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Patterns of low attenuation clusters indicating emphysema and functional small airway disease (fSAD) on paired CT, which may provide additional insights to the target selection of the segmental or subsegmental lobe of the treatments, require further investigation. The low attenuation clusters (LACS) were segmented to identify the scalar and spatial distribution of the lung destructions, in terms of 10 fractions scales of low attenuation density (LAD) located in upper lobes and lower lobes. The LACs of functional small airway disease (fSAD) were delineated by applying the technique of parametric response map (PRM) on the co-registered CT image data. Both emphysematous LACs of inspiratory CT and fSAD LACs on expiratory CT were used to derive the coefficients of the predictive model for estimating the airflow limitation. The voxel-wise severity is then predicted using the regional LACs on the co-registered CT to indicate the functional localization, namely, the bullous parametric response map (BPRM). A total of 100 subjects, 88 patients with mild to very severe COPD and 12 control participants with normal lung functions (FEV<jats:sub>1<\/jats:sub>\/FVC %\u2009&gt;\u200970%), were evaluated. Pearson\u2019s correlations between FEV<jats:sub>1<\/jats:sub>\/FVC% and LAV%<jats:sub>HU-950<\/jats:sub> of severe emphysema are\u2009\u2212\u20090.55 comparing to\u2009\u2212\u20090.67 and\u2009\u2212\u20090.62 of LAV%<jats:sub>HU-856<\/jats:sub> of air-trapping and LAV%<jats:sub>fSAD<\/jats:sub> respectively. Pearson\u2019s correlation between FEV<jats:sub>1<\/jats:sub>\/FVC% and FEV<jats:sub>1<\/jats:sub>\/FVC% predicted by the proposed model using LAD% of HU-950 and fSAD on BPRM is 0.82 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The result of the Bullous Parametric Response Map (BPRM) is capable of identifying the less functional area of the lung, where the BLVR treatment is aimed at removing from a hyperinflated area of emphysematous regions.<\/jats:p>","DOI":"10.1007\/s10278-021-00561-z","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T18:30:36Z","timestamp":1641925836000},"page":"115-126","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bullous Parametric Response Map for Functional Localization of COPD"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3471-9198","authenticated-orcid":false,"given":"Kuo-Lung","family":"Lor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeun-Chung","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong-Jen","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Yi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Ming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"On behalf of the TCORE consortium","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"issue":"4","key":"561_CR1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1159\/000479379","volume":"94","author":"FJ Herth","year":"2017","unstructured":"Herth, F.J., et al., Endoscopic lung volume reduction: an expert panel recommendation-update 2017. 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International journal of chronic obstructive pulmonary disease, 2017. 12: p. 2043.","journal-title":"International journal of chronic obstructive pulmonary disease"}],"container-title":["Journal of Digital Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10278-021-00561-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10278-021-00561-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10278-021-00561-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T17:40:22Z","timestamp":1647279622000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10278-021-00561-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,11]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["561"],"URL":"https:\/\/doi.org\/10.1007\/s10278-021-00561-z","relation":{},"ISSN":["0897-1889","1618-727X"],"issn-type":[{"type":"print","value":"0897-1889"},{"type":"electronic","value":"1618-727X"}],"subject":[],"published":{"date-parts":[[2022,1,11]]},"assertion":[{"value":"1 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study was based on the CT dataset and PFT measurements obtained in the clinical routine and approved by the institutional review board (IRB) of the National Taiwan University Hospital (NTUH) and Cardinal Tien Hospital (CTH). The need for individual informed consent was waived by the Institutional Review Board because of the retrospective nature of the study, and the medical data accessed were anonymized and de-identified prior to analysis. The volumetric CT scans were taken at full inspiration and full expiration for each subject.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"CT image dataset and the corresponding lung function dataset were extracted from projects of Taiwan Clinical Trial Consortium for Respiratory Diseases (TCORE), which is organized by Chong-Jen Yu, MD, Ph.D., (NTUH, Director of Coordinating Center and Core PI of Committee). TCORE was supported by grants from National Science Council (NSC 101\u20132325-B-002\u2013064, 102\u20132325-B-002\u2013087, 103\u20132325-B-002\u2013027, 104\u20132325-B-002\u2013035, 105\u20132325-B-002\u2013030).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"The interpretation and conclusions contained in this study are those of the authors alone. A total of 88 subjects with symptoms of chronic obstructive pulmonary disease (GOLD stage 1\u2009~\u20094) and 12 normal subjects was included; 55 cases of NTUH, and 45 cases of CTH.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}