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ORIGINAL RESEARCH article
Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1555230
This article is part of the Research TopicTranslating Biomechanics of the Human Airways for Classification, Diagnosis and Treatment of Pulmonary DiseasesView all articles
Longitudinal Study of COPD Phenotypes Using Integrated SPECT and qCT Imaging
Provisionally accepted- 1Emory University, Atlanta, United States
- 2The University of Iowa, Iowa City, Iowa, United States
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The aim of this research is to elucidate chronic obstructive pulmonary disease (COPD) progression by quantifying lung ventilation heterogeneities using single photon emission computed tomography (SPECT) images and establishing correlations with quantitative computed tomography (qCT) imaging-based metrics. This approach seeks to enhance our understanding of how structural and functional changes influence ventilation heterogeneity in COPD. Eight COPD subjects completed a longitudinal study with three visits, spaced about a year apart. CT scans were performed at each visit and qCT-based variables were derived to measure the structural and functional characteristics of the lungs, while the SPECT-based variables were used to quantify lung ventilation heterogeneity. The correlations between key qCT-based variables and SPECTbased variables were examined. The SPECT-based ventilation heterogeneity (CVTotal) showed strong correlations with the qCT-based functional small airway disease percentage (fSAD%Total) and emphysematous tissue percentage (Emph%Total) in the total lung, based on cross-sectional data.Over the two-year period, changes in SPECT-based hot spots (TCMax) exhibited strong negative correlations with changes in fSAD%Total, Emph%Total, and the average airway diameter in the left upper lobe, as well as a strong positive correlation with alternations in airflow distribution between the upper and lower lobes. In conclusion, this study found strong positive cross-sectional correlations between CVTotal and both fSAD% and Emph%, suggesting that these markers primarily reflect static disease severity at a single time point. In contrast, longitudinal correlations between changes in TCMax and other variables over two years may capture the dynamic process of hot spot formation, independent of disease severity. These findings suggest that changes in TCMax may serve as a more sensitive biomarker than changes in CVTotal for tracking the underlying mechanisms of COPD progression.
Keywords: CT, SPECT, COPD, Ventilation, Small airway disease
Received: 03 Jan 2025; Accepted: 14 Apr 2025.
Copyright: © 2025 Li, Zhang, Comellas, Hoffman, Graham and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ching-Long Lin, The University of Iowa, Iowa City, 52242, Iowa, United States
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