# Clinical Implications of Bronchiectasis in Smokers

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2020 · $585,156

## Abstract

Project Summary/Abstract
Chronic obstructive pulmonary disease (COPD) affects approximately 26 million people in the United States. It
is estimated that 16%-56% of these people have bronchiectasis (pathologic dilation of the airways). The
presence of bronchiectasis in COPD has been linked to longer hospital stays, prolonged recovery from
exacerbations, and increased mortality. The visual assessment of bronchiectasis on high-resolution computed
tomography (CT) scans is the standard diagnostic method.
In this investigation the visual assessment will be used to further develop, validate, refine, and apply an
automated imaging tool to objectively assess the burden of bronchiectasis in smokers using baseline and
follow-up chest CT scans from the COPDGene Study (a large cohort of smokers with and without COPD). In
Aim 1, we will perform a visual scoring and marking of bronchiectasis on a subset of baseline and 5-yr follow-
up CT scans. We will then assess the associations between baseline bronchiectasis and acute respiratory
disease episodes, health-related quality of life, and death. In aim 2, we will perform point-based (at a single
slice) objective measurements of bronchial dilation and airway morphology in bronchiectatic and non-
bronchiectatic airway sections labeled for Aim 1 to identify CT features that distinguish bronchiectasis. We will
build receiver operating characteristics (ROC) curves to determine the predictive ability of these objective
measurements to detect bronchiectasis. Finally, in Aim 3 we will fully develop, validate, and refine an
automated imaging tool with the features found to be discriminatory to detect bronchiectasis in Aims 1 and 2.
We will then determine the burden of bronchiectasis using this tool on all baseline and follow-up CT scans
(estimated N= 16,300) and assess its association with clinically relevant disease outcomes including acute
respiratory disease episodes, quality of life, and mortality. We will also use ROC analysis as well as the
integrated discrimination index (IDI) and net reclassification index (NRI) measures to assess the contribution of
our imaging tool to predict those outcomes.

## Key facts

- **NIH application ID:** 9935969
- **Project number:** 5R01HL133137-04
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Alejandro Diaz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $585,156
- **Award type:** 5
- **Project period:** 2017-06-20 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9935969

## Citation

> US National Institutes of Health, RePORTER application 9935969, Clinical Implications of Bronchiectasis in Smokers (5R01HL133137-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9935969. Licensed CC0.

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