British Journal of Radiology最新文献

{"title":"The value of ultrasound measured rectus femoris thickness, cross-sectional area and shear wave velocity in assessment of muscle in postmenopausal women with osteosarcopenia.","authors":"Zi-Tong Chen, Jia-Ying Ge, Feng-Shan Jin, Le-Hang Guo, Qiao Wang, Hui Zhao, Li-Ping Sun, Hui-Xiong Xu, Hui Sheng, Xiao-Long Li","doi":"10.1093/bjr/tqaf012","DOIUrl":"https://doi.org/10.1093/bjr/tqaf012","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the value of ultrasound (US) and shear wave velocity (SWV) to assess muscle in postmenopausal women with osteosarcopenia (OSP).</p><p><strong>Methods: </strong>This study included 145 postmenopausal women, comprising 115 osteopenia/osteoporosis participants without sarcopenia (OP alone) and 30 OSP participants. All received the evaluation of bone mineral density (BMD), appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-meter walking speed, and 5-time chair stand test. The cross-sectional area (RFcsa), thickness (RFthickness), and mean SWV of rectus femoris (RF) were measured by US and shear wave elastography. The clinical characteristics, RFcsa, RFthickness, and SWV, were compared between OP alone and OSP to determine the independent predictors of OSP. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of US and SWV for assessment of OSP.</p><p><strong>Results: </strong>The RFcsa, RFthickness, SWV, and BMD of OSP were lower than those of OP alone (all P < 0.05). Through multivariate analysis, the diagnostic performance of the prediction model (area under the ROC curve, AUC, 0.917) composed of RFcsa and SWV was superior to RFcsa (AUC, 0.847), RFthickness (AUC, 0.797), and SWV (AUC, 0.740) alone. Moreover, the prediction model achieved 70.0% sensitivity, 93.0% specificity, and 88.3% accuracy.</p><p><strong>Conclusions: </strong>The RFcsa, RFthickness, and SWV have potential value in assessing muscle in OSP and can be applied to routine clinical management of postmenopausal women.</p><p><strong>Advances in knowledge: </strong>US measured RF thickness, CSA and SWV could assist detection and clinical management of OSP in postmenopausal women.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18F-DCFPyL PET/MRI Radiomics for Intraprostatic Prostate Cancer Detection and Metastases Prediction Using Whole-Gland Segmentation.","authors":"Seyed Ali Mirshahvalad, Adriano Basso Dias, Claudia Ortega, Jorge Andres Abreu Gomez, Satheesh Krishna, Nathan Perlis, Alejandro Berlin, Theodorus van der Kwast, Kartik Jhaveri, Sangeet Ghai, Ur Metser, Anna Theresa Santiago, Patrick Veit-Haibach","doi":"10.1093/bjr/tqaf014","DOIUrl":"https://doi.org/10.1093/bjr/tqaf014","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate 18F-DCFPyL-PET/MRI whole-gland-derived radiomics for detecting clinically significant (cs) prostate cancer (PCa) and predicting metastasis.</p><p><strong>Methods: </strong>Therapy-naïve PCa patients who underwent 18F-DCFPyL PET/MRI were included. Whole-prostate-segmentation was performed. Feature extraction from each modality was done. The selection of potential variables was made through regularized binomial logistic regression. The oversampled training data were used to train binomial logistic regression for each outcome. The estimates of the models were calculated, and the mean accuracy was reported. The trained models were assessed on the test data for comparative evaluation of performance.</p><p><strong>Results: </strong>A total of 103 patients (mean age=65;mean PSA=23.4) were studied. Among them, 89 had csPCa, and 20 had metastatic disease. There were 5 radiomics variables selected for ISUP-GG≥2 from T2w, ADC and PET. To detect N1, five radiomics variables were selected from the T2w and PET. For M1, four radiomics variables were selected from T2w and ADC. Regarding the performance of models for the prediction of csPCa, the imaging-based hybrid model (T2w+PET) provided the highest AUC(0.98). The performance of N1 models showed the highest AUC(0.80) for T2w+PET. To predict M1, the T2w+ADC model showed the highest AUC(0.93).</p><p><strong>Conclusions: </strong>Whole-gland PET/MRI-radiomics may provide a reliable model to predict csPCa. Also, acceptable performance was reached for predicting metastatic disease in our limited population. Our findings may support the value of whole-gland radiomics for non-invasive csPCa detection and prediction of metastatic disease.</p><p><strong>Advances in knowledge: </strong>Whole-gland PET/MRI-radiomics, a less operator-dependent segmentation method, can be potentially used for treatment personalization in PCa patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural History and Long Term Follow-Up of Incidental Thyroid Nodules on Computed Tomography Imaging.","authors":"Eda Lyuman, Claire McArthur","doi":"10.1093/bjr/tqaf002","DOIUrl":"https://doi.org/10.1093/bjr/tqaf002","url":null,"abstract":"<p><strong>Objectives: </strong>incidental thyroid nodules (ITNs) are found in up to 25% of CT scans. Increased use of cross-sectional imaging has contributed to the increased incidence of thyroid cancer worldwide. ITNs pose a management dilemma since nodule malignancy rate is 5-15% but most cancers are indolent and prognosis in differentiated thyroid cancer is excellent. Study aims are to determine prevalence of ITNs ≥1 cm on CT scans, evaluate reporting practices, assess for emergence of clinically evident thyroid cancer during 13-year follow-up and assess interim nodule growth and clinical outcomes in nodules that were further investigated.