# CT-Based Modeling of Bone Micro-Architecture and Fracture-Risk in COPD

> **NIH NIH R01** · UNIVERSITY OF IOWA · 2021 · $728,724

## Abstract

This translational study seeks to establish a Chronic Obstructive Pulmonary Disease (COPD)-specific fracture
prediction model using our unique computed tomography (CT)-based assessment of peripheral bone micro-
architecture. Osteoporosis, a common comorbidity among patients with COPD, accelerates morbidity and
mortality. The basis for this comorbidity is poorly understood, thus the need for characterizing the link between
COPD-related factors and bone micro-architecture and their association to fracture-risk. Multiple COPD-related
factors are associated with osteoporosis. Different COPD-related causes of bone loss may non-uniformly impact
cortical and trabecular bone structures with varying mechanical consequences, reflective of divergent COPD-
associated fracture-risk in individuals with similar bone mineral density (BMD). Little is known about this linkage,
and our goal is to fill this knowledge gap using a clinically suitable emerging CT-based tool for characterization
of bone micro-architecture at peripheral sites. Specifically, this study will—(1) establish the generalizability of our
bone micro-architecture assessment applied to emerging low dose / high resolution CT scanners from different
vendors; (2) assess its potential as compared to dual energy x-ray absorptiometry (DXA) to explain prevalent
fractures and predict incident fractures among patients with COPD; (3) quantify the impact of different COPD-
related factors on bone structures and their implications for fracture-risk; (4) identify COPD subtypes with rapid
bone structural degeneration; and (5) develop a COPD-specific model for assessment of fracture-risk using
patient-specific data. We will take advantage of—(1) existing COPD patient cohorts with lung characterization at
the University of Iowa (UI) and Columbia University (CU) representing a wide demographic range; (2) access to
emerging CT scanners at both sites; and (3) unique image processing methodologies for quantifying three-
dimensional bone structural metrics. We will recruit 470 COPD patients from the UI and CU cohorts and 80 age-
sex-similar never-smoker controls. At baseline and 3-year follow-up visits, we will collect—(1) data related to risk
factors; (2) a lateral spine CT scout scan to assess vertebral fractures; (3) high resolution CT scans of the ankle
and wrist for computation of bone structural metrics; and (4) whole-body, spine and hip DXA. Siemens Force CT
scanners will be used for all participants except for 100 randomly-selected patients and controls from the UI
cohort who, instead, will be imaged via a Toshiba Aquilion ONE 320 scanner. This study will establish an
emerging CT-based scanner-independent generalizable tool to assess bone response to different therapeutic
interventions aimed at slowing or reversing bone loss, and possibly restoring bone structure, potentially leading
to more patient-specific interventions. Also, this study seeks to explain the relationships among various COPD-
related factors,...

## Key facts

- **NIH application ID:** 10146463
- **Project number:** 5R01HL142042-04
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Pranav K. SAHA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $728,724
- **Award type:** 5
- **Project period:** 2018-07-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10146463

## Citation

> US National Institutes of Health, RePORTER application 10146463, CT-Based Modeling of Bone Micro-Architecture and Fracture-Risk in COPD (5R01HL142042-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10146463. Licensed CC0.

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