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Author de Backer, W.; Vos, W.; Van Holsbeke, C.; Vinchurkar, S.; Claes, R.; Hufkens, A.; Parizel, P.M.; Bedert, L.; de Backer, J. pdf  doi
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  Title The effect of roflumilast in addition to LABA/LAMA/ICS treatment in COPD patients Type L1 Letter to the editor
  Year (down) 2014 Publication European Respiratory Journal Abbreviated Journal Eur Respir J  
  Volume 44 Issue 2 Pages 527-529  
  Keywords L1 Letter to the editor; Biophysics and Biomedical Physics; Condensed Matter Theory (CMT); Antwerp Surgical Training, Anatomy and Research Centre (ASTARC); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Copenhagen Editor  
  Language Wos 000340017300029 Publication Date 2014-05-03  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0903-1936;1399-3003; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 10.569 Times cited 26 Open Access  
  Notes ; ; Approved Most recent IF: 10.569; 2014 IF: 7.636  
  Call Number UA @ lucian @ c:irua:117335 Serial 832  
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Author Van Holsbeke, C.S.; Verhulst, S.L.; Vos, W.G.; de Backer, J.W.; Vinchurkar, S.C.; Verdonck, P.R.; van Doorn, J.W.D.; Nadjmi, N.; de Backer, W.A. doi  openurl
  Title Change in upper airway geometry between upright and supine position during tidal nasal breathing Type A1 Journal article
  Year (down) 2014 Publication Journal Of Aerosol Medicine And Pulmonary Drug Delivery Abbreviated Journal J Aerosol Med Pulm D  
  Volume 27 Issue 1 Pages 51-57  
  Keywords A1 Journal article; Biophysics and Biomedical Physics; Condensed Matter Theory (CMT); Laboratory Experimental Medicine and Pediatrics (LEMP); Translational Neurosciences (TNW)  
  Abstract  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language Wos 000331144500007 Publication Date 2013-03-19  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1941-2711;1941-2703; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 2.528 Times cited 16 Open Access  
  Notes ; ; Approved Most recent IF: 2.528; 2014 IF: 2.798  
  Call Number UA @ lucian @ c:irua:115759 Serial 308  
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Author Van Holsbeke, C.S.; Leemans, G.; Vos, W.G.; de Backer, J.W.; Vinchurkar, S.C.; Geldof, M.; Verdonck, P.R.; Parizel, P.M.; van Schil, P.E.; de Backer, W.A. pdf  doi
openurl 
  Title Functional Respiratory Imaging as a tool to personalize respiratory treatment in subjects with unilateral diaphragmatic paralysis Type A1 Journal article
  Year (down) 2013 Publication Respiratory care Abbreviated Journal Resp Care  
  Volume Issue Pages 1-20  
  Keywords A1 Journal article; Condensed Matter Theory (CMT); Antwerp Surgical Training, Anatomy and Research Centre (ASTARC); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract In two subjects with a unilateral diaphragmatic paralysis and complaints of dyspnea, a completely different treatment approach was chosen despite similar anatomical and physiological abnormalities. These decisions were supported by the results generated by Functional Respiratory Imaging (FRI). FRI was able to generate functional information with respect to lobar ventilation and local drug deposition. In one subject, it was found that some lobes were poorly ventilated and drug deposition simulation showed that some regions were undertreated. This subject underwent a diaphragm plication to restore the ventilation. In the other subject, it was found that all lobes were still ventilated. A conservative approach with regular follow-up was chosen to wait for spontaneous recovery of the diaphragmatic function. Both subjects improved subjectively and objectively. These cases demonstrate how novel medical imaging techniques such as FRI can be used to personalize respiratory treatment in subjects with unilateral diaphragmatic paralysis.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Dallas, Tex. Editor  
  Language Wos 000349200100024 Publication Date 2013-12-11  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0020-1324;1943-3654; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 1.733 Times cited 5 Open Access  
  Notes ; ; Approved Most recent IF: 1.733; 2013 IF: 1.840  
  Call Number UA @ lucian @ c:irua:112982 Serial 1303  
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Author de Backer, J.; Vos, W.; Van Holsbeke, C.; Vinchurkar, S.; Claes, R.; Parizel, P.M.; de Backer, W. url  doi
openurl 
  Title Effect of high-dose N-acetylcysteine on airway geometry, inflammation, and oxidative stress in COPD patients Type A1 Journal article
  Year (down) 2013 Publication International Journal Of Chronic Obstructive Pulmonary Disease Abbreviated Journal Int J Chronic Obstr  
  Volume 8 Issue Pages 569-579  
