Brigham and Women's Hospital-Harvard Medical School Pulmonary and Critical Care Fellowship Faculty George R. Washko, M.D., M.M.Sc.
George R. Washko, M.D., M.M.Sc.
Asistant Professor of Medicine, Harvard Medical School

Profile:

Dr. Washko’s overall research goal is to develop the tools necessary to use pulmonary imaging as a tool for the selection of more homogeneous subsets of subjects with COPD for therapeutic intervention and as an intermediate study endpoint for clinical investigation.  There is a tremendous amount of heterogeneity in the clinical manifestations of smoking related lung disease and this has made clinical investigation of COPD a challenge where even the most promising trials have found beneficial impact in only a subset of the study cohort.  Quantitative and qualitative image analysis can improve our understanding of disease pathophysiology, reduce some of the heterogeneity observed in COPD, and potentially allow the selection of subjects who are most and least likely to benefit from intervention.  Dr. Washko’s background includes didactic training in both engineering at the University of Pennsylvania and clinical research over a decade later at Harvard Medical School.  In that interval he completed Pulmonary and Critical Care Fellowship training where he was mentored in clinical research.  He has since become the Associate Director of the Framingham Heart Study Pulmonary Research Center as well as the PI of the sub-contract to perform objective CT measures of disease.  Dr. Washko is also the regional PI of the COPD Clinical Research Network and has secured additional funding through the K23 mechanism and the Parker B. Francis Foundation, the later two of which are focused on the development and validation of image based biomarkers of lung disease.

Publications:

  1. Washko GR, O'Donnell CR, Loring SH. Volume-related and volume-independent effects of posture on esophageal and transpulmonary pressures in healthy subjects. J Appl Physiol 2006;100(3):753-8. PMCID: PMC16306256.

  2. Hersh CP, Washko GR, Jacobson FL, Gill R, Estepar RS, Reilly JJ, Silverman EK. Interobserver variability in the determination of upper lobe-predominant emphysema. Chest. 2007;131(2):424-31. PMCID: PMC17296643.

  3. Reilly J, Washko G, Pinto-Plata V, Velez E, Kenney L, Berger R, Celli B. Biological lung volume reduction: a new bronchoscopic therapy for advanced emphysema. Chest. 2007;131(4):1108-13. PMCID: PMC17426216.

  4. Dransfield MT, Washko GR, Foreman MG, Estepar RS, Reilly J, Bailey WC. Gender differences in the severity of CT emphysema in COPD. Chest. 2007;132(2):464-70.PMCID: PMC17573503.

  5. Washko GR, Criner GJ, Mohsenifar Z, Sciurba FC, Sharafkhaneh A, Make BJ, Hoffman EA, Reilly JJ, for the NETT Research Group. CT based quantification of emphysema and correlation to lung function and mechanics. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2008;5(3):177-186. PMCID: PMC18568842.

  6. Washko GR, Fan VS, Ramsey SD, Mohsenifar Z, Martinez F, Make BJ, Sciurba FC, Criner GJ, Minai O, Decamp MM, Reilly JJ, The effect of lung volume reduction surgery on chronic obstructive pulmonary disease exacerbations. Am J Respir Crit Care Med. 2008;177(2):164-9. PMCID: PMC17962632.

  7. Washko GR, Hoffman E, Reilly JJ. Radiographic evaluation of the potential lung volume reduction surgery candidate. Proc Am Thorac Soc. 2008;5(4):421-6. PMCID: PMC18453349.

  8. Tzeng YS, Hoffman E, Cook-Granroth J, Gereige J, Mansour J, Washko G, Cho M, Stepp E, Lutchen K, Albert M. Investigation of hyperpolarized (3)he magnetic resonance imaging utility in examining human airway diameter behavior in asthma through comparison with high-resolution computed tomography. Acad Radiol. 2008;15(6):799-808. PMCID: PMC18486015.

  9. San José Estépar R, Reilly JJ, Silverman EK, Washko GR.  Three-dimensional airway measurements and algorithms.  Proc Am Thorac Soc  2008; 5(9):905-9   PMCID: PMC19056714.

  10. Hecht A, Ma S, Porszasz J, Casaburi R; COPD Clinical Research Network.  Methodology for using long-term accelerometry monitoring to describe daily activity patterns in COPD.  COPD  2009 Apr:6(2)121-9. PMCID: PMC19378225.

