Clinically Relevant Change in Airway Wall Thickness to Identify Disease Activity in COPD and Smokers At-Risk

This study aimed to define the clinically relevant change in airway wall thickness for identifying disease activity in patients with COPD and smokers at-risk. Using serial CT imaging, changes in airway wall thickness were analyzed to derive the minimal clinically important difference (MCID) associated with disease exacerbation or changes in clinical status. Quantitative airway metrics, including Pi10 and wall area percentage (WA%), were measured in a standardized manner using AVIEW COPD (Coreline Soft). The results suggest that specific thresholds of airway wall thickness change can serve as sensitive imaging biomarkers reflecting COPD disease activity, and are also applicable for detecting early disease changes in smokers at-risk. These findings support the clinical value of longitudinal CT-based airway analysis for disease monitoring and treatment response assessment in COPD.