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Choi B, Díaz AA, San José Estépar R, Enzer N, Castro V, Han MK, Washko GR, San José Estépar R, Ash SY. Association of Acute Respiratory Disease Events with Quantitative Interstitial Abnormality Progression at CT in Individuals with a History of Smoking. Radiology 2024; 311:e231801. [PMID: 38687222 PMCID: PMC11070608 DOI: 10.1148/radiol.231801] [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: 07/21/2023] [Revised: 02/24/2024] [Accepted: 03/06/2024] [Indexed: 05/02/2024]
Abstract
Background Acute respiratory disease (ARD) events are often thought to be airway-disease related, but some may be related to quantitative interstitial abnormalities (QIAs), which are subtle parenchymal abnormalities on CT scans associated with morbidity and mortality in individuals with a smoking history. Purpose To determine whether QIA progression at CT is associated with ARD and severe ARD events in individuals with a history of smoking. Materials and Methods This secondary analysis of a prospective study included individuals with a 10 pack-years or greater smoking history recruited from multiple centers between November 2007 and July 2017. QIA progression was assessed between baseline (visit 1) and 5-year follow-up (visit 2) chest CT scans. Episodes of ARD were defined as increased cough or dyspnea lasting 48 hours and requiring antibiotics or corticosteroids, whereas severe ARD episodes were those requiring an emergency room visit or hospitalization. Episodes were recorded via questionnaires completed every 3 to 6 months. Multivariable logistic regression and zero-inflated negative binomial regression models adjusted for comorbidities (eg, emphysema, small airway disease) were used to assess the association between QIA progression and episodes between visits 1 and 2 (intercurrent) and after visit 2 (subsequent). Results A total of 3972 participants (mean age at baseline, 60.7 years ± 8.6 [SD]; 2120 [53.4%] women) were included. Annual percentage QIA progression was associated with increased odds of one or more intercurrent (odds ratio [OR] = 1.29 [95% CI: 1.06, 1.56]; P = .01) and subsequent (OR = 1.26 [95% CI: 1.05, 1.52]; P = .02) severe ARD events. Participants in the highest quartile of QIA progression (≥1.2%) had more frequent intercurrent ARD (incidence rate ratio [IRR] = 1.46 [95% CI: 1.14, 1.86]; P = .003) and severe ARD (IRR = 1.79 [95% CI: 1.18, 2.73]; P = .006) events than those in the lowest quartile (≤-1.7%). Conclusion QIA progression was independently associated with higher odds of severe ARD events during and after radiographic progression, with higher frequency of intercurrent severe events in those with faster progression. Clinical trial registration no. NCT00608764 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Little in this issue.
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Affiliation(s)
- Bina Choi
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - Alejandro A. Díaz
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - Ruben San José Estépar
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - Nicholas Enzer
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - Victor Castro
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - MeiLan K. Han
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - George R. Washko
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - Raúl San José Estépar
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - Samuel Y. Ash
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
| | - for the COPDGene Study
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (B.C., A.A.D., G.R.W.), Applied Chest Imaging Laboratory (B.C.,
A.A.D., Ruben San José Estépar, N.E., G.R.W., Raúl San
José Estépar), and Department of Radiology (Ruben San José
Estépar, Raúl San José Estépar), Brigham and
Women’s Hospital, 15 Francis St, Boston, MA 02115; Boston University
School of Medicine, Boston, Mass (V.C.); Division of Pulmonary and Critical Care
Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor,
Mich (M.K.H.); Department of Critical Care Medicine, South Shore Health, South
Weymouth, Mass (S.Y.A.); and Tufts University School of Medicine, Boston, Mass
(S.Y.A.)
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4
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Choi B, San José Estépar R, Godbole S, Curtis JL, Wang JM, San José Estépar R, Rosas IO, Mayers JR, Hobbs BD, Hersh CP, Ash SY, Han MK, Bowler RP, Stringer KA, Washko GR, Labaki WW. Plasma metabolomics and quantitative interstitial abnormalities in ever-smokers. Respir Res 2023; 24:265. [PMID: 37925418 PMCID: PMC10625195 DOI: 10.1186/s12931-023-02576-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Quantitative interstitial abnormalities (QIA) are an automated computed tomography (CT) finding of early parenchymal lung disease, associated with worse lung function, reduced exercise capacity, increased respiratory symptoms, and death. The metabolomic perturbations associated with QIA are not well known. We sought to identify plasma metabolites associated with QIA in smokers. We also sought to identify shared and differentiating metabolomics features between QIA and emphysema, another smoking-related advanced radiographic abnormality. METHODS In 928 former and current smokers in the Genetic Epidemiology of COPD cohort, we measured QIA and emphysema using an automated local density histogram method and generated metabolite profiles from plasma samples using liquid chromatography-mass spectrometry (Metabolon). We assessed the associations between metabolite levels and QIA using multivariable linear regression models adjusted for age, sex, body mass index, smoking status, pack-years, and inhaled corticosteroid use, at a Benjamini-Hochberg False Discovery Rate p-value of ≤ 0.05. Using multinomial regression models adjusted for these covariates, we assessed the associations between metabolite levels and the following CT phenotypes: QIA-predominant, emphysema-predominant, combined-predominant, and neither- predominant. Pathway enrichment analyses were performed using MetaboAnalyst. RESULTS We found 85 metabolites significantly associated with QIA, with overrepresentation of the nicotinate and nicotinamide, histidine, starch and sucrose, pyrimidine, phosphatidylcholine, lysophospholipid, and sphingomyelin pathways. These included metabolites involved in inflammation and immune response, extracellular matrix remodeling, surfactant, and muscle cachexia. There were 75 metabolites significantly different between QIA-predominant and emphysema-predominant phenotypes, with overrepresentation of the phosphatidylethanolamine, nicotinate and nicotinamide, aminoacyl-tRNA, arginine, proline, alanine, aspartate, and glutamate pathways. CONCLUSIONS Metabolomic correlates may lend insight to the biologic perturbations and pathways that underlie clinically meaningful quantitative CT measurements like QIA in smokers.
