CE17 - Recherche translationnelle en santé

Multicompartmental lung quantitative computed tomography MLQ-CT – MLQ-CT

Submission summary

The development of High-Resolution Computed Tomography (HRCT)-scan has been a major revolution in pulmonology and particularly made a breakthrough in interstitial lung diseases (ILDs) classification. ILDs compose a large and heterogeneous group of disorders characterised by a large spectrum of diffuse damage of the lung parenchyma responsible for microanatomical and tissue composition alterations. The prognosis of fibrosing ILDs is highly variable and difficult to predict and if HCRT-scan allowed progress in analysis but prognostic biomarkers remain limited. Some ILDs, such as idiopathic pulmonary fibrosis (IPF) has a very pejorative relentless fibrosis evolution leading to death or lung transplantation. For a decade some drugs have been shown to slow the fibrosis process in a set of patients but there is no certitude about those who could personally benefit from their prescription. In recent years it became evident that patients with different types of ILDs beyond IPF are at risk of developing progressive pulmonary fibrosis (PPF) despite appropriate treatment. While each ILD is relatively rare, collectively PPFs represent a devastating condition with a significant burden that may continue to increase in the future. Therefore, the crucial questions are: why does subsets of patients develop a progressive and irreversible fibrotic phenotype even when appropriately treated and which biomarkers could help to make an early diagnosis of potential PPF and what are the possible pathogenic mechanisms driving progression especially structural fibrotic distortion, aberrant composition, and stiffness of the extracellular matrix? Therefore, detection of early changes using non-expensive, non-invasive biomarkers is particularly desired. Detection of changes may focus on peripheral airways and peripheral blood vasculature remodeling and distortion, as well as on characterization of stiffness and mechanics. The expected biomarkers should be relevant not only for diagnosis or prognosis work-up but also for the monitoring of patients’ treatment and new drugs trial. We hypothesize that those developing technologies giving insights to lung anatomical and matrix components and their changes related to pathological processes can be applied to real-time analysis of HCRT-scan from patients with ILDs. We may hypothesize that they will generate significant candidate biomarkers of fibrosis progression providing the basis for identifying pejorative risk factors and appropriate therapeutic strategies. Our consortium, active for almost 5 years, thanks to a close relationship between the two lab partners (École Polytechnique-INRIA and MinesTélécom SudParis) and their clinical and radiology pulmonary partner [Avicenne APHP Hospital Reference Center for rare lung diseases (IPF and other ILDs)], developed research prototypes tools of digitalized analysis associated with artificial intelligence (AI). We are about to develop a software portfolio prototype applied to routine HCRT-scans, which can be divided into two sets: 1/ morphological or static descriptors of anatomical changes related to fibrosis and 2/ functional or dynamic descriptors of lung expansion/contraction of the lung between two states Our objective is to move the various software to an implantable software portfolio in a hospital setting and to test it on local hospital data to identify and assess qualitative and quantitative candidate biomarkers for PPF characterization. We develop this project with two pneumology departments (Avicenne Hospital Bobigny 93000 and Caen CHU 14000). We are confident, that significative results will be obtained by the MLQ -CT project: 1/ at the scientific level,2/ in medical application for pulmonary diseases and 3/ in the development of new tools applied to health care. The MLQ-CT project fit in the desire of the French Gov. to develop digital health programs and to promote AI insertion in medical imaging.

Project coordination

Pierre-Yves BRILLET (HYPOXIE ET POUMON : PNEUMOPATHIES FIBROSANTES, MODULATIONS VENTILATOIRES ET CIRCULATOIRES)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.

Partner

LMS Laboratoire de mécanique des solides
TSP TELECOM SudParis
DRCI Délégation à la Recherche Clinique et à l'Innovation - CHU de Caen
URC URC PARIS SEINE SAINT DENIS
HP - PFMVC HYPOXIE ET POUMON : PNEUMOPATHIES FIBROSANTES, MODULATIONS VENTILATOIRES ET CIRCULATOIRES

Help of the ANR 523,802 euros
Beginning and duration of the scientific project: November 2023 - 24 Months

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