  Keywords A1 Journal article; Biophysics and Biomedical Physics; Condensed Matter Theory (CMT); Antwerp Surgical Training, Anatomy and Research Centre (ASTARC); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract Background: Previous studies have demonstrated the potential beneficial effect of N-acetylcysteine (NAC) in chronic obstructive pulmonary disease (COPD). However, the required dose and responder phenotype remain unclear. The current study investigated the effect of high-dose NAC on airway geometry, inflammation, and oxidative stress in COPD patients. Novel functional respiratory imaging methods combining multislice computed tomography images and computer-based flow simulations were used with high sensitivity for detecting changes induced by the therapy. Methods: Twelve patients with Global Initiative for Chronic Obstructive Lung Disease stage II COPD were randomized to receive NAC 1800 mg or placebo daily for 3 months and were then crossed over to the alternative treatment for a further 3 months. Results: Significant correlations were found between image-based resistance values and glutathione levels after treatment with NAC (P = 0.011) and glutathione peroxidase at baseline (P = 0.036). Image-based resistance values appeared to be a good predictor for glutathione peroxidase levels after NAC (P = 0.02), changes in glutathione peroxidase levels (P = 0.035), and reduction in lobar functional residual capacity levels (P = 0.00084). In the limited set of responders to NAC therapy, the changes in airway resistance were in the same order as changes induced by budesonide/formoterol. Conclusion: A combination of glutathione, glutathione peroxidase, and imaging parameters could potentially be used to phenotype COPD patients who would benefit from addition of NAC to their current therapy. The findings of this small pilot study need to be confirmed in a larger pivotal trial.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language Wos 000327537300001 Publication Date 2013-11-21  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1178-2005; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 3.157 Times cited 21 Open Access  
  Notes ; JDB is a founder/shareholder of FluidDA NV, Kontich, Belgium. WV, SV, and CVH are employed by FluidDA NV, and WDB is the director of FluidDA NV. PMP and RC have no conflicts of interest to report. The study was supported by Zambon SpA, Bresso, Italy. ; Approved Most recent IF: 3.157; 2013 IF: NA  
  Call Number UA @ lucian @ c:irua:112799 Serial 813  
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Author Vos, W.; de Backer, J.; Poli, G.; De Volder, A.; Ghys, L.; Van Holsbeke, C.; Vinchurkar, S.; De Backer, L.; de Backer, W. pdf  doi
openurl 
  Title Novel functional imaging of changes in small airways of patients treated with extrafine beclomethasone/formoterol Type A1 Journal article
  Year (down) 2013 Publication Respiration Abbreviated Journal Respiration  
  Volume 86 Issue 5 Pages 393-401  
  Keywords A1 Journal article; Biophysics and Biomedical Physics; Condensed Matter Theory (CMT); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract Background: Inhaled formulations using extrafine particles of long-acting beta(2)-agonists and corticosteroids were developed to optimize asthma treatment. Findings that these combinations reach and treat smaller airways more effectively are predominantly based on general non-specific outcomes with little information on regional characteristics. Objectives: This study aims to assess long-term effects of extrafine beclomethasone/formoterol on small airways of asthmatic patients using novel functional imaging methods. Methods: Twenty-four stable asthma patients were subdivided into three groups (steroid naive, n = 7; partially controlled, n = 6; well controlled, n = 11). Current treatment was switched to a fixed combination of extrafine beclomethasone/formoterol (Foster (R); Chiesi Pharmaceuticals, Parma, Italy). Patients underwent lung function evaluation and thorax high-resolution computerized tomography (HRCT) scan. Local airway resistance was obtained from computational fluid dynamics (CFD). Results: After 6 months, the entire population showed improvement in pre-bronchodilation imaging parameters, including small airway volume (p = 0.0007), resistance (p = 0.011), and asthma control score (p = 0.016). Changes in small airway volume correlated with changes in asthma control score (p = 0.004). Forced expiratory volume in 1 s (p = 0.044) and exhaled nitric oxide (p = 0.040) also improved. Functional imaging provided more detail and clinical relevance compared to lung function tests, especially in the well-controlled group where only functional imaging parameters showed significant improvement, while the correlation with asthma control score remained. Conclusions: Extrafine beclomethasone/formoterol results in a significant reduction of small airway obstruction, detectable by functional imaging (HRCT/CFD). Changes in imaging parameters correlated significantly with clinically relevant improvements. This indicates that functional imaging is a useful tool for sensitive assessment of changes in the respiratory system after asthma treatment. Copyright (C) 2013 S. Karger AG, Basel  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Basel Editor  
