1
|
Hiremath A, Viswanathan VS, Bera K, Shiradkar R, Yuan L, Armitage K, Gilkeson R, Ji M, Fu P, Gupta A, Lu C, Madabhushi A. Deep learning reveals lung shape differences on baseline chest CT between mild and severe COVID-19: A multi-site retrospective study. Comput Biol Med 2024; 177:108643. [PMID: 38815485 PMCID: PMC11188049 DOI: 10.1016/j.compbiomed.2024.108643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/10/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024]
Abstract
Severe COVID-19 can lead to extensive lung disease causing lung architectural distortion. In this study we employed machine learning and statistical atlas-based approaches to explore possible changes in lung shape among COVID-19 patients and evaluated whether the extent of these changes was associated with COVID-19 severity. On a large multi-institutional dataset (N = 3443), three different populations were defined; a) healthy (no COVID-19), b) mild COVID-19 (no ventilator required), c) severe COVID-19 (ventilator required), and the presence of lung shape differences between them were explored using baseline chest CT. Significant lung shape differences were observed along mediastinal surfaces of the lungs across all severity of COVID-19 disease. Additionally, differences were seen on basal surfaces of the lung when compared between healthy and severe COVID-19 patients. Finally, an AI model (a 3D residual convolutional network) characterizing these shape differences coupled with lung infiltrates (ground-glass opacities and consolidation regions) was found to be associated with COVID-19 severity.
Collapse
Affiliation(s)
- Amogh Hiremath
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH, USA; Picture Health, Cleveland, OH, USA
| | | | - Kaustav Bera
- University Hospitals Cleveland Medical Center, Department of Radiology, Cleveland, OH, USA
| | | | - Lei Yuan
- Renmin Hospital of Wuhan University, Department of Information Center, Wuhan, Hubei, China
| | - Keith Armitage
- University Hospitals Cleveland Medical Center, Department of Infectious Diseases, Cleveland, OH, USA
| | - Robert Gilkeson
- University Hospitals Cleveland Medical Center, Department of Radiology, Cleveland, OH, USA
| | - Mengyao Ji
- Renmin Hospital of Wuhan University, Department of Gastroenterology, Wuhan, Hubei, China
| | - Pingfu Fu
- Case Western Reserve University, Department of Population and Quantitative Health Sciences, Cleveland, OH, USA
| | - Amit Gupta
- University Hospitals Cleveland Medical Center, Department of Radiology, Cleveland, OH, USA
| | - Cheng Lu
- Guangdong Provincial People's Hospital, Department of Radiology, Guangdong Academy of Medical Sciences, Guangzhou, China; Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Academy of Medical Sciences, Guangzhou, China; Guangdong Provincial People's Hospital, Medical Research Center, Guangdong Academy of Medical Sciences, China
| | - Anant Madabhushi
- Georgia Institute of Technology and Emory University, Radiology and Imaging Sciences, Biomedical Informatics (BMI) and Pathology, GA, USA; Atlanta Veterans Administration Medical Center, GA, USA.
| |
Collapse
|
2
|
John J, Clark AR, Kumar H, Burrowes KS, Vandal AC, Wilsher ML, Milne DG, Bartholmai BJ, Levin DL, Karwoski R, Tawhai MH. Evaluating Tissue Heterogeneity in the Radiologically Normal-Appearing Tissue in IPF Compared to Healthy Controls. Acad Radiol 2024; 31:1676-1685. [PMID: 37758587 DOI: 10.1016/j.acra.2023.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/27/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
RATIONALE AND OBJECTIVES Idiopathic Pulmonary Fibrosis (IPF) is a progressive interstitial lung disease characterised by heterogeneously distributed fibrotic lesions. The inter- and intra-patient heterogeneity of the disease has meant that useful biomarkers of severity and progression have been elusive. Previous quantitative computed tomography (CT) based studies have focussed on characterising the pathological tissue. However, we hypothesised that the remaining lung tissue, which appears radiologically normal, may show important differences from controls in tissue characteristics. MATERIALS AND METHODS Quantitative metrics were derived from CT scans in IPF patients (N = 20) and healthy controls with a similar age (N = 59). An automated quantitative software (CALIPER, Computer-Aided Lung Informatics for Pathology Evaluation and Rating) was used to classify tissue as normal-appearing, fibrosis, or low attenuation area. Densitometry metrics were calculated for all lung tissue and for only the normal-appearing tissue. Heterogeneity of lung tissue density was quantified as coefficient of variation and by quadtree. Associations between measured lung function and quantitative metrics were assessed and compared between the two cohorts. RESULTS All metrics were significantly different between controls and IPF (p < 0.05), including when only the normal tissue was evaluated (p < 0.04). Density in the normal tissue was 14% higher in the IPF participants than controls (p < 0.001). The normal-appearing tissue in IPF had heterogeneity metrics that exhibited significant positive relationships with the percent predicted diffusion capacity for carbon monoxide. CONCLUSION We provide quantitative assessment of IPF lung tissue characteristics compared to a healthy control group of similar age. Tissue that appears visually normal in IPF exhibits subtle but quantifiable differences that are associated with lung function and gas exchange.
