Quantitative Ultrasound for Interstitial Lung Diseases

ABSTRACT
The objective is to demonstrate feasibility of LQUS in human patients for assessing the severity of pulmonary
edema due to heart failure and of idiopathic pulmonary fibrosis. The long-term goal is to develop LQUS to monitor
pulmonary edema and fibrosis with high sensitivity and specificity in real time, in vivo, in humans.
In patients with lung diseases such as pulmonary edema or fibrosis, diagnosis and monitoring is done using
chest X-ray and CT scanning, or invasive pulmonary function tests. However, these imaging modalities expose
patients to ionizing radiation, have high inter-observer variability, and are expensive and impractical for frequent
routine monitoring. Pulmonary function tests are effort dependent and coughing and shortness of breath may
affect the results. Therefore, the need for an in-vivo, point-of-care, real-time, non-ionizing, and noninvasive
quantitative monitoring of pulmonary edema is great.
Conventional ultrasound remains challenging in the lung because the air-filled alveoli cause multiple scattering.
Vertical artifacts called B-lines can be observed with various lung diseases. Although they have some diagnostic
relevance, these artifacts are operator- and system-dependent. More critically, they are qualitative and not
specific. A need exists for the development of QUS biomarkers of the lung, to monitor chronic conditions leading
to interstitial lung diseases such as cardiogenic pulmonary edema and idiopathic pulmonary fibrosis. We propose
to develop new LQUS-based metrics of the lung parenchyma. We will develop methods to mitigate chest-wall
effects and optimize the data acquisition for humans (Aim1), and apply LQUS methods in-vivo in humans with
HF (Aim2) and with pulmonary fibrosis (Aim3).