Aerodynamic Simulation of Small Airway Resistance: A New Imaging Biomarker for Chronic Obstructive Pulmonary Disease

Int J Chron Obstruct Pulmon Dis. 2024 May 27:19:1167-1175. doi: 10.2147/COPD.S456878. eCollection 2024.

Abstract

Purpose: To develop a novel method for calculating small airway resistance using computational fluid dynamics (CFD) based on CT data and evaluate its value to identify COPD.

Patients and methods: 24 subjects who underwent chest CT scans and pulmonary function tests between August 2020 and December 2020 were enrolled retrospectively. Subjects were divided into three groups: normal (10), high-risk (6), and COPD (8). The airway from the trachea down to the sixth generation of bronchioles was reconstructed by a 3D slicer. The small airway resistance (RSA) and RSA as a percentage of total airway resistance (RSA%) were calculated by CFD combined with airway resistance and FEV1 measured by pulmonary function test. A correlation analysis was conducted between RSA and pulmonary function parameters, including FEV1/FVC, FEV1% predicted, MEF50% predicted, MEF75% predicted and MMEF75/25% predicted.

Results: The RSA and RSA% were significantly different among the three groups (p<0.05) and related to FEV1/FVC (r = -0.70, p < 0.001; r = -0.67, p < 0.001), FEV1% predicted (r = -0.60, p = 0.002; r = -0.57, p = 0.004), MEF50% predicted (r = -0.64, p = 0.001; r = -0.64, p = 0.001), MEF75% predicted (r = -0.71, p < 0.001; r = -0.60, p = 0.002) and MMEF 75/25% predicted (r = -0.64, p = 0.001; r = -0.64, p = 0.001).

Conclusion: Airway CFD is a valuable method for estimating the small airway resistance, where the derived RSA will aid in the early diagnosis of COPD.

Keywords: COPD; CT; fluid dynamics; small airway disease.

MeSH terms

  • Aged
  • Airway Resistance*
  • Computer Simulation
  • Female
  • Forced Expiratory Volume
  • Humans
  • Hydrodynamics*
  • Lung* / diagnostic imaging
  • Lung* / physiopathology
  • Male
  • Middle Aged
  • Predictive Value of Tests*
  • Pulmonary Disease, Chronic Obstructive* / diagnostic imaging
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Radiographic Image Interpretation, Computer-Assisted
  • Respiratory Function Tests / methods
  • Retrospective Studies
  • Tomography, X-Ray Computed*
  • Vital Capacity

Grants and funding

This work was supported by the National Natural Science Foundation of China (grant numbers 81930049, 82171926), National Key R&D Program of China (grant numbers 2022YFC2010002, 2022YFC2010000), Shanghai Science and Technology Innovation Action Plan project (grant number 21DZ2202600), and the Second Affiliated Hospital of Naval Military Medical University (grant number 2022YLCYJ-Y24).