One-year CT emphysema progression predicts subsequent lung function decline in SPIROMICS

An observational SPIROMICS analysis evaluated whether one-year changes in quantitative chest CT measures predicted subsequent lung function decline. The 880 participants included people with mild/moderate COPD (43%), severe COPD (17%), smoking controls (29%) and nonsmoking controls (11%). Researchers analyzed CT scans from the first two visits and modeled FEV₁ decline from visits two through five, adjusting for demographic, clinical and imaging variables, including smoking.

Overall, FEV₁ declined by 30.4 mL/year (95% CI, 26.3–34.5). Each standard-deviation increase over one year in machine-learned combined bronchitic-apical emphysema (CBaE) and diffuse emphysema measures predicted an additional FEV₁ decline of 4.2 mL/year (95% CI, 0.2–8.3) and 6.2 mL/year (95% CI, 1.8–10.7), respectively. Changes in standard quantitative CT emphysema measures also predicted subsequent FEV₁ decline, but only CBaE and diffuse emphysema remained independently predictive when these measures were considered together.

These findings suggest that short-term changes in CT-defined emphysema subtypes could help assess disease progression in COPD trials. However, the observational associations do not establish that treatment-induced changes in these measures would predict treatment benefits. This report is based on the abstract; the full text was unavailable for assessment of additional methodological details and limitations.