  11. Kim WJ, Silverman EK, Hoffman E, Criner GC, Mosenifar Z, Sciurba FC, Make BJ, Carey V, Diaz A, Reilly JJ, Martinez FJ, and Washko GR for the NETT Research Group.  Computed Tomographic Metrics of Airway Disease and Emphysema in Severe COPD. Chest 2009; 136(2):396-404. PMCID: PMC19411295.

  12. Washko GR, Dransfield MT, San Jose Estepar R, Diaz A, Matsuoka S, Yamashiro T, Hatabu H, Silverman EK, Bailey WC, and Reilly JJ.  Airway wall attenuation: A biomarker of airway disease in subjects with COPD. J Appl Physio 2009; 107(1):185-91.  PMCID: PMC19407254.

  13. Dransfield MT, Moon NH, Han, MK, Harnden S, Criner, GJ, Martinez, FJ, Scanlon PD, Woodruff PG, Washko GR, Connett JE, Anthonisen NR, and Bailey WC for the COPD Clinical Research Network.  Superior Immune Response to Protein-conjugate vs. Free Pneumococcal Polysaccharide Vaccine in COPD. Am J Respir Crit Care Med. 2009;180(6):499-505. PMCID: PMC19556517.

  14. Ross JC, San Jose Estepar R, Diaz A, Westin CF, Kikinis R, Silverman EK, Washko GR. Lung Extraction, Lobe Segmentation and Hierarchical Region Assessment for Quantitative Analysis on High Resolution Computed Tomographic Images.  Med Image Comput Comput Assist Interv Int Conf Med Image Comput Comput Assist Interv.  2009;12(Pt 2):690-98.

  15. Matsuoka S, Yamashiro T, Washko GR, Kurihara Y, Nakajima Y, Hatabu H.  Quantitative CT Assessment of Chronic Obstructive Pulmonary Disease Phenotypes.  Radiographics. 2010;30(1):55-66. PMCID: PMC20083585.

  16. GR Washko, DA Lynch, S Matsuoka, J Ross, S Umeoka, A Diaz, FC Sciurba, GM Hunninghake, EK Silverman, IO Rosas, and H Hatabu. Identification of Early Interstitial Lung Disease in Smokers from the COPDGene Study.  Acad Radiol 2010;17(1):48-53. PMCID: PMC19781963.

  17. Matsuoka S, Washko GR, Dransfield MT, Yamashiro T, San Jose Estepar R, Diaz A, Silverman EK, Patz S, Hatabu H.  Quantitative CT Measurement of Cross-sectional Area of Small Pulmonary Vessel in COPD: Correlations with Emphysema and Airflow Limitation.  Acad Radiol 2010;17(1):93-9. PMCID: PMC19796970.

  18. Yamashiro T, Matsuoka S, San Jose Estepar R, Diaz A, Newell J, Sandhaus RA, Mergo P, Brantly ML, Murayama S, Reilly JJ, Hatabu H, Silverman EK, Washko, GR.  Quantitative airway assessment on computed tomography in patients with ?1-antitrypsin deficiency.  COPD 2009;6(6):468-77. PMCID: PMC19938971.

  19. Matsuoka S, Washko GR, Yamashiro T, San Jose Estepar R, Diaz A, Silverman EK, Hoffman EA, Fessler HE, Criner GJ, Marchetti N, Scharf SM, Martinez FJ, Reilly JJ, Hatabu H.  Pulmonary hypertension and CT measurement of small pulmonary vessels in severe emphysema.  Am J Respir Crit Care Med. 2010;181(3):218-225. PMCID: PMC19875683.

  20. Yamashiro T, Matsuoka S, Bartholmai B, San Jose Estepar R, Ross JC, Diaz A, Murayama S, Silverman EK, Hatabu H, Washko GR. Collapsibility of lung volume by paired inspiratory and expiratory CT scans: correlations with lung function and mean lung density.  Acad Radiol 2010;17(4):489-495. PMCID: PMC20060751.