  Language Wos 000329046200006 Publication Date 2013-04-12  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1423-0356;0025-7931; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 2.772 Times cited 30 Open Access  
  Notes ; ; Approved Most recent IF: 2.772; 2013 IF: 2.924  
  Call Number UA @ lucian @ c:irua:113762 Serial 2376  
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Author Van Holsbeke, C.; Vos, W.; van Hoorenbeeck, K.; Boudewyns, A.; Salgado, R.; Verdonck, P.R.; Ramet, J.; de Backer, J.; De Backer, W.; Verhulst, S.L. pdf  doi
openurl 
  Title Functional respiratory imaging as a tool to assess upper airway patency in children with obstructive sleep apnea Type A1 Journal article
  Year (down) 2013 Publication Sleep Medicine Abbreviated Journal Sleep Med  
  Volume 14 Issue 5 Pages 433-439  
  Keywords A1 Journal article; Condensed Matter Theory (CMT); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract Objective: We aim to investigate if anatomical and functional properties of the upper airway using computerized 3D models derived from computed tomography (CT) scans better predict obstructive sleep apnea (OSA) severity than standard clinical markers. Methods: Consecutive children with suspected OSA underwent polysomnography, clinical assessment of upper airway patency, and a CT scan while awake. A three-dimensional (3D) reconstruction of the pharyngeal airway was built from these images, and computational fluid dynamics modeling of low inspiratory flow was performed using open-source software. Results: Thirty-three children were included (23 boys; mean age, was 6.0 +/- 3.2 y). OSA was diagnosed in 23 patients. Children with OSA had a significantly lower volume of the overlap region between tonsils and the adenoids (median volume, 1408 mm compared to 2173 mm; p = 0.04), a lower mean cross-sectional area at this location (median volume, 69.3 mm(2) compared to 114.3 mm(2); p = 0.04), and a lower minimal cross-sectional area (median volume, 17.9 mm(2) compared to 25.9 mm(2); p = 0.05). Various significant correlations were found between several imaging parameters and the severity of OSA, most pronounced for upper airway conductance (r = -0.46) (p < 0.01) for correlation between upper airway conductance and the apnea-hypopnea index. No differences or significant correlations were observed with clinical parameters of upper airway patency. Preliminary data after treatment showed that none of the patients with residual OSA had their smallest cross-sectional area located in segment 3, and this frequency was significantly lower than in their peers whose sleep study normalized (64%; p = 0.05). Conclusion: Functional imaging parameters are highly correlated with OSA severity and are a more powerful correlate than clinical scores of upper airway patency. Preliminary data also showed that we could identify differences in the upper airway of those subjects who did not benefit from a local upper airway treatment. (c) 2013 Elsevier B.V. All rights reserved.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Amsterdam Editor  
  Language Wos 000318612100009 Publication Date 2013-03-07  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1389-9457; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 3.391 Times cited 18 Open Access  
  Notes ; ; Approved Most recent IF: 3.391; 2013 IF: 3.100  
  Call Number UA @ lucian @ c:irua:109015 Serial 1302  
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Author Horemans, B.; Van Holsbeke, C.; Vos, W.; Darchuk, L.; Novakovic, V.; Fontan, A.C.; de Backer, J.; van Grieken, R.; de Backer, W.; De Wael, K. doi  openurl
  Title Particle deposition in airways of chronic respiratory patients exposed to an urban aerosol Type A1 Journal article
  Year (down) 2012 Publication Environmental science and technology Abbreviated Journal Environ Sci Technol  
  Volume 46 Issue 21 Pages 12162-12169  
