@article {1433780, title = {Computed tomographic-based quantification of emphysema and correlation to pulmonary function and mechanics}, journal = {COPD}, volume = {5}, number = {3}, year = {2008}, month = {2008 Jun}, pages = {177-86}, abstract = {Computed tomographic based indices of emphysematous lung destruction may highlight differences in disease pathogenesis and further enable the classification of subjects with Chronic Obstructive Pulmonary Disease. While there are multiple techniques that can be utilized for such radiographic analysis, there is very little published information comparing the performance of these methods in a clinical case series. Our objective was to examine several quantitative and semi-quantitative methods for the assessment of the burden of emphysema apparent on computed tomographic scans and compare their ability to predict lung mechanics and function. Automated densitometric analysis was performed on 1094 computed tomographic scans collected upon enrollment into the National Emphysema Treatment Trial. Trained radiologists performed an additional visual grading of emphysema on high resolution CT scans. Full pulmonary function test results were available for correlation, with a subset of subjects having additional measurements of lung static recoil. There was a wide range of emphysematous lung destruction apparent on the CT scans and univariate correlations to measures of lung function were of modest strength. No single method of CT scan analysis clearly outperformed the rest of the group. Quantification of the burden of emphysematous lung destruction apparent on CT scan is a weak predictor of lung function and mechanics in severe COPD with no uniformly superior method found to perform this analysis. The CT based quantification of emphysema may augment pulmonary function testing in the characterization of COPD by providing complementary phenotypic information.}, keywords = {Aged, Cohort Studies, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Predictive Value of Tests, Pulmonary Diffusing Capacity, Pulmonary Emphysema, Respiratory Mechanics, Tomography, X-Ray Computed, Total Lung Capacity}, issn = {1541-2563}, doi = {10.1080/15412550802093025}, author = {Washko, George R and Criner, Gerald J and Mohsenifar, Zab and Sciurba, Frank C and Sharafkhaneh, Amir and Make, Barry J and Hoffman, Eric A and Reilly, John J} } @article {1433782, title = {The effect of lung volume reduction surgery on chronic obstructive pulmonary disease exacerbations}, journal = {Am J Respir Crit Care Med}, volume = {177}, number = {2}, year = {2008}, month = {2008 Jan 15}, pages = {164-9}, abstract = {RATIONALE: Lung volume reduction surgery (LVRS) has been demonstrated to provide a functional and mortality benefit to a select group of subjects with chronic obstructive pulmonary disease (COPD). The effect of LVRS on COPD exacerbations has not been as extensively studied, and whether improvement in postoperative lung function alters the risk of disease exacerbations is not known. OBJECTIVES: To examine the effect, and mechanism of potential benefit, of LVRS on COPD exacerbations by comparing the medical and surgical cohorts of the National Emphysema Treatment Trial (NETT). METHODS: A COPD exacerbation was defined using Centers for Medicare and Medicaid Services data and International Classification of Diseases, Ninth Revision, discharge diagnosis. MEASUREMENTS AND MAIN RESULTS: There was no difference in exacerbation rate or time to first exacerbation between the medical and surgical cohorts during the year before study randomization (P = 0.58 and 0.85, respectively). Postrandomization, the surgical cohort experienced an approximate 30\% reduction in exacerbation frequency (P = 0.0005). This effect was greatest in those subjects with the largest postoperative improvement in FEV(1) (P = 0.04) when controlling for changes in other spirometric measures of lung function, lung capacities, and room air arterial blood gas tensions. Finally, LVRS increased the time to first exacerbation in both those subjects with and those without a prior history of exacerbations (P = 0.0002 and P < 0.0001, respectively). CONCLUSIONS: LVRS reduces the frequency of COPD exacerbations and increases the time to first exacerbation. One explanation for this benefit may be the postoperative improvement in lung function.}, keywords = {Aged, Disease Progression, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Male, Middle Aged, Multivariate Analysis, Pneumonectomy, Proportional Hazards Models, Pulmonary Emphysema, Time Factors}, issn = {1535-4970}, doi = {10.1164/rccm.200708-1194OC}, author = {Washko, George R and Fan, Vincent S and Ramsey, Scott D and Mohsenifar, Zab and Martinez, Fernando and Make, Barry J and Sciurba, Frank C and Criner, Gerald J and Minai, Omar and Decamp, Malcolm M and Reilly, John J} } @article {1433783, title = {Image registration assists novice operators in ultrasound assessment of abdominal trauma}, journal = {Stud Health Technol Inform}, volume = {132}, year = {2008}, month = {2008}, pages = {532-7}, abstract = {Transcutaneous ultrasound imaging may be used to detect abdominal hemorrhage in the field setting. The Focused Assessment with Sonography for Trauma (FAST) examination was developed to characterize blunt abdominal trauma and has been shown to be effective for assessing penetrating trauma as well. However, it is unlikely that a minimally trained operator could perform a diagnostic examination. In our system, the operator is be supported by real-time 3D volume displays. The operator will be directed through the examination by prompts from a computer system or outside expert, potentially with knowledge of the anatomy of the injured patient. The key elements of the tele-operated FAST exam capability have been demonstrated; the exam is performed with real-time guidance from anatomic images registered to the body. It appears likely that Image Registration will assist hemorrhage detection at the point of injury or in the initial evaluation by a trauma response team.