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Affiliation(s)
- Bina Choi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Pulmonary-PBB-CA-3, Boston, MA, 02115, USA.
- Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA.
| | - Raúl San José Estépar
- Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Suneeta Godbole
- Anschutz Medical Campus, Department of Biostatistics and Informatics, University of Colorado, Aurora, CO, USA
| | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Medical Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Jennifer M Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Rubén San José Estépar
- Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Jared R Mayers
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Pulmonary-PBB-CA-3, Boston, MA, 02115, USA
| | - Brian D Hobbs
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Pulmonary-PBB-CA-3, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Craig P Hersh
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Pulmonary-PBB-CA-3, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Samuel Y Ash
- Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
- Department of Critical Care, South Shore Hospital, South Weymouth, MA, USA
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Russell P Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Kathleen A Stringer
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Pulmonary-PBB-CA-3, Boston, MA, 02115, USA
- Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - Wassim W Labaki
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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7
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Ash SY, Harmouche R, Ross JC, Diaz AA, Rahaghi FN, Vegas Sanchez-Ferrero G, Putman RK, Hunninghake GM, Onieva Onieva J, Martinez FJ, Choi AM, Bowler RP, Lynch DA, Hatabu H, Bhatt SP, Dransfield MT, Wells JM, Rosas IO, San Jose Estepar R, Washko GR. Interstitial Features at Chest CT Enhance the Deleterious Effects of Emphysema in the COPDGene Cohort. Radiology 2018; 288:600-609. [PMID: 29869957 PMCID: PMC6069608 DOI: 10.1148/radiol.2018172688] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/06/2018] [Accepted: 02/06/2018] [Indexed: 12/28/2022]
Abstract
Purpose To determine if interstitial features at chest CT enhance the effect of emphysema on clinical disease severity in smokers without clinical pulmonary fibrosis. Materials and Methods In this retrospective cohort study, an objective CT analysis tool was used to measure interstitial features (reticular changes, honeycombing, centrilobular nodules, linear scar, nodular changes, subpleural lines, and ground-glass opacities) and emphysema in 8266 participants in a study of chronic obstructive pulmonary disease (COPD) called COPDGene (recruited between October 2006 and January 2011). Additive differences in patients with emphysema with interstitial features and in those without interstitial features were analyzed by using t tests, multivariable linear regression, and Kaplan-Meier analysis. Multivariable linear and Cox regression were used to determine if interstitial features modified the effect of continuously measured emphysema on clinical measures of disease severity and mortality. Results Compared with individuals with emphysema alone, those with emphysema and interstitial features had a higher percentage predicted forced expiratory volume in 1 second (absolute difference, 6.4%; P < .001), a lower percentage predicted diffusing capacity of lung for carbon monoxide (DLCO) (absolute difference, 7.4%; P = .034), a 0.019 higher right ventricular-to-left ventricular (RVLV) volume ratio (P = .029), a 43.2-m shorter 6-minute walk distance (6MWD) (P < .001), a 5.9-point higher St George's Respiratory Questionnaire (SGRQ) score (P < .001), and 82% higher mortality (P < .001). In addition, interstitial features modified the effect of emphysema on percentage predicted DLCO, RVLV volume ratio, 6WMD, SGRQ score, and mortality (P for interaction < .05 for all). Conclusion In smokers, the combined presence of interstitial features and emphysema was associated with worse clinical disease severity and higher mortality than was emphysema alone. In addition, interstitial features enhanced the deleterious effects of emphysema on clinical disease severity and mortality.
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Affiliation(s)
- Samuel Y. Ash
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Rola Harmouche
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - James C. Ross
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Alejandro A. Diaz
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Farbod N. Rahaghi
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Gonzalo Vegas Sanchez-Ferrero
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Rachel K. Putman
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Gary M. Hunninghake
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Jorge Onieva Onieva
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Fernando J. Martinez
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Augustine M. Choi
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Russell P. Bowler
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - David A. Lynch
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Hiroto Hatabu
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Surya P. Bhatt
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Mark T. Dransfield
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - J. Michael Wells
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Ivan O. Rosas
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - Raul San Jose Estepar
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - George R. Washko
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
| | - for the COPDGene Investigators
- From the Division of Pulmonary and Critical Care Medicine, Department
of Medicine (S.Y.A., A.A.D., F.N.R., R.K.P., G.M.H., I.O.R., G.R.W.), Laboratory
of Mathematics in Imaging, Department of Radiology (R.H., J.C.R., G.V.S.,
J.O.O., R.S.J.E.), and Department of Radiology (H.H.), Brigham and
Women’s Hospital, 75 Francis St, PBB CA-3, Boston, MA 02115; Department
of Medicine, Weil Cornell Medical College, New York, NY (F.J.M., A.M.C.);
Departments of Medicine (R.P.B.) and Radiology (D.A.L.), National Jewish Health,
Denver, Colo; and Division of Pulmonary, Allergy and Critical Care Medicine,
Department of Medicine, University of Alabama at Birmingham, Birmingham, Ala
(S.P.B., M.T.D., J.M.W.)
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