Abstract
Background Exposure to cigarette smoke has been shown to lead to vascular remodelling. Computed tomography (CT) imaging measures of vascular pruning have been associated with pulmonary vascular disease, an important morbidity associated with smoking. In this study we compare CT-based measures of distal vessel loss to histological vascular and parenchymal changes.
Methods A retrospective review of 80 patients who had undergone lung resection identified patients with imaging appropriate for three-dimensional (3D) vascular reconstruction (n=18) and a second group for two-dimensional (2D) analysis (n=19). Measurements of the volume of the small vessels (3D) and the cross-sectional area of the small vessels (<5 mm2 cross-section) were computed. Histological measures of cross-sectional area of the vasculature and loss of alveoli septa were obtained for all subjects.
Results The 2D cross-sectional area of the vasculature on CT imaging was associated with the histological vascular cross-sectional area (r=0.69; p=0.001). The arterial small vessel volume assessed by CT correlated with the histological vascular cross-sectional area (r=0.50; p=0.04), a relationship that persisted even when adjusted for CT-derived measures of emphysema in a regression model.
Conclusions Loss of small vessel volume in CT imaging of smokers is associated with histological loss of vascular cross-sectional area. Imaging-based quantification of pulmonary vasculature provides a noninvasive method to study the multiscale effects of smoking on the pulmonary circulation.
Abstract
Vascular density on CT imaging correlates with vascular density in histology in smokers. Imaging-based quantification of pulmonary vasculature provides a noninvasive method to study the multiscale effects of smoking on the pulmonary circulation. http://bit.ly/2WprQe8
Footnotes
This article has supplementary material available from erj.ersjournals.com
Conflict of interest: F.N. Rahaghi has nothing to disclose.
Conflict of interest: G. Argemi has nothing to disclose.
Conflict of interest: P. Nardelli has nothing to disclose.
Conflict of interest: D. Dominguez-Fandos has nothing to disclose.
Conflict of interest: P. Arguis has nothing to disclose.
Conflict of interest: V.I. Peinado has nothing to disclose.
Conflict of interest: J.C. Ross reports grants from NIH, during the conduct of the study.
Conflict of interest: S.Y. Ash has nothing to disclose.
Conflict of interest: I. de La Bruere has nothing to disclose.
Conflict of interest: C.E. Come reports grants from NIH/NHLBI (K23HL114735), during the conduct of the study.
Conflict of interest: A.A. Diaz has nothing to disclose.
Conflict of interest: M. Sanchez has nothing to disclose.
Conflict of interest: G.R. Washko reports grants from NIH and BTG Interventional Medicine, grants from and has provided consultancy and participated on advisory boards for Boehringer Ingelheim, has provided consultancy for Genentech, Regeneron and GlaxoSmithKline, has provided consultancy and participated on data and safety monitoring boards for PulmonX, participated on advisory boards for ModoSpira and Toshiba, grants from and has provided consultancy for Janssen Pharmaceuticals, outside the submitted work; and is a founder and co-owner of Quantitative Imaging Solutions, which is a company that provides image-based consulting and develops software to enable data sharing; in addition, G.R. Washko's spouse works for Biogen, which is focused on developing therapies for fibrotic lung disease.
Conflict of interest: J.A. Barberà has nothing to disclose.
Conflict of interest: R. San Jose Estepar reports grants from NHLBI, personal fees from Toshiba and Boehringer Ingelheim, outside the submitted work; and is also a founder and co-owner of Quantitative Imaging Solutions, which is a company that provides image-based consulting and develops software to enable data sharing.
Support statement: Authors in this study were supported by NHLBI grants 5T32HL007633, K23HL136905 (F.N. Rahaghi), 1R01HL116931 and 1R01HL116473 (R. San Jose Estepar and G.R. Washko); and grants PS0900536 from Institute of Health Carlos III (ISCIII) (J.A. Barberà) and 2017SGR617 from Agència de Gestió d'Ajuts Universitaris i de Recerca (J.A. Barberà), and an educational grant from Menarini, Spain. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received August 3, 2018.
- Accepted May 11, 2018.
- Copyright ©ERS 2019
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