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This montage depicts a stack of
CT sections (lower left); a three-dimensional
airway tree (center); a tumor obstructing the
bronchial tree, incl. the tumor's association with
surrounding major vascular structures (upper and
lower right); a bronchoscopic image of the
obstructed airway tree (left-center); and a
superposed graph showing objective measures of
airway cross-sectional area as a function of
distance down the tree. Such imaging is currently
being used on a regular basis for custom-designed
interventions to eliminate obstructions via laser
surgery and/or to build custom stents to hold open
the obstructed segment. Quantitative methods are
now allowing for the accurate measurement of airway
segments as small as 1 mm in diameter, with
sub-millimeter accuracy.
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Comprehensive
Quantification of Lung Structure and
Function
Currents
6-27-01
- Eric Hoffman, Ph.D.
- Divison
of Physiologic Imaging
- Department
of Radiology
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- As part of the effort to build a
computer-based model of the normal male and
female human lung spanning four decades of
age, our group is focusing on four primary
aspects of pulmonary structure-function
relationships: 1) Airway-tree anatomy and its
reaction to stimuli; 2) Regional delivery of
blood-to-the-gas exchange interface of the
lung; 3) Regional delivery of inspired
air-to-the-gas exchange interface of the
lung; and 4) Lung tissue pathology (tissue
characterization). The data obtained using
advanced sub-second multi-slice CT scanning
and quantitative computer modeling will form
a baseline to which an individual can be
compared when seeking to detect and quantify
early pathologic processes. Expect the full
story in the next issue of Currents.
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- Clinically available x-ray CT-scanners'
use has progressed from pure visualization
tasks to quantification of pulmonary
structure and function. This new approach
offers the potential to generate new
structural and functional information that
can be obtained concurrently and evaluated on
a regional, sub-lobar basis. It will likely
add significantly to the understanding of the
normal human lung under a variety of
conditions, such as exercise, air pollution,
altitude hypoxia, lung growth, and the normal
aging process. The response of the human lung
to insults, such as acute and chronic
cigarette smoking, and to the effects of
chemotherapy and radiotherapy can also be
evaluated. Furthermore, as pulmonary research
efforts bring about the potential for
dramatic therapeutic interventions, such as
gene therapy for cystic fibrosis,
anti-elastase therapy for emphysema,
receptor-blocking therapies for lung cancer,
etc., objective, accurate, and reproducible
measures are needed to assess disease and its
response to therapy more rapidly.
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