Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Breathe in, breathe out: New way of imaging lungs could improve COPD diagnosis and treatment

08.10.2012
CT scan technique developed at U-M can differentiate types of lung damage

A new approach to lung scanning could improve the diagnosis and treatment of a lung disease that affects approximately 24 million Americans and is the country's third-highest cause of death.

In a new paper published online in Nature Medicine, a team from the University of Michigan Medical School reports on a technique called parametric response mapping, or PRM. They used PRM to analyze computed tomography, or CT, scans of the lungs of patients with chronic obstructive pulmonary disease, known as COPD, who took part in the national COPDGene study funded by the National Heart, Lung and Blood Institute.

The researchers report that the PRM technique for analyzing CT scans allows them to better distinguish between early-stage damage to the small airways of the lungs, and more severe damage known as emphysema. They've also shown that the overall severity of a patient's disease, as measured with PRM, matches closely with the patient's performance on standard lung tests based on breathing ability.

"Essentially, with the PRM technique, we've been able to tell sub-types of COPD apart, distinguishing functional small airway disease or fSAD from emphysema and normal lung function," says Brian Ross, Ph.D., the Roger A. Berg Research Professor of radiology, professor of biological chemistry and senior author of the new paper. "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."

COPD limits a patient's breathing ability, causing shortness of breath, coughing, wheezing and reduced ability to exercise, walk and do other things. Over time, many COPD patients become disabled as their disease worsens. Most often associated with smoking, COPD can also result from long-term exposure to dust, and certain gases and chemicals.

"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," says Ella Kazerooni, M.D., M.S., FACS, a radiology professor who leads U-M's lung imaging program and is a member of the COPDGene trial.

Originally developed to show the response of brain tumors to treatment, the PRM technique allows researchers to identify COPD specific changes in three-dimensional lung regions over time.

Already, a U-M spinoff company, Imbio, has licensed U-M's patents on the PRM technique, and is developing the technology for use in early prediction of treatment response of brain tumors and other cancers. Now Imbio has begun developing PRM for COPD subtype diagnosis and tracking.

Ross and co-author Alnawaz Rehemtulla, Ph.D., the Ruth Tuttle Freeman Research Professor of Radiation Oncology, co-founded Imbio and act as scientific advisors to the company. They also co-direct the U-M Center for Molecular Imaging, which pursues a broad range of imaging research.

With the PRM technique, the researchers use powerful computer techniques to overlay the CT scan taken during a full inhalation with an image taken during a full exhalation. The overlaid, or registered, CT images share the same geometric space, so that the lung tissue in the inflated and deflated lungs aligns. The density of healthy lung tissue will change more between the two images than the density of diseased lung, allowing researchers to create a three-dimensional "map" of the patient's lungs.

PRM assign colors to each small 3-D area, called a voxel, according to the difference in signal changes within each of the areas between the two scans. Green means healthy, yellow means a reduced ability to push air out of the small sacs, and red means severely reduced ability.

PRM could take COPD sub-typing to the next level, say the authors of the new paper. "By distinguishing small airway abnormality from that involving the lung parenchyma, such as emphysema, PRM could help physicians personalize therapy for individual COPD patients – and select patients for clinical trials of new treatment options more precisely", says Fernando Martinez, M.D., M.S., an internal medicine professor who is also participated in the COPDGene trial.

"PRM can also help to track COPD progression or response to treatment over time," says lead author Craig Gabán, assistant professor of radiology. Although the current study mostly looked at a "snapshot" of CT scans taken a one time, it also includes data on two U-M COPD patients who were imaged over more than two years. More longitudinal data is needed to make sure that PRM works well for long-term tracking and studies are already underway.

While a simple breathing test called spirometry is still considered the best way to diagnose the disease, spirometry has limitations in its ability to distinguish between different types of lung damage that COPD patients experience.

"The PRM technique is a step forward in being able to better sub-classify patients with COPD so that targeted therapies can be developed," says co-author MeiLan Han, M.D. M.S., a U-M pulmonologist and COPDGene investigator. "This is one of many important studies that is being made possible by the data being collected through NHLBI funded COPD initiatives."

The research team also included Jennifer Boes, Komal Chughtai, Charles R. Meyer, and Timothy D. Johnson, and Stefanie Galbán. Johnson has a joint appointment in the Department of Biostatistics in the U-M School of Public Health.

Volunteers are needed for the COPDGene trial at U-M. For more information, visit http://umhealth.me/COPDgene or contact 734-764-7388 or debthomp@umich.edu.

Funding for the study was provided by the National Institutes of Health, including research grant P50CA93990 from the National Cancer Institute and COPDGene grants from the National Heart, Lung and Blood Institute U01HL089897 and U01HL089856 as well as training grant T32EB005172 from the National Institute of Biomedical Imaging and Bioengineering.

Craig Galban, Rehemtulla and Ross have a financial interest in the underlying technology which has been licensed from the University of Michigan to Imbio, LLC. Ross and Rehemtulla have a financial interest in the company itself.

Reference: Nature Medicine, advance online publication, doi:10.1038/nm.2971

Kara Gavin | EurekAlert!
Further information:
http://www.umich.edu

More articles from Health and Medicine:

nachricht Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Powerful IT security for the car of the future – research alliance develops new approaches

The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.

Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

In focus: Climate adapted plants

25.05.2018 | Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

 
Latest News

In focus: Climate adapted plants

25.05.2018 | Event News

Flow probes from the 3D printer

25.05.2018 | Machine Engineering

Less is more? Gene switch for healthy aging found

25.05.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>