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1 Department of Biomedical Engineering, Boston University, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: bsuki{at}bu.edu.
The mean linear intercept (Lm) can be used to estimate the surface area for gas exchange in the lung. However, in recent years it is most commonly used as an index for characterizing the enlargement of airspaces in emphysema and the associated severity of structural destruction in the lung. Specifically, an increase in Lm is thought to result from an increase in airspace sizes. In this paper, we examined how accurately Lm measures the linear dimensions of airspaces from histological sections and a variety of computer-generated test images. To this end, we developed an automated method for measuring linear intercepts (LI) from digitized images of tissue sections and calculate Lm as their mean. We examined how the shape of airspaces and the variability of their sizes influence Lm as well as the distribution of LI. We found that for a relatively homogeneous enlargement of airspaces, Lm was a reliable index for detecting emphysema. However, in the presence of spatial heterogeneities with a large variability of airspace sizes, Lm did not significantly increase and sometimes even decreased compared to its value in normal tissue. We also developed an automated method for measuring the area and computed an equivalent diameter (d) of each individual airspace that is independent of shape. Finally, we introduced new indices based on the moments of d that we found to be more reliable than Lm to characterize airspace enlargement in the presence of heterogeneities.
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