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Imaging biomarkers for patient selection and treatment planning in emphysema

Matthew Brown, Fereidoun Abtin, Hyun J Kim, Michael McNitt-Gray and Jonathan Goldin

Emphysema is a disease that causes destruction of lung tissue and an overall reduction in lung compliance as air becomes trapped in the diseased regions. It affects an estimated 60 million people worldwide and up to 2 million Americans. As the disease progresses, the hyperinflated regions continue to expand, limiting the effective volume available for more viable lung tissue. New biomedical valves and stents are being developed that can be implanted in target airways to allow air to escape from the most diseased lung lobe, thereby reducing its volume and providing more space for the adjacent (healthier) lobe to expand. The challenge facing the clinician is to determine which patients are most likely to benefit from the treatment and which lobe/airway should be treated. This article describes imaging biomarkers and an automated computer-aided diagnosis system to perform patient selection and treatment targeting in emphysema.