CT Vascular Pruning Markers Identify Chronic Vasculopathy in Sickle Cell Disease

Sickle cell disease involves systemic vasculopathy and chronic organ damage, necessitating the development of robust biomarkers to track disease progression and treatment response [1]. Pulmonary complications remain a primary driver of mortality, often manifesting as impaired gas exchange, chronic parenchymal changes, or secondary pulmonary hypertension [2]. While traditional metrics like carbon monoxide diffusing capacity provide essential functional data, they do not always capture the specific structural remodeling occurring within the pulmonary vascular bed [2]. The search for non-invasive imaging markers to differentiate vascular phenotypes and identify early remodeling is a priority in chronic diseases characterized by microvascular rarefaction (the progressive loss or thinning of the smallest blood vessels) [3]. Accurate assessment of these vascular changes is critical for identifying patients at risk for long-term complications such as pulmonary embolism or right heart failure [4]. A recent study investigates whether automated quantification of small-vessel rarefaction on routine imaging can bridge this diagnostic gap.