Collapse
Affiliation(s)
- Joyce John
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand (J.J., A.R.C., H.K., K.S.B., M.H.T.)
| | - Alys R Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand (J.J., A.R.C., H.K., K.S.B., M.H.T.)
| | - Haribalan Kumar
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand (J.J., A.R.C., H.K., K.S.B., M.H.T.)
| | - Kelly S Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand (J.J., A.R.C., H.K., K.S.B., M.H.T.)
| | - Alain C Vandal
- Department of Statistics, University of Auckland, Auckland, New Zealand (A.C.V.)
| | - Margaret L Wilsher
- Respiratory Services, Auckland City Hospital, Auckland, New Zealand (M.L.W.)
| | - David G Milne
- Radiology, Auckland City Hospital, Auckland, New Zealand (D.G.M.)
| | | | - David L Levin
- Radiology, Mayo Clinic, Rochester, Minnesota (B.J.B., D.L.L., R.K.)
| | - Ronald Karwoski
- Radiology, Mayo Clinic, Rochester, Minnesota (B.J.B., D.L.L., R.K.)
| | - Merryn H Tawhai
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand (J.J., A.R.C., H.K., K.S.B., M.H.T.).
| |
Collapse
|
3
|
Williams J, Ahlqvist H, Cunningham A, Kirby A, Katz I, Fleming J, Conway J, Cunningham S, Ozel A, Wolfram U. Validated respiratory drug deposition predictions from 2D and 3D medical images with statistical shape models and convolutional neural networks. PLoS One 2024; 19:e0297437. [PMID: 38277381 PMCID: PMC10817191 DOI: 10.1371/journal.pone.0297437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/04/2024] [Indexed: 01/28/2024] Open
Abstract
For the one billion sufferers of respiratory disease, managing their disease with inhalers crucially influences their quality of life. Generic treatment plans could be improved with the aid of computational models that account for patient-specific features such as breathing pattern, lung pathology and morphology. Therefore, we aim to develop and validate an automated computational framework for patient-specific deposition modelling. To that end, an image processing approach is proposed that could produce 3D patient respiratory geometries from 2D chest X-rays and 3D CT images. We evaluated the airway and lung morphology produced by our image processing framework, and assessed deposition compared to in vivo data. The 2D-to-3D image processing reproduces airway diameter to 9% median error compared to ground truth segmentations, but is sensitive to outliers of up to 33% due to lung outline noise. Predicted regional deposition gave 5% median error compared to in vivo measurements. The proposed framework is capable of providing patient-specific deposition measurements for varying treatments, to determine which treatment would best satisfy the needs imposed by each patient (such as disease and lung/airway morphology). Integration of patient-specific modelling into clinical practice as an additional decision-making tool could optimise treatment plans and lower the burden of respiratory diseases.
