Quantitative assessment of pulmonary vascular alterations in chronic obstructive lung disease: Associations with pulmonary function test and survival in the KOLD cohort

This study aimed to automatically extract pulmonary vessels from volumetric chest CT scans and evaluate their associations with clinical parameters, including survival, in patients with chronic obstructive pulmonary disease (COPD). Pulmonary vessels were successfully extracted using the AVIEW COPD lung vessel analysis software in 344 adult COPD patients. Quantitative pulmonary vessel features obtained from different lung surface areas (LSAs) showed significant associations with survival and pulmonary function tests. Specifically, the percentage of total vessel area measured at 18 mm depth from the pleural surface (%VA18mm) and the number of small vessels per 10 cm2 of LSA at 9 mm depth from the pleural surface (N<5mm/LSA9mm) demonstrated the strongest predictability for clinical parameters. Furthermore, significant correlations were observed between quantitative pulmonary vessel features and the extent of emphysema. The study highlights the technical feasibility and clinical relevance of automated pulmonary vessel extraction and quantitative assessment using the AVIEW COPD lung vessel analysis software, providing valuable insights into the relationship between pulmonary vascular alterations and COPD.