1. Volume 155, Issue 1, Pages 79-87 (January 2019)
CT Imaging-Based Low-Attenuation Super Clusters in Three Dimensions and the Progression of Emphysema 
Jarred R. Mondoñedo, PhD, Susumu Sato, MD, PhD, Tsuyoshi Oguma, MD, PhD, Shigeo Muro, MD, PhD, Adam H. Sonnenberg, MS, Dean Zeldich, BS, Harikrishnan Parameswaran, PhD, Toyohiro Hirai, MD, PhD, Béla Suki, PhD 
CHEST 
Volume 155, Issue 1, Pages (January 2019)
DOI: /j.chest
Copyright © 2018 American College of Chest Physicians Terms and Conditions

2. Figure 1
Representative LAV cluster size distributions for individual lungs in a control subject (circles) and a patient with COPD (triangle) fitted to a power law (solid lines). As illustrated here, the super cluster is identified for the patient with COPD as the LAV outlier (arrow) nearly three orders of magnitude larger than the remaining distribution, while a similar large cluster is not present in the distribution for the control patient. Inset: comparing distribution exponents across all patients, we found that values of D were significantly lower in patients with COPD compared with control subjects at baseline. COPD = chronic obstructive pulmonary disease; D = power law exponent; LAV = low-attenuation volume.
CHEST  , 79-87DOI: ( /j.chest )
Copyright © 2018 American College of Chest Physicians Terms and Conditions

3. Figure 2
The super cluster is a characteristic feature of advanced parenchymal destruction in emphysema. A, Patients with COPD with super clusters had significantly larger %LAVtot compared with COPD and control patients without them. B, The probability of finding a super cluster increased with %LAVtot. Dashed lines represent 10th and 90th percentiles, the solid red line shows a three-parameter sigmoidal fit (a = 19.8, b = 9.2). %LAVtot = total percentage of all voxels in the lung field below threshold. See Figure 1 legend for expansion of other abbreviation.
CHEST  , 79-87DOI: ( /j.chest )
Copyright © 2018 American College of Chest Physicians Terms and Conditions

4. Figure 3
A, Super cluster volume (Vsc) was linearly related to disease severity as characterized by %LAVtot. B, Normalizing by low-attenuation volume (VLAV∗, open circles) and total lung volume (VTLV∗, filled circles) yielded similar trends. GOLD = Global Initiative for Chronic Obstructive Lung Disease.
CHEST  , 79-87DOI: ( /j.chest )
Copyright © 2018 American College of Chest Physicians Terms and Conditions

5. Figure 4
A, Super cluster progression in the same patient at baseline and annual follow-up; boundaries are shown by shaded regions. B, Annual changes in normalized volume (ΔVTLV∗) increased linearly with super cluster volume (ΔVsc), indicating super cluster growth was not due to hyperinflation of the entire lung. C and D, Annual changes in (C) distribution exponents (ΔD) and (D) number of LAVs (ΔLAN) were associated with changes in adjusted percent low-attenuation volume (ΔLAVadj), reflecting coalescence of LAVs with super cluster expansion. See Figure 3 legend for expansion of other abbreviation.
CHEST  , 79-87DOI: ( /j.chest )
Copyright © 2018 American College of Chest Physicians Terms and Conditions