Seeing the forest for the trees: fractal dimensions measure COPD airway remodeling
Eleanor M. Dunican
Eleanor M. Dunican
Published December 3, 2018; First published October 29, 2018
Citation Information: J Clin Invest. 2018;128(12):5203-5205. https://doi.org/10.1172/JCI124776.
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Commentary

Seeing the forest for the trees: fractal dimensions measure COPD airway remodeling

Abstract

Chronic obstructive pulmonary disease (COPD) is extremely heterogenous in its effects on airway remodeling. Parsing the complex and interrelated morphologic changes and understanding their contribution to disease severity has posed a significant challenge to the field. In the current issue of the JCI, Bodduluri et al. measured the complex effects of COPD on the airway tree using airway fractal dimension (AFD) on computerized tomography in a large cohort of smokers with and without COPD. They found that lower AFD was independently associated with disease severity and mortality in COPD. This work highlights AFD as a noninvasive approach to analyze complex changes in airway geometry.

Authors

Eleanor M. Dunican

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Figure 1

Fractional dimensions and self-similarity are defining properties of fractal geometry.

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Fractional dimensions and self-similarity are defining properties of fra...
(A) Two-dimensional airway trees of varying fractal dimensions (Df) ranging from 1.09 to 2. The airway geometry becomes more space filling as Df approaches 2, the Euclidean dimension of a plane (24). (B) Three-dimensional model of the human airway tree showing self-similarity at different scales (25).