  21. Washko GR.  Diagnostic imaging in COPD.  Seminars in Resp Med 2010;31(3):276-85.

  22. Washko GR, Martinez FJ, Hoffman EA, Loring SL, San Jose Estepar R, Diaz A, Sciurba FC, Silverman EK, Han M, DeCamp M, Reilly JJ, for the NETT Research Group.  Physiologic and computed tomographic predictors of outcome from lung volume reduction surgery.  Am J Respir Crit Care Med. 2010;181(5):494-500. PMCID: PMC19965810.

  23. Wan ES, Pober BR, Washko GR, Raby BA, Silverman EK. Pulmonary function and emphysema in Williams-Bueren Syndrome.  Am J Med Genet. A. 2010;152A(3):653-6. PMCID: PMC20186780.

  24. Yamashiro T, Matsuoka S, San Jose Estepar R, Dransfield MT, Reilly JJ, Hatabu H, Washko GR.  Quantitative assessment of bronchial wall attenuation on thin-section CT: An indicator of airflow limitation in chronic obstructive pulmonary disease.  Am J. Roent 2010;195(2):363-9.

  25. Nishino M, Washko GR, Hatabu H. Volumetric expiratory HRCT of the lung: clinical applications. Radiol Clin North Am. 2010;48(1):177-183. PMCID: PMC19995635.

  26. Diaz A, Bartholmai B, San Jose Estepar R, Ross J, Matsuoka S, Yamashiro T, Hatabu H, Reilly JJ, Silverman EK, and Washko GR.  Relationship of Emphysema and Airway Disease Assessed by CT to Exercise Capacity in Subjects with COPD.  Resp Med 2010;104(8):1145-51.

  27. Cho MH, Washko GR, Hoffman TJ, Criner GJ, Hoffman EA, Martinez, FJ, Laird N, Reilly JJ, and Silverman EK Cluster Analysis in Severe Emphysema Subjects Using Phenotype and Genotype Data: An Exploratory Investigation. Respiratory Research 2010;11(1):30. PMCID: PMC20233420.

  28. Chandra D, Lipson, DA, Hoffman EA, Hansen-Flaschen J, Sciurba FC, DeCamp MM, Reilly JJ, Washko GR for the NETT Research Group. Perfusion scintigraphy and patient selection for lung volume reduction surgery.  Am J Respir Crit Care Med. 2010;182(7):937-46. 
     
  29. Han MK, Agusti A, Calverley PM, Celli BR, Criner G, Curtis JL, Fabbri LM, Goldin JG, Jones PW, MacNee W, Make BJ, Rabe KF, Rennard SI, Sciurba FC, Silverman EK, Vestbo J, Washko GR, Wouters EFM, and Marinez FJ. COPD Phenotypes: The future of COPD.  Am J Respir Crit Care Med. 2010;182(5):598-604.

  30. Diaz A, Valim C, Yamashiro T, San Jose Estepar R, Ross J, Matsuoka S, Bartholmai B, Hatabu H, Silverman EK, and Washko GR.  Airway count and emphysema assessed by chest CT predicts clinical outcome in smokers.  Chest. 2010;138(4):880-7.

  31. Kim WJ, Hoffman EA, Reilly JJ, Hersh C, DeMeo DD, Washko GR, Silverman EK. Association of COPD candidate genes with CT emphysema and airway phenotypes in severe COPD. Eur Resp J. 2010. In Press.

  32. Sorheim, IC, DeMeo DL, Washko GR, Litonjua A, Sparrow D, Bowler R, Bakke PS, Pillai SG, Coxson HO, Lomas DA, Silverman EK, and Hersh CP.  Polymorphisms in the superoxide dismutase-3 gene are associated with emphysema in COPD.  COPD. 2010 In press.

  33. Kong X, Cho MH, Anderson W, Coxson H, Muller N, Washko G, Hoffman E, Bakke P, Gulsvik A, Lomas DA, Silverman EK, Pillai SG. Genome-wide association study identifies BICD1 as a potential susceptibility gene for emphysema. Am J Resp Crit Care Med. 2011;183(1):43-49.

  34. Matsuoka S, Yamashiro T, Diaz A, San Jose Estepar R, Ross JC, Silverman EK, Kobayashi Y, Dransfield MT, Bartholmai B, Hatabu H, and Washko GR. Relationship between small pulmonary vascular alteration and aortic atherosclerosis in chronic obstructive pulmonary disease: Quantitative CT analysis.  Acad Radiol. 2010:18(1);40-6.

