CLINICAL PRACTICE CLINICAL TRIALS FUNCTIONAL … · functional respiratory imaging respiratory...
Transcript of CLINICAL PRACTICE CLINICAL TRIALS FUNCTIONAL … · functional respiratory imaging respiratory...
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FLUIDDAA Respiratory Solutions Company
CLINICAL TRIALS
CLINICAL PRACTICE
FUNCTIONAL RESPIRATORY IMAGING
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FUNCTIONAL RESPIRATORY IMAGING (FRI)
Proprietary Backbone of the Respiratory Solutions
1 Image Acquisition 2 Structure Segmentation 3 Flow Simulations
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LUNG STRUCTURE LUNG FUNCTION EXPOSURE TO INHALED PARTICLES
Lung and Lobar Volumes Airway Volumes
Airway Wall
VolumeBlood Vessel
Volume
Emphysema
Internal Airflow
Distribution
Air trapping
Ventilation/Perfusion
reserve
Airway Resistance at
FRC and TLC
Aerosol Deposition
FUNCTIONAL RESPIRATORY IMAGING ENDPOINTS
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CONVENTIONAL RESPIRATORY MEDICINE
FEV1 = 85%p
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QUANTITATIVE IMAGING IN RESPIRATORY MEDICINE
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MACHINE LEARNING IN RESPIRATORY MEDICINE
EXACERBATION RISK
MACHINE LEARNING
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MACHINE LEARNING IN RESPIRATORY MEDICINE
Predicting imminent COPD exacerbations
Predicting treatment response in Idiopathic Pulmonary Fibrosis
Predicting lung transplant rejection
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MACHINE LEARNING IN RESPIRATORY MEDICINE
Predicting imminent COPD exacerbations
Predicting treatment response in Idiopathic Pulmonary Fibrosis
Predicting lung transplant rejection
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n = 62 COPD patients
94 HRCT and Clinical parameters
No baseline spirometry parameters could predict imminent exacerbations
Using baseline HRCT scans an imminent exacerbation in COPD patients could be predicted with an accuracy of 81% using
Expiratory scan
Adjusted Airway Volume
Adjusted Airway Resistance
PREDICTING IMMINENT COPD EXACERBATIONSMACHINE LEARNING ON IMAGING PARAMETERS
Lanclus et al. Acad Radiol. 2018 Nov 23. S1076-6332(18)30487-2.
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PREDICTING IMMINENT COPD EXACERBATIONSMACHINE LEARNING ON IMAGING PARAMETERS
Lanclus et al. Acad Radiol. 2018 Nov 23. S1076-6332(18)30487-2.
ADJUSTED AIRWAY VOLUMEADJUSTED AIRWAY RESISTANCE
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PREDICTING IMMINENT COPD EXACERBATIONSMACHINE LEARNING ON IMAGING PARAMETERS
Lanclus et al. Acad Radiol. 2018 Nov 23. S1076-6332(18)30487-2.
STABLEIMMINENT EXACERBATIONS
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MACHINE LEARNING IN RESPIRATORY MEDICINE
Predicting imminent COPD exacerbations
Predicting treatment response in Idiopathic Pulmonary Fibrosis
Predicting lung transplant rejection
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PREDICTING TREATMENT RESPONSE IN IPFMACHINE LEARNING ON IMAGING PARAMETERS
Wu et al. Am J Respir Crit Care Med. 2019 Jan 1;199(1):12-21.
n = 66 IPF patients
16 HRCT and Clinical parameters
Treatment FG3019 for 48 weeks
Using baseline HRCT scans, FVC stability or decline >10%p after 48 week treatment with FG3019 could be predicted with an accuracy of 86.5% using
Inspiratory Scan
Lobe Volumes
Adjusted Airway Volumes
Expiratory Scan
Adjusted Airway Volumes (lower lobes)
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MACHINE LEARNING IN RESPIRATORY MEDICINE
Predicting imminent COPD exacerbations
Predicting treatment response in Idiopathic Pulmonary Fibrosis
Predicting lung transplant rejection
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PREDICTING LUNG TRANSPLANT REJECTIONMACHINE LEARNING ON IMAGING PARAMETERS
Barbosa et al. Acad Radiol. 2018 Sep;25(9):1201-1212.
n = 41 Lung Transplant patients
31 HRCT and Clinical parameters
No baseline spirometry parameters could predict transplant rejection
Using baseline HRCT scans, transplant rejection could be predicted with an accuracy of 85% using
Inspiratory Scan
Lobe Volumes
Adjusted Airway Surface Area
Expiratory Scan
Airway Resistance
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PREDICTING LUNG TRANSPLANT REJECTIONMACHINE LEARNING ON IMAGING PARAMETERS
AIRWAY VOLUME [ml]LOBE VOLUMES [%p]
Barbosa et al. Acad Radiol. 2018 Sep;25(9):1201-1212.
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FROM AI-BASED FRI TO RESPIRATORY SOLUTIONS
FUNCTIONAL RESPIRATORY IMAGING
RESPIRATORY DISEASES REGULATORY
CLINICAL TRIAL PROCESSTREATMENTS
ASTHMA
COPD
IPF
CF
PH
SLEEP APNEA
SINUSITIS
BOS
BRONCHODILATORS
MEDICAL DEVICES
ANTI-INFLAMMATORY DRUGS (INC BIOLOGICS)
ANTI-FIBROTIC
MUCOLYTIC
FDA SUPPORT
BIOMARKER QUALIFICATION PROGRAM
NEGOTIATED ENDPOINTS
FLUIDDA SPONSORED TRIALS (n > 10)
FULL SERVICE CRO (n > 10)
IMAGING CRO (n > 25)
RESPONDER PHENOTYPINGCOMPANION DIAGNOSTICS
STOPPING RULES FOR HIGH PRICE TREATMENTSRISK SHARING REAL WORLD EVIDENCE
PAYER ENGAGEMENT
CLINICAL TRIALS
CLINICAL PRACTICE