Collapse
Affiliation(s)
- Josh Williams
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom
- Hartree Centre, STFC Daresbury Laboratory, Daresbury, United Kingdom
| | - Haavard Ahlqvist
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom
| | - Alexander Cunningham
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom
| | - Andrew Kirby
- Royal Hospital for Children and Young People, NHS Lothian, Edinburgh, United Kingdom
| | | | - John Fleming
- National Institute of Health Research Biomedical Research Centre in Respiratory Disease, Southampton, United Kingdom
- Department of Medical Physics and Bioengineering, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Joy Conway
- National Institute of Health Research Biomedical Research Centre in Respiratory Disease, Southampton, United Kingdom
- Respiratory Sciences, Centre for Health and Life Sciences, Brunel University, London, United Kingdom
| | - Steve Cunningham
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Ali Ozel
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom
| | - Uwe Wolfram
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, United Kingdom
- Institute for Material Science and Engineering, TU Clausthal, Clausthal-Zellerfeld, Germany
| |
Collapse
|
4
|
John J, Clark AR, Kumar H, Vandal AC, Burrowes KS, Wilsher ML, Milne DG, Bartholmai B, Levin DL, Karwoski R, Tawhai MH. Pulmonary vessel volume in idiopathic pulmonary fibrosis compared with healthy controls aged > 50 years. Sci Rep 2023; 13:4422. [PMID: 36932117 PMCID: PMC10023743 DOI: 10.1038/s41598-023-31470-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is characterised by progressive fibrosing interstitial pneumonia with an associated irreversible decline in lung function and quality of life. IPF prevalence increases with age, appearing most frequently in patients aged > 50 years. Pulmonary vessel-like volume (PVV) has been found to be an independent predictor of mortality in IPF and other interstitial lung diseases, however its estimation can be impacted by artefacts associated with image segmentation methods and can be confounded by adjacent fibrosis. This study compares PVV in IPF patients (N = 21) with PVV from a healthy cohort aged > 50 years (N = 59). The analysis includes a connected graph-based approach that aims to minimise artefacts contributing to calculation of PVV. We show that despite a relatively low extent of fibrosis in the IPF cohort (20% of the lung volume), PVV is 2-3 times higher than in controls. This suggests that a standardised method to calculate PVV that accounts for tree connectivity could provide a promising tool to provide early diagnostic or prognostic information in IPF patients and other interstitial lung disease.
Collapse
Affiliation(s)
- Joyce John
- Auckland Bioengineering Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Alys R Clark
- Auckland Bioengineering Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Haribalan Kumar
- Auckland Bioengineering Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Alain C Vandal
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Kelly S Burrowes
- Auckland Bioengineering Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | | | - David G Milne
- Radiology, Auckland City Hospital, Auckland, New Zealand
| | | | | | | | - Merryn H Tawhai
- Auckland Bioengineering Institute, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
| |
Collapse
|
5
|
Ashworth ET, Burrowes KS, Clark AR, Ebrahimi BSS, Tawhai MH. An in silico approach to understanding the interaction between cardiovascular and pulmonary lymphatic dysfunction. Am J Physiol Heart Circ Physiol 2023; 324:H318-H329. [PMID: 36607796 DOI: 10.1152/ajpheart.00591.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The lung is extremely sensitive to interstitial fluid balance, yet the role of pulmonary lymphatics in lung fluid homeostasis and its interaction with cardiovascular pressures is poorly understood. In health, there is a fine balance between fluid extravasated from the pulmonary capillaries into the interstitium and the return of fluid to the circulation via the lymphatic vessels. This balance is maintained by an extremely interdependent system governed by pressures in the fluids (air and blood) and tissue (interstitium), lung motion during breathing, and the permeability of the tissues. Chronic elevation in left atrial pressure (LAP) due to left heart disease increases the capillary blood pressure. The consequent fluid accumulation in the delicate lung tissue increases its weight, decreases its compliance, and impairs gas exchange. This interdependent system is difficult, if not impossible, to study experimentally. Computational modeling provides a unique perspective to analyze fluid movement in the cardiopulmonary vasculature in health and disease. We have developed an initial in silico model of pulmonary lymphatic function using an anatomically structured model to represent ventilation and perfusion and underlying biophysical laws governing fluid transfer at the interstitium. This novel model was tested against increased LAP and noncardiogenic effects (increased permeability). The model returned physiologically reasonable values for all applications, predicting pulmonary edema when LAP reached 25 mmHg and with increased permeability.NEW & NOTEWORTHY This model presents a novel approach to understanding the interaction between cardiac dysfunction and pulmonary lymphatic function, using anatomically structured models and biophysical equations to estimate regional variation in fluid transport from blood to interstitial and lymphatic flux. This fluid transport model brings together advanced models of ventilation, perfusion, and lung mechanics to produce a detailed model of fluid transport in health and various altered pathological conditions.
