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The goal of Lung Tissue Resource Consortium (LTRC) is to improve the management of diffuse lung diseases through a
better understanding of the biology of Chronic Obstructive Pulmonary Disease (COPD) and fibrotic interstitial lung
disease (ILD) including Idiopathic Pulmonary Fibrosis (IPF). Participants are subjected to a battery of tests including
tissue biopsies, physiologic testing, clinical history reporting, and CT scanning of the chest. The LTRC is a repository
from which investigators can request tissue specimens and test results as well as semi-quantitative radiology reports,
pathology reports, and automated quantitative image analysis results from the CT scan data performed by the LTRC core
laboratories. The LTRC Radiology Core Laboratory (RCL), in conjunction with the Biomedical Imaging Resource
(BIR), has developed novel processing methods for comprehensive characterization of pulmonary processes on
volumetric high-resolution CT scans to quantify how these diseases manifest in radiographic images. Specifically, the
RCL has implemented a semi-automated method for segmenting the anatomical regions of the lungs and airways. In
these anatomic regions, automated quantification of pathologic features of disease including emphysema volumes and
tissue classification are performed using both threshold techniques and advanced texture measures to determine the
extent and location of emphysema, ground glass opacities, "honeycombing" (HC) and "irregular linear" or "reticular"
pulmonary infiltrates and normal lung. Wall thickness measurements of the trachea, and its branches to the 3rd and
limited 4th order are also computed. The methods for processing, segmentation and quantification are described. The
results are reviewed and verified by an expert radiologist following processing and stored in the public LTRC database
for use by pulmonary researchers. To date, over 1200 CT scans have been processed by the RCL and the LTRC project
is on target for recruitment of the 2200 patients with 1800 CT scans in the repository for the 5-year effort. Ongoing
analysis of the results in the LTRC database by the LTRC participating institutions and outside investigators are
underway to look at the clinical and physiological significance of the imaging features of these diseases and correlate
these findings with quality of life and other important prognostic indicators of severity. In the future, the quantitative
measures of disease may have greater utility by showing correlation with prognosis, disease severity and other
physiological parameters. These imaging features may provide non-invasive alternative endpoints or surrogate markers
to alleviate the need for tissue biopsy or provide an accurate means to monitor rate of disease progression or response to
therapy.
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