  35. Dransfield MT, Huang F, Nath H, Singh SP, Bailey WC, and Washko GR.  CT emphysema predicts thoracic aortic calcification in smokers with and without COPD. COPD. 2010:7(6);404-10.

  36. Woodruff P, Albert R, Bailey W, Casaburi R, Connett J, Cooper J, Criner G, Curtis J, Dransfield M, Han M, Harnden S, Kim V, Marchetti N, Martinez F, McEvoy C, Niewoehner D, Reilly J, Rice K, Scanlon P, Scharf S, Sciurba F, Washko G, Lazarus S. Randomized trial of Zileuton for treatment of COPD exacerbations requiring hospitalization. COPD. 2010. In press.

  37. Yamashiro T, San Jose Estepar R, Matsuoka S, Bartholmai BJ, Ross JC, Diaz A, Murayama S, Silverman EK, Hatabu H, Washko GR.  Intrathoracic tracheal volume and collapsibility on inspiratory and end-expiratory CT scans:  Correlations with lung volume and pulmonary function in 85 smokers.  Acad Radiol 2010. In Press.

  38. Yamashiro T, Matsuoka S, San Jose Estepar R, Bartholmai B, Diaz A, Ross J, Murayama S, Silverman E, Hatabu H, Washko GR.  Kurtosis and skewness of density histograms on inspiratory and expiratory CT scans in smokers.  COPD. 2010. In Press.

  39. Washko GR*, Hunninghake GM*, Fernandez IE, Nishino M, Okajima Y, Yamashiro T, Ross JC, San Jose Estepar R, Lynch DA, Brehm JM, Andriole KP, Diaz AA, Silverman EK, Hatabu H, Rosas IO and the COPDGene Investigators. Lung Volumes and Emphysema in Smokers with Interstitial Lung Abnormalities. NEJM. 2011. In Press.
    *Co-First Authors

  40. Patz S, Muradyan I, Hrovat MI, Dabaghyan M, Washko GR, Hatabu H, Butler JP. Diffusion of Hyperpolarized 129Xe in the Lung: Simplified Model of 129Xe Septal Uptake & Experimental Results.  New J. Phys. 2010. In Press.

  41. Hersh CP, Hokanson JE, Lynch DA, Washko GR, Make BJ, Crap JD, Silverman EK, and the COPDGene Investigators. Family history is a risk factor for chronic obstructive pulmonary disease. Chest. 2011. In Press.

  42. Han MK, Kazerooni EA, Lynch DA, Liu LX, Murray S, Curtis JL, Criner GC, Kim V, Bowler RP, Hanania NA, Anzueto AR, Make BJ, Hokanson JE, Crapo JD, Silverman EK, Martinez FJ, Washko GR for the COPDGene Investigators.  Radiologic Phenotypes Associated with COPD Exacerbations in COPDGene. Radiology. 2011 In Press.

  43. Foreman MG, Zhang L,  Murphy J, Hansel NN, Make B, Hokanson JE, Washko G, Crapo JD, Silverman EK, DeMeo DL, and the COPDGene Investigators.  Early-Conset COPD is Associated with Female Gender, Maternal Factors, and African American Race in the COPDGene Study. Am J Respir Crit Care Med. 2011. In Press.

  44. Albert RK, Connett J, Bailey WC, Casaburi R, Cooper JAD, Criner GJ, Curtis JL, Dransfield MT, Han M, Lazarus SC, Make B, Marchetti N, Martinez FJ, Madinger NE, McEvoy C, Niewoehner DE, Porsasz J, Price CS, Reilly J, Scanlon PD, Sciurba FC, Scharf SM, Washko GR, Woodruff PG, and Anthonisen NR for the COPD Clinical Research Network.  Chronic Administration of Azithromycin Decreases the Frequency of Chronic Obstructive Pulmonary Disease Exacerbations.  Results of a Randomized Trail. NEJM 2011. In Press.

  45. Kim DK, Jacobson FL, Washko GR, Casaburi R, Make BJ, Crapo JD, Silverman ED, Hersh CP. Clinical and radiographic correlates of hypoxemia and oxygen therapy in the COPDGene study. Respir Med. 2011. In Press.

  46. Okajima Y, Ohno Y, Washko GR, Hatabu H. Assessment of pulmonary hypertension what CT and MRI can provide. Acad Radiol. 2011 Apr;18(4):437-53.