Collapse
Affiliation(s)
- E T Ashworth
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - K S Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - A R Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | - M H Tawhai
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| |
Collapse
|
6
|
Darquenne C, Borojeni AA, Colebank MJ, Forest MG, Madas BG, Tawhai M, Jiang Y. Aerosol Transport Modeling: The Key Link Between Lung Infections of Individuals and Populations. Front Physiol 2022; 13:923945. [PMID: 35795643 PMCID: PMC9251577 DOI: 10.3389/fphys.2022.923945] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/24/2022] [Indexed: 12/18/2022] Open
Abstract
The recent COVID-19 pandemic has propelled the field of aerosol science to the forefront, particularly the central role of virus-laden respiratory droplets and aerosols. The pandemic has also highlighted the critical need, and value for, an information bridge between epidemiological models (that inform policymakers to develop public health responses) and within-host models (that inform the public and health care providers how individuals develop respiratory infections). Here, we review existing data and models of generation of respiratory droplets and aerosols, their exhalation and inhalation, and the fate of infectious droplet transport and deposition throughout the respiratory tract. We then articulate how aerosol transport modeling can serve as a bridge between and guide calibration of within-host and epidemiological models, forming a comprehensive tool to formulate and test hypotheses about respiratory tract exposure and infection within and between individuals.
Collapse
Affiliation(s)
- Chantal Darquenne
- Department of Medicine, University of California, San Diego, San Diego, CA, United States
- *Correspondence: Chantal Darquenne,
| | - Azadeh A.T. Borojeni
- Department of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Mitchel J. Colebank
- Edwards Lifesciences Foundation Cardiovascular Innovation and Research Center and Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States
| | - M. Gregory Forest
- Departments of Mathematics, Applied Physical Sciences, and Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Balázs G. Madas
- Environmental Physics Department, Centre for Energy Research, Budapest, Hungary
| | - Merryn Tawhai
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Yi Jiang
- Department of Mathematics and Statistics, Georgia State University, Atlanta, GA, United States
| |
Collapse
|
7
|
Hoffman EA. Origins of and lessons from quantitative functional X-ray computed tomography of the lung. Br J Radiol 2022; 95:20211364. [PMID: 35193364 PMCID: PMC9153696 DOI: 10.1259/bjr.20211364] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/20/2022] [Accepted: 01/27/2022] [Indexed: 12/16/2022] Open
Abstract
Functional CT of the lung has emerged from quantitative CT (qCT). Structural details extracted at multiple lung volumes offer indices of function. Additionally, single volumetric images, if acquired at standardized lung volumes and body posture, can be used to model function by employing such engineering techniques as computational fluid dynamics. With the emergence of multispectral CT imaging including dual energy from energy integrating CT scanners and multienergy binning using the newly released photon counting CT technology, function is tagged via use of contrast agents. Lung disease phenotypes have previously been lumped together by the limitations of spirometry and plethysmography. QCT and its functional embodiment have been imbedded into studies seeking to characterize chronic obstructive pulmonary disease, severe asthma, interstitial lung disease and more. Reductions in radiation dose by an order of magnitude or more have been achieved. At the same time, we have seen significant increases in spatial and density resolution along with methodologic validations of extracted metrics. Together, these have allowed attention to turn towards more mild forms of disease and younger populations. In early applications, clinical CT offered anatomic details of the lung. Functional CT offers regional measures of lung mechanics, the assessment of functional small airways disease, as well as regional ventilation-perfusion matching (V/Q) and more. This paper will focus on the use of quantitative/functional CT for the non-invasive exploration of dynamic three-dimensional functioning of the breathing lung and beating heart within the unique negative pressure intrathoracic environment of the closed chest.
