  • Humans
  • Benchmarking
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Hsia, C. C. W., Bates, J. H. T., Driehuys, B., Fain, S. B., Goldin, J. G., Hoffman, E. A., … Hopkins, S. R. (2023). Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report. Ann Am Thorac Soc, 20(2), 161–195. https://doi.org/10.1513/AnnalsATS.202211-915ST
Hsia, Connie C. W., Jason H. T. Bates, Bastiaan Driehuys, Sean B. Fain, Jonathan G. Goldin, Eric A. Hoffman, James C. Hogg, et al. “Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report.Ann Am Thorac Soc 20, no. 2 (February 2023): 161–95. https://doi.org/10.1513/AnnalsATS.202211-915ST.
Hsia CCW, Bates JHT, Driehuys B, Fain SB, Goldin JG, Hoffman EA, et al. Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report. Ann Am Thorac Soc. 2023 Feb;20(2):161–95.
Hsia, Connie C. W., et al. “Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report.Ann Am Thorac Soc, vol. 20, no. 2, Feb. 2023, pp. 161–95. Pubmed, doi:10.1513/AnnalsATS.202211-915ST.
Hsia CCW, Bates JHT, Driehuys B, Fain SB, Goldin JG, Hoffman EA, Hogg JC, Levin DL, Lynch DA, Ochs M, Parraga G, Prisk GK, Smith BM, Tawhai M, Vidal Melo MF, Woods JC, Hopkins SR. Quantitative Imaging Metrics for the Assessment of Pulmonary Pathophysiology: An Official American Thoracic Society and Fleischner Society Joint Workshop Report. Ann Am Thorac Soc. 2023 Feb;20(2):161–195.

Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

February 2023

Volume

20

Issue

2

Start / End Page

161 / 195

Location

United States

Related Subject Headings

  • Respiration
  • Pulmonary Emphysema
  • Magnetic Resonance Imaging
  • Lung Diseases
  • Lung
  • Humans
  • Benchmarking
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology