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Bayfield KJ, Weinheimer O, Middleton A, Boyton C, Fitzpatrick R, Kennedy B, Blaxland A, Jayasuriya G, Caplain N, Wielpütz MO, Yu L, Galban CJ, Robinson TE, Bartholmai B, Gustafsson P, Fitzgerald D, Selvadurai H, Robinson PD. Comparative sensitivity of early cystic fibrosis lung disease detection tools in school aged children. J Cyst Fibros 2024:S1569-1993(24)00075-4. [PMID: 38969602 DOI: 10.1016/j.jcf.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 05/05/2024] [Accepted: 05/20/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Effective detection of early lung disease in cystic fibrosis (CF) is critical to understanding early pathogenesis and evaluating early intervention strategies. We aimed to compare ability of several proposed sensitive functional tools to detect early CF lung disease as defined by CT structural disease in school aged children. METHODS 50 CF subjects (mean±SD 11.2 ± 3.5y, range 5-18y) with early lung disease (FEV1≥70 % predicted: 95.7 ± 11.8 %) performed spirometry, Multiple breath washout (MBW, including trapped gas assessment), oscillometry, cardiopulmonary exercise testing (CPET) and simultaneous spirometer-directed low-dose CT imaging. CT data were analysed using well-evaluated fully quantitative software for bronchiectasis and air trapping (AT). RESULTS CT bronchiectasis and AT occurred in 24 % and 58 % of patients, respectively. Of the functional tools, MBW detected the highest rates of abnormality: Scond 82 %, MBWTG RV 78 %, LCI 74 %, MBWTG IC 68 % and Sacin 51 %. CPET VO2peak detected slightly higher rates of abnormality (9 %) than spirometry-based FEV1 (2 %). For oscillometry AX (14 %) performed better than Rrs (2 %) whereas Xrs and R5-19 failed to detect any abnormality. LCI and Scond correlated with bronchiectasis (r = 0.55-0.64, p < 0.001) and AT (r = 0.73-0.74, p < 0.001). MBW-assessed trapped gas was detectable in 92 % of subjects and concordant with CT-assessed AT in 74 %. CONCLUSIONS Significant structural and functional deficits occur in early CF lung disease, as detected by CT and MBW. For MBW, additional utility, beyond that offered by LCI, was suggested for Scond and MBW-assessed gas trapping. Our study reinforces the complementary nature of these tools and the limited utility of conventional oscillometry and CPET in this setting.
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Affiliation(s)
- Katie J Bayfield
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research DZL, Heidelberg, Germany
| | - Anna Middleton
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Christie Boyton
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Rachel Fitzpatrick
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Brendan Kennedy
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Anneliese Blaxland
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Geshani Jayasuriya
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Neil Caplain
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research DZL, Heidelberg, Germany
| | - Lifeng Yu
- Division of Radiology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Craig J Galban
- Department of Radiology, Michigan Medicine, Ann Arbor, MI, USA
| | - Terry E Robinson
- Department of Pediatrics, Center of Excellence in Pulmonary Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Brian Bartholmai
- Division of Radiology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Per Gustafsson
- Department of Paediatrics, Central Hospital, Skövde, Sweden
| | - Dominic Fitzgerald
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia; The University of Sydney, Sydney, New South Wales, Australia
| | - Hiran Selvadurai
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia; The University of Sydney, Sydney, New South Wales, Australia
| | - Paul D Robinson
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Woolcock Institute of Medical Research, Sydney, New South Wales, Australia; The University of Sydney, Sydney, New South Wales, Australia; Children's Health and Environment Program, Child Health Research Centre, University of Queensland, South Brisbane, Australia.
