# Prediction of COPD Progression by PRM

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $700,225

## Abstract

PROJECT ABSTRACT
 Chronic obstructive pulmonary disease (COPD) is a highly prevalent and heterogeneous disorder that afflicts
nearly 30 million Americans. Current disease staging and therapy is based primarily on spirometry and clinical
characteristics. Due to limitations in the standard phenotyping approaches, patients with similarly staged COPD
may exhibit strikingly different progression patterns. Small airways disease (SAD), a treatable but occult
component of COPD, is a significant contributor to airflow obstruction manifesting early in COPD. In recent years,
SAD has been has been implicated as a precursor to the irreversible destruction of lung parenchyma, i.e.
emphysema. The ability to predict if and when SAD will lead to emphysema would have an immediate clinical
impact on the care of COPD patients. In 2012 we reported on the Parametric Response Map (PRM) analytical
technique that when applied to paired inspiratory and expiratory CT scans is capable of simultaneously
visualizing and quantifying the extent of “functional” SAD (fSAD) and emphysema in a single COPD patient.
Since then we have made three key advances: first, PRM-derived fSAD is predictive of spirometric decline in
COPD patients and emphysema development; second, we have validated in human lung samples that PRM-
derived fSAD is a measure of small airway narrowing and loss; and finally, applying techniques to capture
regional variation of fSAD within the lung, we have enhanced PRM (topological PRM [tPRM]) to provide a more
sensitive measure of local disease severity than what is possible with the original PRM concept. Based on our
findings, we postulate that PRM, or its advanced form tPRM, has the potential to predict long-term patient
progression. The goal of this proposal will be to use baseline, Year 5 and recently available Year 10 COPDGene
data to determine the ability of PRM to predict disease progression through three Specific Aims: 1) Characterize
PRM-derived fSAD progression patterns over a 5 and 10 year period; 2) Determine how regional differences in
disease distribution, as determined by tPRM, identify regional onset of local emphysema; and 3) Apply machine
learning strategies to PRM/tPRM and other clinical metrics to develop models that predict patient disease
trajectories. It is our expectation that PRM metrics will identify COPD patients at risk for more rapid disease
progression but that utilizing regional information and machine learning strategies will further enhance our
approach. The results of such analyses could both identify patients appropriate for more intense, targeted
therapy at an early disease stage and contribute to our understanding of the progression of small airways disease
and emphysema in COPD.

## Key facts

- **NIH application ID:** 9865565
- **Project number:** 1R01HL150023-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Craig J Galban
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $700,225
- **Award type:** 1
- **Project period:** 2020-03-15 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9865565

## Citation

> US National Institutes of Health, RePORTER application 9865565, Prediction of COPD Progression by PRM (1R01HL150023-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9865565. Licensed CC0.

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