Collapse
Affiliation(s)
- Eric A Hoffman
- Departments of Radiology, Internal Medicine and Biomedical Engineering University of Iowa, Iowa, United States
| |
Collapse
|
8
|
Ebrahimi BS, Kumar H, Tawhai MH, Burrowes KS, Hoffman EA, Clark AR. Simulating Multi-Scale Pulmonary Vascular Function by Coupling Computational Fluid Dynamics With an Anatomic Network Model. FRONTIERS IN NETWORK PHYSIOLOGY 2022; 2:867551. [PMID: 36926101 PMCID: PMC10012968 DOI: 10.3389/fnetp.2022.867551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022]
Abstract
The function of the pulmonary circulation is truly multi-scale, with blood transported through vessels from centimeter to micron scale. There are scale-dependent mechanisms that govern the flow in the pulmonary vascular system. However, very few computational models of pulmonary hemodynamics capture the physics of pulmonary perfusion across the spatial scales of functional importance in the lung. Here we present a multi-scale model that incorporates the 3-dimensional (3D) complexities of pulmonary blood flow in the major vessels, coupled to an anatomically-based vascular network model incorporating the multiple contributing factors to capillary perfusion, including gravity. Using the model we demonstrate how we can predict the impact of vascular remodeling and occlusion on both macro-scale functional drivers (flow distribution between lungs, and wall shear stress) and micro-scale contributors to gas exchange. The model predicts interactions between 3D and 1D models that lead to a redistribution of blood between postures, both on a macro- and a micro-scale. This allows us to estimate the effect of posture on left and right pulmonary artery wall shear stress, with predictions varying by 0.75-1.35 dyne/cm2 between postures.
Collapse
Affiliation(s)
| | - Haribalan Kumar
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Merryn H Tawhai
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Kelly S Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Alys R Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| |
Collapse
|
9
|
Vindin HJ, Oliver BG, Weiss AS. Elastin in healthy and diseased lung. Curr Opin Biotechnol 2021; 74:15-20. [PMID: 34781101 DOI: 10.1016/j.copbio.2021.10.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 01/05/2023]
Abstract
Elastic fibers are an essential part of the pulmonary extracellular matrix (ECM). Intact elastin is required for normal function and its damage contributes profoundly to the etiology and pathology of lung disease. This highlights the need for novel lung-specific imaging methodology that enables high-resolution 3D visualization of the ECM. We consider elastin's involvement in chronic respiratory disease and examine recent methods for imaging and modeling of the lung in the context of advances in lung tissue engineering for research and clinical application.
Collapse
Affiliation(s)
- Howard J Vindin
- Charles Perkins Centre, The University of Sydney, Sydney 2006, NSW, Australia; School of Life and Environmental Sciences, The University of Sydney, 2006 Sydney, NSW, Australia; The Woolcock Institute, The University of Sydney, Sydney 2006, NSW, Australia
| | - Brian Gg Oliver
- The Woolcock Institute, The University of Sydney, Sydney 2006, NSW, Australia
| | - Anthony S Weiss
- Charles Perkins Centre, The University of Sydney, Sydney 2006, NSW, Australia; School of Life and Environmental Sciences, The University of Sydney, 2006 Sydney, NSW, Australia; Sydney Nano Institute, The University of Sydney, 2006 Sydney, NSW, Australia.