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Dudurych I, Pelgrim GJ, Sidorenkov G, Garcia-Uceda A, Petersen J, Slebos DJ, de Bock GH, van den Berge M, de Bruijne M, Vliegenthart R. Low-Dose CT-derived Bronchial Parameters in Individuals with Healthy Lungs. Radiology 2024; 311:e232677. [PMID: 38916504 DOI: 10.1148/radiol.232677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Background CT-derived bronchial parameters have been linked to chronic obstructive pulmonary disease and asthma severity, but little is known about these parameters in healthy individuals. Purpose To investigate the distribution of bronchial parameters at low-dose CT in individuals with healthy lungs from a Dutch general population. Materials and Methods In this prospective study, low-dose chest CT performed between May 2017 and October 2022 were obtained from participants who had completed the second-round assessment of the prospective, longitudinal Imaging in Lifelines study. Participants were aged at least 45 years, and those with abnormal spirometry, self-reported respiratory disease, or signs of lung disease at CT were excluded. Airway lumens and walls were segmented automatically. The square root of the bronchial wall area of a hypothetical airway with an internal perimeter of 10 mm (Pi10), luminal area (LA), wall thickness (WT), and wall area percentage were calculated. Associations between sex, age, height, weight, smoking status, and bronchial parameters were assessed using univariable and multivariable analyses. Results The study sample was composed of 8869 participants with healthy lungs (mean age, 60.9 years ± 10.4 [SD]; 4841 [54.6%] female participants), including 3672 (41.4%) never-smokers and 1197 (13.5%) individuals who currently smoke. Bronchial parameters for male participants were higher than those for female participants (Pi10, slope [β] range = 3.49-3.66 mm; LA, β range = 25.40-29.76 mm2; WT, β range = 0.98-1.03 mm; all P < .001). Increasing age correlated with higher Pi10, LA, and WT (r2 range = 0.06-0.09, 0.02-0.01, and 0.02-0.07, respectively; all P < .001). Never-smoking individuals had the lowest Pi10 followed by formerly smoking and currently smoking individuals (3.62 mm ± 0.13, 3.68 mm ± 0.14, and 3.70 mm ± 0.14, respectively; all P < .001). In multivariable regression models, age, sex, height, weight, and smoking history explained up to 46% of the variation in bronchial parameters. Conclusion In healthy individuals, bronchial parameters differed by sex, height, weight, and smoking history; male sex and increasing age were associated with wider lumens and thicker walls. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Emrich and Varga-Szemes in this issue.
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Affiliation(s)
- Ivan Dudurych
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Gert-Jan Pelgrim
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Grigory Sidorenkov
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Antonio Garcia-Uceda
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Jens Petersen
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Dirk-Jan Slebos
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Geertruida H de Bock
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Maarten van den Berge
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Marleen de Bruijne
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
| | - Rozemarijn Vliegenthart
- From the Departments of Radiology (I.D., G.J.P., G.S., R.V.), Epidemiology (G.S., G.H.d.B.), and Pulmonology (D.J.S., M.v.d.B.), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 GZ Groningen, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands (A.G.U., M.d.B.); Department of Computer Science, Copenhagen University, Copenhagen, Denmark (J.P., M.d.B.); and Department of Oncology, Rigshospitalet, Copenhagen, Denmark (J.P.)
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Sewer A, Talikka M, Calvino-Martin F, Luettich K, Iskandar A. Quantitative modeling of in vitro data using an adverse outcome pathway for the risk assessment of decreased lung function in humans. Toxicol Lett 2024; 393:107-113. [PMID: 38350531 DOI: 10.1016/j.toxlet.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/18/2024] [Accepted: 02/07/2024] [Indexed: 02/15/2024]
Abstract
In the absence of epidemiological data, there is a need to develop computational models that convert in vitro findings to human disease risk predictions following toxicant exposure. In such efforts, in vitro data can be evaluated in the context of adverse outcome pathways (AOPs) that organize mechanistic knowledge based on empirical evidence into a sequence of molecular-, cellular-, tissue-, and organ-level key events that precede an adverse outcome (AO). Here we combined data from advanced in vitro organotypic airway models exposed to combustible cigarette (CC) smoke or Tobacco Heating System (THS) aerosol with an AOP for increased oxidative stress leads to decreased lung function. The mathematical modeling predicted reduced risk of decreased ciliary beating frequency (CBF) based on oxidative stress measurements and reduced risk of decreased mucociliary clearance (MCC) based on CBF measurements in THS aerosol- compared with CC smoke-exposed cultures. To extend the predictions to the AO of decreased lung function, we leveraged human MCC data from current smokers, nonsmokers, former smokers, and users of heated tobacco products. This approach provided a plausible prediction of diminished reduction in lung function in response to THS use compared with continued smoking. The current approach may also present a basis for an integrated approach to testing and assessment of tobacco products for future regulatory decision-making.
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Affiliation(s)
- Alain Sewer
- PMI R&D, Philip Morris Products S.A., Neuchâtel, Switzerland.