</p><p><strong>Methods: </strong>direct image review of 1499 consecutive CT scans that included the thyroid, performed during January 2009 in a large NHS health board was performed. Clinical data up to January 2022 was analysed in 150 patients with at least one ITN > =1cm.</p><p><strong>Results: </strong>ITN prevalence was 11% with mean patient age 70 years and mean nodule diameter 17.5 mm. 30% of ITNs were mentioned in the CT report. During the follow-up period 11% proceeded to thyroid ultrasound, 5% fine needle aspiration and 2% diagnostic hemithyroidectomy with no thyroid malignancy found. 120 patients (80%) were deceased by the study endpoint, none from thyroid malignancy. No patients presented with clinically evident thyroid malignancy during follow-up.</p><p><strong>Conclusions: </strong>None of150 ITN cases developed clinically evident thyroid malignancy in a 13-year follow-up period with 80% of patients deceased by the study endpoint from non-thyroid causes.</p><p><strong>Advances in knowledge: </strong>This would suggest that ITNs detected on CT do not require further investigation unless malignant appearances or significant clinical concern for thyroid malignancy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone lesion cryotherapy: pictorial review and review of current evidence.","authors":"N Jenko, R D Henderson, A T Patel","doi":"10.1093/bjr/tqaf007","DOIUrl":"https://doi.org/10.1093/bjr/tqaf007","url":null,"abstract":"<p><p>Over the last two decades the development of small probes has enabled percutaneous use of cryotherapy. Cryotherapy, also known as cryoablation, enables the treatment of much larger lesions than other thermal ablation techniques, particularly when using multiple evenly spaced probes. Using rapid cooling to as low as -200 degrees Celsius (at the tip of the probe), reliable, and predictable necrosis can be induced. Probes are usually percutaneously inserted under computed tomography (CT) guidance under sedation or general anaesthesia, often as a day case. The procedure is safe with severe complications occurring rarely; the commonest complication is neural injury in lesions closely related to neurovascular bundles. Cryotherapy has been applied to the symptomatic and occasionally curative treatment of bone metastases and a range of primary bone lesions. This review summarises the published evidence base for the use of cryotherapy in metastatic and primary bone lesions and describes the experience with cryotherapy at the Royal Orthopaedic Hospital, Birmingham, a quaternary bone tumour referral hospital, where cryotherapy has been used for 3 years.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update on pancreatic cancer imaging, staging, and use of the PACT-UK radiology template pre- and post-neoadjuvant treatment.","authors":"Carmelo Corallo, Abdullah S Al-Adhami, Nigel Jamieson, Juan Valle, Ganesh Radhakrishna, John Moir, Raneem Albazaz","doi":"10.1093/bjr/tqae217","DOIUrl":"10.1093/bjr/tqae217","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma continues to have a poor prognosis, although recent advances in neoadjuvant treatments (NATs) have provided some hope. Imaging assessment of suspected tumours can be challenging and requires a specific approach, with pancreas protocol CT being the primary imaging modality for staging with other modalities used as problem-solving tools to facilitate appropriate management. Imaging assessment post NAT can be particularly difficult due to a current lack of robust radiological criteria to predict response and differentiate treatment induced fibrosis/inflammation from residual tumour. This review aims to provide an update of pancreatic ductal adenocarcinoma with particular focus on three points: tumour staging pre- and post-NAT including vascular assessment, structured reporting with introduction of the PAncreatic Cancer reporting Template-UK (PACT-UK) radiology template, and the potential future role of artificial intelligence in the diagnosis and staging of pancreatic cancer.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"13-26"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculating optic nerve planning organ at risk volume margins for stereotactic radiosurgery using optic nerve motion determined using MRI.","authors":"Sagar Sabharwal, Geoff Heyes, George S J Tudor, Robert Flintham, Swarupsinh Chavda, Paul Sanghera","doi":"10.1093/bjr/tqae201","DOIUrl":"10.1093/bjr/tqae201","url":null,"abstract":"<p><strong>Objectives: </strong>The combination of sharp dose gradients in stereotactic radiosurgery (SRS) and minute optic nerve motion may significantly increase dose to the optic nerves when treating perioptic lesions. The aim of this study was to calculate optic nerve planning organ at risk volume (PRV) margins for CyberKnife SRS treatment planning.