  Keywords A1 Journal article; AXES (Antwerp X-ray Analysis, Electrochemistry and Speciation); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract Urban atmospheres in modern cities carry characteristic mixtures of particulate pollution which are potentially aggravating for chronic respiratory patients (CRP). Although air quality surveys can be detailed, the obtained information is not always useful to evaluate human health effects. This paper presents a novel approach to estimate particle deposition rates in airways of CRP, based on real air pollution data. By combining computational fluid dynamics with physical-chemical characteristics of particulate pollution, deposition rates are estimated for particles of different toxicological relevance, that is, minerals, iron oxides, sea salts, ammonium salts, and carbonaceous particles. Also, it enables some qualitative evaluation of the spatial, temporal, and patient specific effects on the particle dose upon exposure to the urban atmosphere. Results show how heavy traffic conditions increases the deposition of anthropogenic particles in the trachea and lungs of respiratory patients (here, +0.28 and +1.5 μg·h1, respectively). In addition, local and synoptic meteorological conditions were found to have a strong effect on the overall dose. However, the pathology and age of the patient was found to be more crucial, with highest deposition rates for toxic particles in adults with a mild anomaly, followed by mild asthmatic children and adults with severe respiratory dysfunctions (7, 5, and 3 μg·h1, respectively).  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Easton, Pa Editor  
  Language Wos 000310665000082 Publication Date 2012-10-04  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0013-936X;1520-5851; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 6.198 Times cited 5 Open Access  
  Notes ; We are grateful for the financial support of n.v. Vooruitzicht. Furthermore, co-workers at the environmental analysis research group are acknowledged for their help in the fieldwork. ; Approved Most recent IF: 6.198; 2012 IF: 5.257  
  Call Number UA @ lucian @ c:irua:101411 Serial 2557  
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Author Vinchurkar, S.; De Backer, L.; Vos, W.; Van Holsbeke, C.; de Backer, J.; de Backer, W. doi  openurl
  Title A case series on lung deposition analysis of inhaled medication using functional imaging based computational fluid dynamics in asthmatic patients : effect of upper airway morphology and comparison with in vivo data Type A1 Journal article
  Year (down) 2012 Publication Inhalation Toxicology Abbreviated Journal Inhal Toxicol  
  Volume 24 Issue 2 Pages 81-88  
  Keywords A1 Journal article; Pharmacology. Therapy; Biophysics and Biomedical Physics; Condensed Matter Theory (CMT); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract Context: Asthma affects 20 million Americans resulting in an economic burden of approximately $18 billion in the US alone (Allergies and Asthma Foundation 2000; National Center for Environmental Health (NCEH) 1999). Research studies based on differences in patient-specific airway morphology for asthma and the associated effect on deposition of inhaled aerosols are currently not available in the literature. Therefore, the role of morphological variations such as upper airway (extrathoracic) occlusion is not well documented. Objective: Functional imaging based computational fluid dynamics (CFD) of the respiratory airways for five asthmatic subjects is performed in this study using computed tomography (CT) based patient-specific airway models and boundary conditions. Methods: CT scans for 5 asthma patients were used to reconstruct 3D lung models using segmentation software. An averaged inhalation profile and patient-specific lobar flow distribution were used to perform the simulation. The simulations were used to obtain deposition for BDP/Formoterol (R) HFA pMDI in the patient-specific airway models. Results: The lung deposition obtained using CFD was in excellent agreement with available in vivo data using the same product. Specifically, CFD resulted in 30% lung deposition, whereas in vivo lung deposition was reported to be approximately 31%. Conclusion: It was concluded that a combination of patient-specific airway models and lobar boundary conditions can be used to obtain accurate lung deposition estimates. Lower lung deposition can be expected for patients with higher extrathoracic resistance. Novel respiratory drug delivery devices need to accommodate population subgroups based on these morphological and anatomical differences in addition to subject age.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication New York, N.Y. Editor  
  Language Wos 000299744800001 Publication Date 2012-01-20  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0895-8378;1091-7691; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 1.751 Times cited 36 Open Access  
  Notes ; ; Approved Most recent IF: 1.751; 2012 IF: 1.894  
  Call Number UA @ lucian @ c:irua:96238 Serial 286  
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Author De Backer, L.A.; Vos, W.; de Backer, J.; Van Holsbeke, C.; Vinchurkar, S.; de Backer, W. pdf  doi
openurl 