}, keywords = {Abdominal Injuries, Diagnosis, Computer-Assisted, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Ultrasonography, User-Computer Interface}, issn = {0926-9630}, author = {Kirby G. Vosburgh and Stoll, Jeffrey and Noble, Vicki and Pohl, Kilian and San Jos{\'e} Estepar, Raul and Takacs, Barnabas} } @article {1433781, title = {Radiographic evaluation of the potential lung volume reduction surgery candidate}, journal = {Proc Am Thorac Soc}, volume = {5}, number = {4}, year = {2008}, month = {2008 May 01}, pages = {421-6}, abstract = {Delineating the extent and distribution of emphysema is an essential component of the evaluation of candidates for lung volume reduction surgery (LVRS). Imaging also may identify contraindications to LVRS, including bronchiectasis and pleural scarring. The chest X-ray is of limited utility in LVRS evaluation. Chest computed tomography (CT) scanning is an essential component of the evaluation, demonstrating the presence of emphysema and its amount and distribution. Clinical experience has shown that a substantial minority of chest CT scans will also demonstrate pulmonary nodules, some of which represent lung cancers. Published series, including the National Emphysema Treatment Trial, consistently demonstrate that patients with upper lobe predominant or heterogeneous emphysema are most likely to benefit from LVRS. Heterogeneity and distribution can also be assessed by radionuclide ventilation perfusion scanning, but this modality adds little additional information to CT scanning.}, keywords = {Humans, Patient Selection, Pneumonectomy, Predictive Value of Tests, Pulmonary Emphysema, Radiography, Thoracic, Tomography, X-Ray Computed}, issn = {1546-3222}, doi = {10.1513/pats.200802-017ET}, author = {Washko, George R and Hoffman, Eric and Reilly, John J} } @article {1433779, title = {Three-dimensional airway measurements and algorithms}, journal = {Proc Am Thorac Soc}, volume = {5}, number = {9}, year = {2008}, month = {2008 Dec 15}, pages = {905-9}, abstract = {Advances in high-resolution computed tomography (CT) imaging are making a full three-dimensional analysis of the lungs feasible. In particular, airway morphology can be studied in vivo and quantitative metrics of airway size and shape can be extracted. The thickening process associated with the inflammatory response in the diseased lung can be quantified by means of image processing techniques that extract the airway lumen and airway wall. In this article, we give an overview of these imaging techniques and their diverse nature. We also offer a comprehensive view of the analysis pipeline for three-dimensional airway trees and a validation framework that is needed to compare different techniques.}, keywords = {Algorithms, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Lung, Pulmonary Disease, Chronic Obstructive, Tomography, X-Ray Computed}, issn = {1546-3222}, doi = {10.1513/pats.200809-104QC}, author = {San Jos{\'e} Est{\'e}par, Ra{\'u}l and Reilly, John J and Silverman, Edwin K and Washko, George R} } @article {473406, title = {Image registration assists novice operators in ultrasound assessment of abdominal trauma.}, journal = {Studies in health technology and informaticsStudies in health technology and informatics}, volume = {132}, year = {2008}, pages = {532-537}, abstract = {Transcutaneous ultrasound imaging may be used to detect abdominal hemorrhage in the field setting. The Focused Assessment with Sonography for Trauma (FAST) examination was developed to characterize blunt abdominal trauma and has been shown to be effective for assessing penetrating trauma as well. However, it is unlikely that a minimally trained operator could perform a diagnostic examination. In our system, the operator is be supported by real-time 3D volume displays. The operator will be directed through the examination by prompts from a computer system or outside expert, potentially with knowledge of the anatomy of the injured patient. The key elements of the tele-operated FAST exam capability have been demonstrated; the exam is performed with real-time guidance from anatomic images registered to the body. It appears likely that Image Registration will assist hemorrhage detection at the point of injury or in the initial evaluation by a trauma response team.}, author = {Kirby G. Vosburgh and Stoll, Jeffrey and Noble, Vicki and Pohl, Kilian and San Jose Est{\'e}par, Ra{\'u}l and Takacs, Barnabas} } @article {473401, title = {Airway Inspector: an Open Source Application for Lung Morphometry}, journal = {First International Workshop on Pulmonary Image ProcessingFirst International Workshop on Pulmonary Image Processing}, year = {2008}, month = {Sep}, pages = {293-302}, abstract = {... 1. (a) Airway Inspector and 3D Slicer software components and dependencies, (b) Computational components of Airway Inspector . ... For the automatic segmentation of the airway tree, Airway Inspector currently relies on the Editor module capabilities provided by 3D Slicer . ...}, author = {San Jose Est{\'e}par, Ra{\'u}l and Washko, GG and Silverman, E K and Reilly, JJ and R. Kikinis and CF Westin} } @article {473396, title = {Three-dimensional airway measurements and algorithms.}, journal = {Proceedings of the American Thoracic SocietyProceedings of the American Thoracic Society}, volume = {5}, year = {2008}, month = {Dec 15}, pages = {905-909}, abstract = {Advances in high-resolution computed tomography (CT) imaging are making a full three-dimensional analysis of the lungs feasible. In particular, airway morphology can be studied in vivo and quantitative metrics of airway size and shape can be extracted. The thickening process associated with the inflammatory response in the diseased lung can be quantified by means of image processing techniques that extract the airway lumen and airway wall. In this article, we give an overview of these imaging techniques and their diverse nature. We also offer a comprehensive view of the analysis pipeline for three-dimensional airway trees and a validation framework that is needed to compare different techniques.}, author = {San Jose Est{\'e}par, Ra{\'u}l and Reilly, John J and Silverman, Edwin K and Washko, George R} }