</p><p><strong>Methods: </strong>MRI scans were taken of 10 healthy volunteers looking left, right, up, down, and straight ahead to measure optic nerve motion. The measured optic nerve motion and the uncertainties in the technical accuracy of CyberKnife were used to calculate optic nerve PRV margins.</p><p><strong>Results: </strong>Two optic nerve PRV margins were calculated: a non-isotropic margin of mL/R,PRV=3 mm, mSup/Inf,PRV=2 mm, and mAnt/Post,PRV=1 mm which considers the full range of motion measured in a worst case scenario; and an isotropic margin of mPRV=1 mm which considers a scenario where patients are asked to look neutrally during imaging and treatment. Applying these PRVs to 8 historical sphenoid wing meningioma CyberKnife plans showed tolerance levels may be exceeded due to optic nerve motion.</p><p><strong>Conclusions: </strong>Optic nerve PRV margins may be needed in CyberKnife planning to reduce risk to the optic nerves. The use of a mPRV=1 mm PRV to account for organ motion, along with instructing patients to hold their gaze neutrally during imaging and treatment, may be a suitable organ sparing strategy.</p><p><strong>Advances in knowledge: </strong>Measured optic nerve motion and the technical accuracy of the CyberKnife system have been used to calculate optic nerve PRV margins.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"107-113"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomic analysis of cohort-specific diagnostic errors in reading dense mammograms using artificial intelligence.","authors":"Xuetong Tao, Ziba Gandomkar, Tong Li, Patrick C Brennan, Warren M Reed","doi":"10.1093/bjr/tqae195","DOIUrl":"10.1093/bjr/tqae195","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate radiologists' interpretation errors when reading dense screening mammograms using a radiomics-based artificial intelligence approach.</p><p><strong>Methods: </strong>Thirty-six radiologists from China and Australia read 60 dense mammograms. For each cohort, we identified normal areas that looked suspicious of cancer and the malignant areas containing cancers. Then radiomic features were extracted from these identified areas and random forest models were trained to recognize the areas that were most frequently linked to diagnostic errors within each cohort. The performance of the model and discriminatory power of significant radiomic features were assessed.</p><p><strong>Results: </strong>We found that in the Chinese cohort, the AUC values for predicting false positives were 0.864 (CC) and 0.829 (MLO), while in the Australian cohort, they were 0.652 (CC) and 0.747 (MLO). For false negatives, the AUC values in the Chinese cohort were 0.677 (CC) and 0.673 (MLO), and in the Australian cohort, they were 0.600 (CC) and 0.505 (MLO). In both cohorts, regions with higher Gabor and maximum response filter outputs were more prone to false positives, while areas with significant intensity changes and coarse textures were more likely to yield false negatives.</p><p><strong>Conclusions: </strong>This cohort-based pipeline proves effective in identifying common errors for specific reader cohorts based on image-derived radiomic features.</p><p><strong>Advances in knowledge: </strong>This study demonstrates that radiomics-based AI can effectively identify and predict radiologists' interpretation errors in dense mammograms, with distinct radiomic features linked to false positives and false negatives in Chinese and Australian cohorts.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"75-88"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of low-dose CT and MRI in enthesitis-related arthritis patients with sacroiliitis.","authors":"Yunus Emre Bayrak, Törehan Özer, Yonca Anık, Nihal Şahin, Hafize Emine Sönmez","doi":"10.1093/bjr/tqae210","DOIUrl":"10.1093/bjr/tqae210","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the utility of low-dose CT (ldCT) compared with MRI in diagnosing sacroiliitis in enthesitis-related arthritis (ERA) patients.</p><p><strong>Methods: </strong>Thirty patients diagnosed with ERA were evaluated, with a median follow-up of 1.47 years. Images from patients were examined by two paediatric radiologists. For each patient, we assessed the density changes on ldCT at corresponding locations, employing the signal intensity observed on MRI across each joint surface as a reference. While measurements in areas without oedema on MRI showed relatively high density, measurements in areas with oedema on MRI showed relatively low density.</p><p><strong>Results: </strong>MRI revealed bilateral bone marrow oedema in 22 (73.3%) patients. During the ldCT evaluation of the right iliac crest, lower density was identified on ldCT in regions displaying heightened signal intensity on MRI in 20 (66.6%) patients. On the right sacral side, lower density was observed in the ldCT of 22 (73.3%) patients. Moving to the left iliac crest, 18 (60%) patients displayed a lower density. On the left sacral side, lower density was identified on ldCT in 22 (73.3%) patients. Erosion was detected in 23 patients on ldCT, whereas only 11 patients showed erosion on MRI.