Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Robarts Research Institute, Western University, London, ON, Canada.
Eur Respir J. 2018 Nov 29;52(5). doi: 10.1183/13993003.01570-2018. Print 2018 Nov.
A number of chronic diseases have benefited from both imaging and personalised medicine, but unfortunately, for patients with chronic obstructive pulmonary disease (COPD), there has been little clinical uptake or recognition of the key advances in thoracic imaging that might help detect disease early, or, perhaps more importantly, might help develop and phenotype patients for novel or personalised therapies that may halt disease progression. We outline our vision for how computed tomography and magnetic resonance imaging may be used to better inform COPD patient care, and, perhaps more importantly, how these may be used to help develop new therapies directed at early disease. We think that imaging and precision medicine should be considered and used together as "precision imaging" at specific stages of COPD when the major pathologies may be more responsive to therapy. While "precision medicine" is the tailoring of medical treatment to individual patients, we define "precision imaging" as the tailoring of specific therapies and interventions to individual patients with a detailed quantitative understanding of their specific imaging phenotypes and measurements. Finally, we stress the importance of "seeing" the pathology, because without this understanding, you can neither treat nor cure patients with COPD.
许多慢性疾病都受益于影像学和个体化医学，但不幸的是，对于慢性阻塞性肺疾病（COPD）患者，尽管在胸部影像学方面取得了一些有助于早期发现疾病的关键进展，甚至可能更重要的是，这些进展有助于开发针对新型或个体化疗法的患者，并对其进行表型分析，以阻止疾病进展，但在临床应用或认识方面却收效甚微。我们概述了我们的愿景，即如何利用计算机断层扫描和磁共振成像来更好地为 COPD 患者提供护理，也许更重要的是，如何利用这些方法来帮助开发针对早期疾病的新疗法。我们认为，在 COPD 的特定阶段，影像学和精准医学应该被视为“精准影像学”，并一起使用，此时主要的病变可能对治疗更有反应。虽然“精准医学”是将医疗治疗个体化，但我们将“精准影像学”定义为根据患者的特定影像学表型和测量结果，对其进行详细的定量了解，从而为每个患者量身定制特定的治疗和干预措施。最后，我们强调“看到”病理学的重要性，因为没有这种认识，就无法治疗或治愈 COPD 患者。
