Pietro Nardelli, PhD: From Macrovascular Changes to Microvascular Defects: Advances in Imaging-based Approaches for Pulmonary Hypertension

Pietro Nardelli, PhD

Instructor in Radiology
Brigham and Women’s Hospital
Harvard Medical School

Abstract

Pulmonary hypertension (PH) is a complex condition frequently arising as a complication of common diseases such as COPD, heart failure, and pulmonary embolism. Despite recent advances, the early detection, etiology, and evolution of PH are still poorly understood, due in part to its complex etiology and the lack of well-validated biomarkers that can account for the disease’s heterogeneity. My research focuses on leveraging artificial intelligence (AI) to identify new structural and functional markers of PH derived from non-contrast CT scans, with a particular emphasis on PH associated with COPD. A key aspect of this work involves refining quantitative measures of vascular morphology to better define the impact of PH on the pulmonary vasculature.

In this talk, I will discuss the role of CT and spectral CT imaging in providing scalable, non-invasive tools for better PH classification. While vascular pruning is a measurable feature on CT, it does not fully capture the vascular remodeling that is central to PH progression. To address this, we are developing advanced AI-based techniques for detecting subtle changes in the vascular wall from non-contrast CT, allowing for a more precise characterization of microvascular pathology.

Furthermore, I will discuss how recent advancements in spectral imaging, such as dual-energy and photon-counting CT, will offer opportunities to assess microvascular remodeling. We are refining material decomposition techniques to improve the detection of vascular walls, providing deeper insights into vascular health. Finally, radiomics approaches are beginning to identify imaging markers with diagnostic value in pulmonary vascular disease, offering new opportunities for both clinical application and therapeutic development.

Short Bio

Pietro Nardelli is an Instructor in Radiology at the Brigham and Women’s Hospital. Originally trained in biomedical engineering, he obtained his PhD in Electrical and Electronic Engineering from the University College Cork, Ireland. He has a specific expertise in medical imaging and Artificial Intelligence applied to medicine. In 2016, he joined the Applied Chest Imaging Laboratory, led by Dr. San José Estépar and Dr. George R. Washko, where he has developed innovative deep learning algorithms to extract novel, image-based biomarkers for pulmonary vascular disease. His research focuses on the analysis of peripheral bronchial and vascular morphology from CT images, the role of pulmonary vasculature in pulmonary hypertension (PH), and predicting clinical outcomes directly from imaging with using AI techniques. Recently, Pietro was awarded an NIH K25 grant to expand his work in developing computational methods that quantify vascular structural and functional changes in the lungs of patients with PH and COPD. Pietro’s goal is to create non-invasive tools for detecting PH in smokers, enhance our understanding of the disease, and pave the way for more targeted therapies.