</p><p><strong>Conclusions: </strong>This study suggests that ldCT is superior to MRI for early structural change detection. Pixel-based density evaluation in ldCT aligns with MRI for bone marrow oedema.</p><p><strong>Advances in knowledge: </strong>The present study showed that ldCT is superior to MRI for early structural change detection. Pixel-based density evaluation in ldCT aligns with MRI findings for bone marrow oedema.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"143-149"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequencing microsphere selective internal radiotherapy after external beam radiotherapy for hepatocellular carcinoma: proof of concept of a synergistic combination.","authors":"Carlos Huesa-Berral, Jack F Terry, Louis Kunz, Alejandro Bertolet","doi":"10.1093/bjr/tqae209","DOIUrl":"10.1093/bjr/tqae209","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the synergistic effects of combining stereotactic body radiation therapy (SBRT) and selective internal radiation therapy (SIRT) in that specific sequence for treating hepatocellular carcinoma (HCC), particularly in patients at high risk of radiation-induced liver disease (RILD).</p><p><strong>Methods: </strong>We analysed a case of a patient with HCC who was treated with SBRT at our institution. A virtual 90Y dose distribution was added using our in-house MIDOS model to keep a minimum dose to the healthy liver tissue. BED and EUD metrics were calculated to harmonize the dose distributions of SBRT and SIRT.</p><p><strong>Results: </strong>Our radiation biology-based models suggest that the combination of SBRT and SIRT could maintain effective tumour control while reducing the dose to normal liver tissue. Specifically, an SBRT plan of 10 Gy×3 fractions combined with SIRT yielded comparable tumour control probability to an SBRT-only plan of 10 Gy×5 fractions.</p><p><strong>Conclusions: </strong>The combination of SBRT and SIRT is a promising treatment strategy for HCC patients at high risk of RILD. While the LQ model and associated formalisms provide a useful starting point, further studies are needed to account for factors beyond these models. Nonetheless, the potential for significant dose reduction to normal tissue suggests that this combination therapy could offer substantial clinical benefits.</p><p><strong>Advances in knowledge: </strong>This article presents a proposal to combine SBRT and SIRT, in this specific order, for HCC, discussing its advantages. A framework for future research into optimizing combination therapy for HCC is provided, utilizing a novel HCC vascular model to simulate 90Y doses.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"50-57"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated CT-based decoupling of the effects of airway narrowing and wall thinning on airway counts in chronic obstructive pulmonary disease.","authors":"Syed Ahmed Nadeem, Xinyu Zhang, Prashant Nagpal, Eric A Hoffman, Kung-Sik Chan, Alejandro P Comellas, Punam K Saha","doi":"10.1093/bjr/tqae211","DOIUrl":"10.1093/bjr/tqae211","url":null,"abstract":"<p><strong>Objective: </strong>We examine pathways of airway alteration due to wall thinning, narrowing, and obliteration in chronic obstructive pulmonary disease (COPD) using CT-derived airway metrics.</p><p><strong>Methods: </strong>Ex-smokers (N = 649; age mean ± std: 69 ± 6 years; 52% male) from the COPDGene Iowa cohort (September 2013-July 2017) were studied. Total airway count (TAC), peripheral TAC beyond 7th generation (TACp), and airway wall thickness (WT) were computed from chest CT scans using previously validated automated methods. Causal relationships among demographic, smoking, spirometry, COPD severity, airway counts, WT, and scanner variables were analysed using causal inference techniques including direct acyclic graphs to assess multi-pathway alterations of airways in COPD.</p><p><strong>Results: </strong>TAC, TACp, and WT were significantly lower (P < .0001) in mild, moderate, and severe COPD compared to the preserved lung function group. TAC (TACp) losses attributed to narrowing and obliteration of small airways were 4.59%, 13.29%, and 32.58% (4.64%, 17.82%, and 45.51%) in mild, moderate, and severe COPD, while the losses attributed to wall thinning were 8.24%, 17.01%, and 22.95% (12.79%, 25.66%, and 33.95%) in respective groups.</p><p><strong>Conclusions: </strong>Different pathways of airway alteration in COPD are observed using CT-derived automated airway metrics. Wall thinning is a dominant contributor to both TAC and TACp loss in mild and moderate COPD while narrowing and obliteration of small airways is dominant in severe COPD.</p><p><strong>Advances in knowledge: </strong>This automated CT-based study shows that wall thinning dominates airway alteration in mild and moderate COPD while narrowing and obliteration of small airways leads the alteration process in severe COPD.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"150-159"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}