  47. Kim DK, Hersh CP, Washko GR, Hokanson JE, Lynch DA, Newell JD, Murphy JR, Crapo JD, Silverman EK; COPDGene Investigators. Epidemiology, radiology, and genetics of nicotine dependence in COPD. Respir Res. 2011 Jan 13;12:9.

  48. Kim, Schroeder, Lynch DA, Newell J, Make BJ, Friedlander A, San Jose Estepar R, Hanania N, Washko GR, Murphy J, Wilson C, Hokanson J, Zach J, Butterfield, Bowler R.  Gender differences of airway dimensions in anatomically matched sites on CT in smokers. COPD. 2011. In Press.

  49. Come CE, Divo MJ, San José Estépar R, Sciurba FC, Criner GJ, Marchetti N, Scharf SM, Mosenifar Z, Make BJ, Keller CA, Minai OA, Martinez FJ, Han MK, Reilly JJ, Celli BR, Washko GR for the NETT Research Group.  Lung Deflation and Oxygen Pulse in COPD: Results from the NETT Randomized Trial. Respiratory Medicine, 2011. In Press.

  50. Diaz A, Come C, Ross J, San José Estépar R, MeiLan M, Loring S, Silverman EK, Washko GR.  Association between Airway Caliber Changes with Lung Inflation and Emphysema assessed by volumetric CT in patients with COPD. Chest 2011. In Press.

  51. COPDGene CT workshop group. A combined pulmonary-radiology workshop for visual evaluation of COPD: study design, chest CT findings and concordance with quantitative evaluation. COPD, 2011. In Press.

  52. Xu J*, Washko GR*, Nakahira K, Hatabu H, Fernandez IE, Nishino M, Okajima Y, Yamashiro T, Patel AS, Ross JC, San Jose Estepar R, Diaz AA, Li H, Qu J, Himes BE, Come CE, D’Aco K, Martinez FJ, Han MK, Lynch DA, Crapo JD, Morse M, Ryter SW, Silverman EK, Rosas IO, Choi AM, Hunninghake GM, and the COPDGene Investigators.  Statins and Pulmonary Fibrosis: The potential role of NLRP3 Inflammasome Activation. Am. J. Respir. Crit. Care Med. 2011. In Press. *Co-First Authors

  53. Doyle TW, Washko GR, Fernandez IE, Nishino M, Okajima Y, Yamashiro T, Divo MJ, Celli BR, Sciurba FS, Silverman EK, Hatabu H, Rosas IO, Hunninghake GM, and the COPDGene Investigators. Interstitial Lung Abnormalities and Reduced Exercise Capacity. Am. J. Respir. Crit. Care Med. 2011. In Press.

  54. Martinez CH, Chen Y, Westgate PM, Liu LX, Murray S, Curtis JL, Make BJ, Kazerooni EA, Lynch DA, Marchetti N, Washko GR, Martinez FJ, Han MK. Relationship between quantitative CT metrics and health status and BODE in COPD. Thorax 2012. In Press.

  55. Barr CC, Berkowitz EA, Bigazzi F, Bode F, Bon J, Bowler RP, Chiles C, Crapo JD, Criner GJ, Curtis JL, Dass C, Dirksen A, Dransfield MT, Edula G, Erikkson L, Friedlander A, Galperin-Aizenberg M, Gefter WB, Gierada DS, Grenier PA, Goldin J, Han MK, Hanania NA, Hansel NN, Jacobson FL, Kauczor HU, Kinnula VL, Lipson DA, Lynch DA, Macnee W, Make BJ, Mamary AJ, Mann H, Marchetti N, Mascalchi M, McLennan G, Murphy JR, Naidich D, Nath H, Newell JD Jr, Pistolesi M, Regan EA, Reilly JJ, Sandhaus R, Schroeder JD, Sciurba F, Shaker S, Sharafkhaneh A, Silverman EK, Steiner RM, Strange C, Sverzellati N, Tashjian JH, Beek EJ, Washington L, Washko GR, Westney G, Wood SA, Woodruff Deceased PG.  A combined Pulmonary-Radiology workshop for visual evaluation of COPD: Study design, chest CT findings and concordance with quantitative evaluation.  COPD. 2012. In press.