TY - JOUR T1 - Pulmonary Vascular Density: Comparison of Findings on CT Imaging with Histology JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00370-2019 SP - 1900370 AU - Farbod N. Rahaghi AU - Gemma Argemí AU - Pietro Nardelli AU - David Domínguez-Fandos AU - Pedro Arguis AU - Víctor I. Peinado AU - James C. Ross AU - Samuel Ash AU - Isaac de La Bruere AU - Carolyn E. Come AU - Alejandro A. Diaz AU - Marcelo Sánchez AU - George R. Washko AU - Joan Albert Barberà AU - Raúl San José Estépar Y1 - 2019/01/01 UR - http://erj.ersjournals.com/content/early/2019/05/08/13993003.00370-2019.abstract N2 - Background & Significance Exposure to cigarette smoke has been shown to lead to vascular remodelling. 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 histologic vascular and parenchymal changes.Methods A retrospective review of 80 patients having undergone lung resection identified patients with imaging appropriate for 3D vascular reconstruction (N=18) and a second group for 2D analysis (N=19). Measurement of the volume of the small vessels (3D) and the cross-sectional area of small vessels (<5 mm2 cross-section) were computed. Histologic 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 scan correlated with histological vascular cross-sectional area (Spearman R=0.50; p=0.04), a relationship which persisted even when adjusted for CT derived measure of emphysema in a regression model.Conclusions Loss of small vessel volume in CT imaging of smokers is associated with histologic loss of vascular cross sectional area. Imaging based quantification of pulmonary vasculature provides a non-invasive method to study the multi-scale effects of smoking on the pulmonary circulation.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Rahaghi has nothing to disclose.Conflict of interest: Dr. Argemi has nothing to disclose.Conflict of interest: Dr. Nardelli has nothing to disclose.Conflict of interest: Dr. Dominguez-Fandos has nothing to disclose.Conflict of interest: Dr. Arguis has nothing to disclose.Conflict of interest: Dr. Peinado has nothing to disclose.Conflict of interest: Dr. Ross reports grants from NIH, during the conduct of the study.Conflict of interest: Dr. Ash has nothing to disclose.Conflict of interest: Dr. de La Bruere has nothing to disclose.Conflict of interest: Dr. Come reports grants from NIH/NHLBI, during the conduct of the study.Conflict of interest: Dr. Diaz has nothing to disclose.Conflict of interest: Dr. Sanchez has nothing to disclose.Conflict of interest: Dr. Washko reports grants from NIH, grants and other from Boehringer Ingelheim, other from Genentech, other from Quantitative Imaging Solutions, other from PulmonX, other from Regeneron, other from ModoSpira, grants from BTG Interventional Medicine, grants and other from Janssen Pharmaceuticals, other from Toshiba, other from GlaxoSmithKline, outside the submitted work; and Dr. Washko's spouse works for Biogen which is focused on developing therapies for fibrotic lung disease.Conflict of interest: Dr. Barberà has nothing to disclose.Conflict of interest: Dr. San Jose Estepar reports grants from NHLBI, personal fees from Toshiba, personal fees from Boehringer Ingelheim, outside the submitted work; and he 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. ER -