  Title The acute effect of budesonide/formoterol in COPD : a multi-slice computed tomography and lung function study Type A1 Journal article
  Year (down) 2012 Publication European Respiratory Journal Abbreviated Journal Eur Respir J  
  Volume 40 Issue 2 Pages 298-305  
  Keywords A1 Journal article; Biophysics and Biomedical Physics; Condensed Matter Theory (CMT); Laboratory Experimental Medicine and Pediatrics (LEMP)  
  Abstract The Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of chronic obstructive pulmonary disease (COPD) does not always match with other clinical disease descriptors such as exacerbation frequency and quality of life, indicating that forced expiratory volume in 1 s (FEV1) is not a perfect descriptor of the disease. The aim of this study was to find out whether changes in airway geometry after inhalation of the most commonly used inhalation therapy in severe COPD can more adequately be described with an image-based approach than with spirometry. 10 COPD GOLD stage III patients were assessed in a double-blind crossover study. Airway volumes were analysed using segmentation of multi-slice computed tomography (MSCT) images; airway resistance was determined using computational fluid dynamics (CFD). Distal airway volume significantly increased (p=0.011) in patients 4 h after receiving a budesonide/formoterol combination from 9.6+/-4.67 cm(3) to 10.14+/-4.81 cm(3). Also CFD-determined airway resistance significantly decreased (p=0.047) from 0.051+/-0.021 kPa.s.L-1 to 0.043+/- 0.019 kPa.s.L-1. None of the lung function parameters showed a significant change. Only functional residual capacity (FRC) showed a trend to decline (p=0.056). Only the image-based parameters were able to predict the visit at which the combination product was administered. This study showed that imaging is a sensitive, complementary tool to describe changes in airway structure.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Copenhagen Editor  
  Language Wos 000307291700006 Publication Date 2011-12-20  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0903-1936;1399-3003; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 10.569 Times cited 37 Open Access  
  Notes ; ; Approved Most recent IF: 10.569; 2012 IF: 6.355  
  Call Number UA @ lucian @ c:irua:101113 Serial 3568  
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Author van Holsbeke, C.; de Backer, J.; Vos, W.; Verdonck, P.; van Ransbeeck, P.; Claessens, T.; Braem, M.; Vanderveken, O.; de Backer, W. pdf  doi
openurl 
  Title Anatomical and functional changes in the upper airways of sleep apnea patients due to mandibular repositioning: a large scale study Type A1 Journal article
  Year (down) 2011 Publication Journal of biomechanics Abbreviated Journal J Biomech  
  Volume 44 Issue 3 Pages 442-449  
  Keywords A1 Journal article; Condensed Matter Theory (CMT); Vision lab; Laboratory Experimental Medicine and Pediatrics (LEMP); Translational Neurosciences (TNW)  
  Abstract The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a sleep related breathing disorder. A popular treatment is the use of a mandibular repositioning appliance (MRA) which advances the mandibula during the sleep and decreases the collapsibility of the upper airway. The success rate of such a device is, however, limited and very variable within a population of patients. Previous studies using computational fluid dynamics have shown that there is a decrease in upper airway resistance in patients who improve clinically due to an MRA. In this article, correlations between patient-specific anatomical and functional parameters are studied to examine how MRA induced biomechanical changes will have an impact on the upper airway resistance. Low-dose computed tomography (CT) scans are made from 143 patients suffering from OSAHS. A baseline scan and a scan after mandibular repositioning (MR) are performed in order to study variations in parameters. It is found that MR using a simulation bite is able to induce resistance changes by changing the pharyngeal lumen. The change in minimal cross-sectional area is the best parameter to predict the change in upper airway resistance. Looking at baseline values, the ideal patients for MR induced resistance decrease seem to be women with short airways, high initial resistance and no baseline occlusion.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication New York, N.Y. Editor  
  Language Wos 000287551000014 Publication Date 2010-10-23  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0021-9290; ISBN Additional Links UA library record; WoS full record; WoS citing articles  
  Impact Factor 2.664 Times cited 23 Open Access  
  Notes ; ; Approved Most recent IF: 2.664; 2011 IF: 2.434  
  Call Number UA @ lucian @ c:irua:85305 Serial 112  
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