| | - Marja Talikka
- PMI R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Karsta Luettich
- PMI R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Anita Iskandar
- PMI R&D, Philip Morris Products S.A., Neuchâtel, Switzerland
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Wielpütz MO, Mall MA. Therapeutic improvement of CFTR function and reversibility of bronchiectasis in cystic fibrosis. Eur Respir J 2024; 63:2400234. [PMID: 38548272 DOI: 10.1183/13993003.00234-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/14/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Center for Lung Research (DZL), associated partner site, Berlin, Germany
- Berlin Institute of Health (BIH) at Charité-Universitätsmedizin Berlin, Berlin, Germany
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Pu Y, Zhou X, Zhang D, Guan Y, Xia Y, Liu S, Fan L. Quantitative Assessment Characteristics of Small Pulmonary Vessel Remodelling in Populations at High Risk for COPD and Smokers Using Low-Dose CT. Int J Chron Obstruct Pulmon Dis 2024; 19:51-62. [PMID: 38205400 PMCID: PMC10778209 DOI: 10.2147/copd.s436242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Purpose To explore the morphological alterations in small pulmonary vessels in populations at high risk for chronic obstructive pulmonary disease (COPD) and smokers based on multiple computed tomography (CT) quantitative parameters. Patients and Methods A total of 1969 Three Major Chest Diseases Screening Study participants with available demographic data and smoking history who underwent low-dose chest CT from 2018 to 2020 were included. All subjects were divided into normal, high risk for COPD, and COPD groups according to their pulmonary function test (PFT) results. Furthermore, the three groups were further subdivided into never-smokers, current smokers, and former smokers subgroups according to their smoking history. Quantitative parameters, such as the number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels, were extracted by computer software. Differences in small pulmonary vessel parameters among the groups were compared using two-way ANOVA. Results The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the group at high risk for COPD were lower than those in the normal group (P<0.05). The number, area at 6 mm~24 mm subpleura and volume of small pulmonary vessels in the COPD group were higher than those in the normal group (P<0.05). The number, area of small pulmonary vessels at 6 mm~12 mm subpleura in current smokers with high risk for COPD were higher than those in former smokers with high risk for COPD (P<0.05). Conclusion The number, area, and volume of small pulmonary vessels in populations at high risk for COPD were decreased. Smoking cessation may impede structural changes in small pulmonary vessels in populations at high risk for COPD.
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Affiliation(s)
- Yu Pu
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
| | - Xiuxiu Zhou
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
| | - Di Zhang
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
| | - Yu Guan
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
| | - Yi Xia
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
| | - Shiyuan Liu
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
| | - Li Fan
- Department of Radiology, Second Affiliated Hospital of PLA Naval Medical University, Shanghai, People’s Republic of China
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Bodenberger AL, Konietzke P, Weinheimer O, Wagner WL, Stiller W, Weber TF, Heussel CP, Kauczor HU, Wielpütz MO. Quantification of airway wall contrast enhancement on virtual monoenergetic images from spectral computed tomography. Eur Radiol 2023; 33:5557-5567. [PMID: 36892642 PMCID: PMC10326154 DOI: 10.1007/s00330-023-09514-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/31/2022] [Accepted: 02/02/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVES Quantitative computed tomography (CT) plays an increasingly important role in phenotyping airway diseases. Lung parenchyma and airway inflammation could be quantified by contrast enhancement at CT, but its investigation by multiphasic examinations is limited. We aimed to quantify lung parenchyma and airway wall attenuation in a single contrast-enhanced spectral detector CT acquisition. METHODS For this cross-sectional retrospective study, 234 lung-healthy patients who underwent spectral CT in four different contrast phases (non-enhanced, pulmonary arterial, systemic arterial, and venous phase) were recruited. Virtual monoenergetic images were reconstructed from 40-160 keV, on which attenuations of segmented lung parenchyma and airway walls combined for 5th-10th subsegmental generations were assessed in Hounsfield Units (HU) by an in-house software. The spectral attenuation curve slope between 40 and 100 keV (λHU) was calculated. RESULTS Mean lung density was higher at 40 keV compared to that at 100 keV in all groups (p < 0.001). λHU of lung attenuation was significantly higher in the systemic (1.7 HU/keV) and pulmonary arterial phase (1.3 HU/keV) compared to that in the venous phase (0.5 HU/keV) and non-enhanced (0.2 HU/keV) spectral CT (p < 0.001). Wall thickness and wall attenuation were higher at 40 keV compared to those at 100 keV for the pulmonary and systemic arterial phase (p ≤ 0.001). λHU for wall attenuation was significantly higher in the pulmonary arterial (1.8 HU/keV) and systemic arterial (2.0 HU/keV) compared to that in the venous (0.7 HU/keV) and non-enhanced (0.3 HU/keV) phase (p ≤ 0.002). CONCLUSIONS Spectral CT may quantify lung parenchyma and airway wall enhancement with a single contrast phase acquisition, and may separate arterial and venous enhancement. Further studies are warranted to analyze spectral CT for inflammatory airway diseases. KEY POINTS • Spectral CT may quantify lung parenchyma and airway wall enhancement with a single contrast phase acquisition. • Spectral CT may separate arterial and venous enhancement of lung parenchyma and airway wall. • The contrast enhancement can be quantified by calculating the spectral attenuation curve slope from virtual monoenergetic images.
