Precision Imaging Insights to
Navigate COPD Complexity
Addressing current challenges
Despite progress in COPD care, effective assessment and treatment remain challenging. Spirometry provides functional insights but overlooks the structural complexity of the disease.
CT imaging effectively visualizes airway and parenchymal abnormalities; however, interpretation currently relies largely on subjective analysis, which leads to significant variability both across different readers and within the same reader over time. Combined with patient heterogeneity, variable progression, and frequent comorbidities, this limits consistent disease evaluation.
of death
30%-40%
of patients with severe diagnosis
40%-50%
1-year mortality after severe exacerbations
Advancing treatment strategies with AI
We have built unique expertise in lung image analysis by leveraging over 20 years of research and insights from 25,000+ scans, conducted in long-term collaboration with COPDGene - the world’s largest COPD study.
Our AI-powered LungQ® analyses automatically quantify bronchial dimensions, bronchial count, mucus plug count, trapped air, lung density, vessel diameters and volumes, delivering objective and reliable metrics that enable:
- Phenotypic characterization through quantification of bronchial changes associated with inflammation and emphysema
- Identification and quantification of small airway disease (SAD)
- Non-invasive evaluation of COPD related vascular abnormalities
- Comprehensive understanding on disease mechanism and progression trajectories
- Precise treatment target identification, planning and post-treatment follow up for surgical or bronchoscopic interventions
Artificial Intelligence-enabled analysis of lung CT scan have already become world standard for qualifying COPD patients with severe emphysema, for an endobronchial valve placement. Having anatomical lung structures quantified down to a few millimeters, and the parenchymal density precisely calculated by AI, I can confidently take the most optimal treatment decisions for my patient.
Prof. Dr. Dirk-Jan Slebos, MD
University Medical Center Groningen
Use cases accelerating precision medicine
Bronchial measures linked to COPD progression and exacerbation risk
COPD is a complicated disease with several pathways to progression. structural changes in bronchi play a role in this progression.
LungQ metrics derived from long-term COPDGene data revealed that structural bronchial changes are strongly associated with COPD progression and exacerbation risk. Over 10 years, increases in bronchial wall thickness, reductions in lumen diameter, and higher mucus plugs were linked to disease worsening, while higher GOLD stages corresponded with greater bronchial tapering and emphysema burden.
Validation studies
American Thoracic Society Conference
| May 2025
Assessment of 10-year Progression in COPDGene Using Automated Measurements of Bronchus-Artery Ratios and Mucus Plugging
European Respiratory Journal
| January 2026
Automated analysis of airway remodeling and emphysema across GOLD Stages: Insights in COPD Severity
European Respiratory Journal
| January 2026
AI-measured bronchial dimensions and emphysema: A duo for predicting airflow limitation in COPD
European Respiratory Journal
| January 2026
COPD progressors vs. non-progressors: 10-year change in Bronchus-Artery ratios & mucus plugs
JAMA
| May 2024
Automated Quantification of Mucus Plugs in Smokers Using the LungQ Algorithm: A COPDGene Cohort Study
Identifying vascular phenotypes and mortality risk in COPD
In chronic obstructive pulmonary disease (COPD), vascular alterations have been shown to contribute to hypoxia and pulmonary hypertension, yet the independent contribution of small vessel abnormalities to mortality has remained unclear.
Using LungQ® AVX for high-precision quantification of pulmonary arteries and veins down to a diameter of 0.2 mm, a recent COPDGene study found that abnormally high small-vessel volumes (arteries and veins) are independently associated with increased mortality. These vascular abnormalities correlate with severe emphysema, air trapping, and coronary calcification, identifying a more aggressive disease phenotype.
Validation studies
American Thoracic Society Conference
| May 2023
Can AI-based Pulmonary Vascular Phenotyping on Chest-CT Detect Volume Shifts in Pulmonary Arterial and Venous Blood Volume in Operable and Non-operable Chronic Thromboembolic Pulmonary Hypertension?
American Journal of Respiratory and Critical Care Medicine
| May 2024
Prevalence of Pulmonary Vascular Abnormalities in Smokers With and Without COPD
European Respiratory Journal (ERS Congress)
| October 2024
Higher pulmonary artery and vein volumes are associated with disease severity and mortality in smokers with and without COPD
American Thoracic Society Conference
| May 2025
Changes in Low Attenuation Regions and Arterial and Venous Blood Volume Distribution in Response to CFTR Modulator Therapy in People With Cystic Fibrosis
American Thoracic Society Conference
| May 2025
Association of Pulmonary Vascular Metrics on CT With Hemodynamic Alterations in Pulmonary Hypertension
Journal of Personalized Medicine
| August 2025
Effect of High Altitude on Small Pulmonary Vein and Artery Volume in the COPDGene Cohort: Towards Better Understanding of Lung Physiology and Pulmonary Disease
QCT-based Fissure Completeness Score (FCS) expand EBV eligibility for low-FCS Patients
Evaluating the absence of interlobar collateral ventilation is a prerequisite for successful Lung Volume Reduction treatments. lower FCS score may exclude patients from the treatment. however, an earlier study suggest that a low FCS does not definitively exclude a patient from successful EBV treatment.
With Thirona’s quantitative CT fissure completeness scores, The recent study focusing on patients with a right upper lobe (RUL; FCS <90%) revealed a critical insight: the absence of interlobar collateral ventilation (CV) was still confirmed in 64% of this patient group and the majority achieved clinically relevant improvements after receiving EBV treatment. This indicates that patients with a clear RUL target lobe should not be excluded from further evaluation based on a low FCS.
