What question did this study set out to answer?

The study aims to assess pulmonary elasticity in COPD patients using HRCT and its relationship with acute exacerbation risk and disease severity.

May 20, 2026

D13-07 Quantification of Pulmonary Elasticity as a Potential Imaging Marker for Acute Exacerbation Risk in Chronic Obstructive Pulmonary Disease

Key Points

The study aims to assess pulmonary elasticity in COPD patients using HRCT and its relationship with acute exacerbation risk and disease severity.
Prospectively enrolled 72 stable COPD patients and 30 age- and sex-matched controls.
Used high-resolution computed tomography (HRCT) with elastic registration to evaluate pulmonary elasticity.
Monitored acute exacerbation events via a telehealth management system over a 1-year follow-up.
Jac-mean was significantly lower in COPD patients (|−0.15|) than in controls (|−0.25|, P<0.001).
In COPD patients, Jac-mean and DSC were lower in GOLD 3-4 group compared to GOLD 1-2 group (Jac-mean: |−0.10|; DSC: 0.30 vs. Jac-mean: |−0.19|; DSC: 0.86, both P<0.001).
COPD patients with acute exacerbations had lower Jac-mean (|−0.12|) and DSC (0.55) than those without (Jac-mean: |−0.16|, P=0.001; DSC: 0.78, P=0.023).

Abstract

Abstract Objective To evaluate pulmonary elasticity in patients with chronic obstructive pulmonary disease (COPD) using high-resolution computed tomography (HRCT) with an elastic registration technique, and to examine its correlation with risk of acute exacerbation (AE) and disease severity. Methods We prospectively enrolled 72 stable COPD patients (mean age: 62±8 years) and 30 age- and sex-matched controls (mean age: 61±5 years). A telehealth-based COPD management system was used to monitor AE events during 1-year follow-up. Pulmonary elasticity was assessed using the mean log-normalized Jacobian determinants (Jac-mean) and the Dice similarity coefficient (DSC), both derived from elastic registration between full inspiratory and expiratory HRCT images. Spearman’s correlation analysis was performed to evaluate the correlations between pulmonary elasticity, AE, and disease severity. Results The Jac-mean (absolute value) was significantly lower in COPD patients (|−0.15|) compared to healthy controls (|−0.25|, P 0.001). The Jac-mean (absolute value) and DSC in GOLD 3-4 group (Jac-mean: |−0.10|; DSC: 0.30) were significantly lower than GOLD 1-2 group (Jac-mean: |−0.19|, P 0.001; DSC: 0.86, P 0.001). Moreover, COPD patients who experienced AE exhibited significantly lower Jac-mean (absolute value) and DSC values (Jac-mean: |−0.12|; DSC: 0.55) than those without AE. (Jac-mean: |−0.16|, P = 0.001; DSC: 0.78, P= 0.023). Additionally, Jac-mean and DSC showed significant correlation with AE frequency, pulmonary function test results, 6-minute walk distance, COPD assessment test scores, and quantitative HRCT parameters (P 0.05). Conclusions Compared to healthy controls, pulmonary elasticity was significantly lower in stable COPD patients and further reduced in those with severe disease, potentially serving as an imaging marker for AE risk in COPD patients. This abstract is funded by: Key research and development program of Ningxia hui autonomous (No.2018BEG03035; 2023BEG02021).

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