| |
Collapse
|
10
|
Ebrahimi BS, Tawhai MH, Kumar H, Burrowes KS, Hoffman EA, Wilsher ML, Milne D, Clark AR. A computational model of contributors to pulmonary hypertensive disease: impacts of whole lung and focal disease distributions. Pulm Circ 2021; 11:20458940211056527. [PMID: 34820115 PMCID: PMC8607494 DOI: 10.1177/20458940211056527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
Pulmonary hypertension has multiple etiologies and so can be difficult to diagnose, prognose, and treat. Diagnosis is typically made via invasive hemodynamic measurements in the main pulmonary artery and is based on observed elevation of mean pulmonary artery pressure. This static mean pressure enables diagnosis, but does not easily allow assessment of the severity of pulmonary hypertension, nor the etiology of the disease, which may impact treatment. Assessment of the dynamic properties of pressure and flow data obtained from catheterization potentially allows more meaningful assessment of the strain on the right heart and may help to distinguish between disease phenotypes. However, mechanistic understanding of how the distribution of disease in the lung leading to pulmonary hypertension impacts the dynamics of blood flow in the main pulmonary artery and/or the pulmonary capillaries is lacking. We present a computational model of the pulmonary vasculature, parameterized to characteristic features of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension to help understand how the two conditions differ in terms of pulmonary vascular response to disease. Our model incorporates key features known to contribute to pulmonary vascular function in health and disease, including anatomical structure and multiple contributions from gravity. The model suggests that dynamic measurements obtained from catheterization potentially distinguish between distal and proximal vasculopathy typical of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. However, the model suggests a non-linear relationship between these data and vascular structural changes typical of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension which may impede analysis of these metrics to distinguish between cohorts.
Collapse
Affiliation(s)
| | - Merryn H. Tawhai
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Haribalan Kumar
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Kelly S. Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Eric A. Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA,
USA
| | - Margaret L. Wilsher
- Respiratory Services, Auckland City Hospital, Auckland, New Zealand
- Faculty of Medical and Health Sciences, University of Auckland,
Auckland, New Zealand
| | - David Milne
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Alys R. Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| |
Collapse
|
11
|
Osanlouy M, Bandrowski A, de Bono B, Brooks D, Cassarà AM, Christie R, Ebrahimi N, Gillespie T, Grethe JS, Guercio LA, Heal M, Lin M, Kuster N, Martone ME, Neufeld E, Nickerson DP, Soltani EG, Tappan S, Wagenaar JB, Zhuang K, Hunter PJ. The SPARC DRC: Building a Resource for the Autonomic Nervous System Community. Front Physiol 2021; 12:693735. [PMID: 34248680 PMCID: PMC8265045 DOI: 10.3389/fphys.2021.693735] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/28/2021] [Indexed: 02/01/2023] Open
Abstract
The Data and Resource Center (DRC) of the NIH-funded SPARC program is developing databases, connectivity maps, and simulation tools for the mammalian autonomic nervous system. The experimental data and mathematical models supplied to the DRC by the SPARC consortium are curated, annotated and semantically linked via a single knowledgebase. A data portal has been developed that allows discovery of data and models both via semantic search and via an interface that includes Google Map-like 2D flatmaps for displaying connectivity, and 3D anatomical organ scaffolds that provide a common coordinate framework for cross-species comparisons. We discuss examples that illustrate the data pipeline, which includes data upload, curation, segmentation (for image data), registration against the flatmaps and scaffolds, and finally display via the web portal, including the link to freely available online computational facilities that will enable neuromodulation hypotheses to be investigated by the autonomic neuroscience community and device manufacturers.
Collapse
Affiliation(s)
- Mahyar Osanlouy
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Anita Bandrowski
- Department of Neuroscience, University of California, San Diego, San Diego, CA, United States
| | - Bernard de Bono
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - David Brooks
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | - Richard Christie
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Nazanin Ebrahimi
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Tom Gillespie
- Department of Neuroscience, University of California, San Diego, San Diego, CA, United States
| | - Jeffrey S. Grethe
- Department of Neuroscience, University of California, San Diego, San Diego, CA, United States
| | | | - Maci Heal
- MBF Bioscience, Williston, VT, United States
| | - Mabelle Lin
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Niels Kuster
- IT'IS Foundation, Zurich, Switzerland
- Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology (ETHZ), Zurich, Switzerland
| | - Maryann E. Martone
- Department of Neuroscience, University of California, San Diego, San Diego, CA, United States
| | - Esra Neufeld
- IT'IS Foundation, Zurich, Switzerland
- Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology (ETHZ), Zurich, Switzerland
| | - David P. Nickerson
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Elias G. Soltani
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | | | | | - Peter J. Hunter
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| |
Collapse
|