{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:59:41Z","timestamp":1755223181401,"version":"3.43.0"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R21 HL175750","R01 HL142042","5U01 HL089897","R01 HL112986"],"award-info":[{"award-number":["R21 HL175750","R01 HL142042","5U01 HL089897","R01 HL112986"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Respiratory function is impaired in chronic obstructive pulmonary disease (COPD). Automation of multi\u2010volume CT\u2010based measurements of different components of breathing\u2010related airway deformations will help understand multi\u2010pathway impairments in respiratory mechanics in COPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To develop and evaluate multi\u2010volume chest CT\u2010based automated measurements of breathing\u2010related radial and longitudinal expansion of individual airways between inspiratory and expiratory lung volumes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a method to compute breathing\u2010related airway deformation metrics and applied it to total lung capacity (TLC) and functional residual capacity (FRC) chest CT scans. The computational pipeline involves: (1) segmentation of airways; (2) skeletonization of airways; (3) labeling of anatomical airway segments at TLC and FRC; and (4) computation of radial and longitudinal expansion metrics of individual airways across lung volumes. Radial expansion (\u2206CSA) of an airway is computed as the percent change of its cross\u2010sectional area (CSA) between two lung volumes. Longitudinal expansion (\u2206L) of an airway is computed as the percent change in its airway path\u2010length from the carina between lung volumes. These measures are summarized at different airway anatomic generations. Agreement of automated measures with their manually derived values was examined in terms of concordance correlation coefficient (CCC) of automated measures with those derived using manual outlining. Intra\u2010class correlation coefficient (ICC) of automated measures from repeat CT scans (<jats:italic>n<\/jats:italic>\u00a0=\u00a037) was computed to assess repeatability. The method was also applied to a set of participants from the Genetic Epidemiology of COPD (COPDGene) Iowa cohort, distributed across COPD severity groups (<jats:italic>n<\/jats:italic>\u00a0=\u00a04 \u00d7 60).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The CCC values for the automated \u2206CSA measure with manually derived values were 0.930 at the trachea, 0.898 at primary bronchi, and greater than 0.95 at pre\u2010segmental and segmental airways; these CCC values were consistently greater than 0.95 for \u2206L at all airway generations. ICC values for repeatability of \u2206CSA were 0.974, 0.950, 0.943, and 0.901 at trachea, primary bronchi, pre\u2010segmental, and segmental airways, respectively; these ICC values for \u2206L were 0.973, 0.954, and 0.952 at primary bronchi, pre\u2010segmental, and segmental airways, respectively. \u2206CSA values were significantly reduced (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) with increasing COPD severity at each of primary bronchi, pre\u2010segmental, and segmental airways. Significantly lower \u2206L values were observed for moderate (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.042 at pre\u2010segmental and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.037 at segmental) and severe (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.019 at pre\u2010segmental and <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001 at segmental) COPD groups as compared to the preserved lung function group. Body mass index (BMI) and smoking status were found to significantly associate with \u2206CSA at segmental airways (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.17 and \u22120.19, respectively; significance threshold\u00a0=\u00a00.13), while age and sex were significantly associated with \u2206L (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.21 and \u22120.17, respectively); COPD severity was significantly associated with both \u2206CSA and \u2206L (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.35 and \u22120.22, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our CT\u2010based automated measures of breathing\u2010related radial and longitudinal expansion of airways are repeatable and in agreement with manually derived values. Automation of different airway mechanical biomarkers and their observed significant associations with age, sex, BMI, smoking, and COPD severity establish an effective tool to investigate multi\u2010pathway impairments of respiratory mechanics in COPD and other lung diseases.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17592","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T08:34:42Z","timestamp":1734683682000},"page":"2316-2329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Automated CT\u2010based measurements of radial and longitudinal expansion of airways due to breathing\u2010related lung volume change"],"prefix":"10.1002","volume":"52","author":[{"given":"Syed Ahmed","family":"Nadeem","sequence":"first","affiliation":[{"name":"Department of Radiology, Carver College of Medicine University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro P.","family":"Comellas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Carver College of Medicine University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kung\u2010Sik","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, College of Liberal Arts and Sciences University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric A.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of Radiology, Carver College of Medicine University of Iowa  Iowa City Iowa USA"},{"name":"Department of Internal Medicine, Carver College of Medicine University of Iowa  Iowa City Iowa USA"},{"name":"Department of Biomedical Engineering, College of Engineering University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean B.","family":"Fain","sequence":"additional","affiliation":[{"name":"Department of Radiology, Carver College of Medicine University of Iowa  Iowa City Iowa USA"},{"name":"Department of Biomedical Engineering, College of Engineering University of Iowa  Iowa City Iowa USA"},{"name":"Department of Electrical and Computer Engineering, College of Engineering University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Punam K.","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Radiology, Carver College of Medicine University of Iowa  Iowa City Iowa USA"},{"name":"Department of Electrical and Computer Engineering, College of Engineering University of Iowa  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)61380\u20104"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201501\u20100148OC"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200801-059OC"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.163.5.7976869"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00128008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0050OC"},{"key":"e_1_2_7_8_1","first-page":"535","volume-title":"Quantifying the Lung at Risk in Chronic Obstructive Pulmonary Disease. Does Emphysema Beget Emphysema?","author":"Parr DG","year":"2017"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196806202782501"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00025.2015"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00010002"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1984.129.1.33"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.39.4.264"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00141607"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1465\u20109921\u20109\u201012"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200502\u2010262OC"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2211002"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/15412550903499522"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl\u20102013\u2010203897"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00111707"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2012.665520"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.3.9907120"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08\u20102858"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-008-9071-0"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.10102"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201807\u20101351SO"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201704\u20100692OC"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl\u20102014\u2010205160"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.1919"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010018\u20100888\u20107"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201910\u20101948LE"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.12.1004"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.2546004"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2020.3029013"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.15326\/jcopdf.1.1.2014.0111#sthash.nxTDeRi7.dpuf"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1148\/ryct.210311"},{"key":"e_1_2_7_37_1","first-page":"424","volume-title":"3D U\u2010Net: Learning Dense Volumetric Segmentation from Sparse Annotation","author":"\u00c7i\u00e7ek \u00d6","year":"2016"},{"key":"e_1_2_7_38_1","first-page":"234","volume-title":"U\u2010Net: Convolutional Networks for Biomedical Image Segmentation","author":"Ronneberger O","year":"2015"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1109\/JPROC.2020.3004555"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2014.2366792"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.patrec.2015.04.002"},{"key":"e_1_2_7_42_1","first-page":"185","volume-title":"Segmental Anatomy of the Lungs. A Study of the Patterns of the Segmental Bronchi and Related Pulmonary Vessels","author":"Boyden EA","year":"1955"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1109\/ISBI45749.2020.9098558"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2012.05.001"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2006.01.015"},{"volume-title":"Quantitative Human Physiology: An Introduction","year":"2017","author":"Feher JJ","key":"e_1_2_7_46_1"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.2.370"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S51152"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1419"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.17592","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T12:28:37Z","timestamp":1754915317000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.17592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,20]]},"references-count":49,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/mp.17592"],"URL":"https:\/\/doi.org\/10.1002\/mp.17592","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"type":"print","value":"0094-2405"},{"type":"electronic","value":"2473-4209"}],"subject":[],"published":{"date-parts":[[2024,12,20]]},"assertion":[{"value":"2024-05-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}