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Affiliation(s)
- Arndt Lukas Bodenberger
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
| | - Philip Konietzke
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Willi Linus Wagner
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Wolfram Stiller
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Tim Frederik Weber
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Claus Peter Heussel
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Mark Oliver Wielpütz
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, 69120, Heidelberg, Germany.
- Department of Diagnostic and Interventional Radiology With Nuclear Medicine, Thoraxklinik at University of Heidelberg, Röntgenstraße 1, 69126, Heidelberg, Germany.
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Konietzke P, Brunner C, Konietzke M, Wagner WL, Weinheimer O, Heußel CP, Herth FJF, Trudzinski F, Kauczor HU, Wielpütz MO. GOLD stage-specific phenotyping of emphysema and airway disease using quantitative computed tomography. Front Med (Lausanne) 2023; 10:1184784. [PMID: 37534319 PMCID: PMC10393128 DOI: 10.3389/fmed.2023.1184784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/22/2023] [Indexed: 08/04/2023] Open
Abstract
Background In chronic obstructive pulmonary disease (COPD) abnormal lung function is related to emphysema and airway obstruction, but their relative contribution in each GOLD-stage is not fully understood. In this study, we used quantitative computed tomography (QCT) parameters for phenotyping of emphysema and airway abnormalities, and to investigate the relative contribution of QCT emphysema and airway parameters to airflow limitation specifically in each GOLD stage. Methods Non-contrast computed tomography (CT) of 492 patients with COPD former GOLD 0 COPD and COPD stages GOLD 1-4 were evaluated using fully automated software for quantitative CT. Total lung volume (TLV), emphysema index (EI), mean lung density (MLD), and airway wall thickness (WT), total diameter (TD), lumen area (LA), and wall percentage (WP) were calculated for the entire lung, as well as for all lung lobes separately. Results from the 3rd-8th airway generation were aggregated (WT3-8, TD3-8, LA3-8, WP3-8). All subjects underwent whole-body plethysmography (FEV1%pred, VC, RV, TLC). Results EI was higher with increasing GOLD stages with 1.0 ± 1.8% in GOLD 0, 4.5 ± 9.9% in GOLD 1, 19.4 ± 15.8% in GOLD 2, 32.7 ± 13.4% in GOLD 3 and 41.4 ± 10.0% in GOLD 4 subjects (p < 0.001). WP3-8 showed no essential differences between GOLD 0 and GOLD 1, tended to be higher in GOLD 2 with 52.4 ± 7.2%, and was lower in GOLD 4 with 50.6 ± 5.9% (p = 0.010 - p = 0.960). In the upper lobes WP3-8 showed no significant differences between the GOLD stages (p = 0.824), while in the lower lobes the lowest WP3-8 was found in GOLD 0/1 with 49.9 ± 6.5%, while higher values were detected in GOLD 2 with 51.9 ± 6.4% and in GOLD 3/4 with 51.0 ± 6.0% (p < 0.05). In a multilinear regression analysis, the dependent variable FEV1%pred can be predicted by a combination of both the independent variables EI (p < 0.001) and WP3-8 (p < 0.001). Conclusion QCT parameters showed a significant increase of emphysema from GOLD 0-4 COPD. Airway changes showed a different spatial pattern with higher values of relative wall thickness in the lower lobes until GOLD 2 and subsequent lower values in GOLD3/4, whereas there were no significant differences in the upper lobes. Both, EI and WP5-8 are independently correlated with lung function decline.
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Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Christian Brunner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Marilisa Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Willi Linus Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Claus Peter Heußel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Felix J. F. Herth
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Pulmonology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Franziska Trudzinski
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Pulmonology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Mark Oliver Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
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8
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Wucherpfennig L, Triphan SM, Weinheimer O, Eichinger M, Wege S, Eberhardt R, Puderbach MU, Kauczor HU, Heussel CP, Heussel G, Wielpütz MO. Reproducibility of pulmonary magnetic resonance angiography in adults with muco-obstructive pulmonary disease. Acta Radiol 2023; 64:1038-1046. [PMID: 35876445 DOI: 10.1177/02841851221111486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent studies support magnetic resonance angiography (MRA) as a diagnostic tool for pulmonary arterial disease. PURPOSE To determine MRA image quality and reproducibility, and the dependence of MRA image quality and reproducibility on disease severity in patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). MATERIAL AND METHODS Twenty patients with COPD (mean age 66.5 ± 8.9 years; FEV1% = 42.0 ± 13.3%) and 15 with CF (mean age 29.3 ± 9.3 years; FEV1% = 66.6 ± 15.8%) underwent morpho-functional chest magnetic resonance imaging (MRI) including time-resolved MRA twice one month apart (MRI1, MRI2), and COPD patients underwent non-contrast computed tomography (CT). Image quality was assessed visually using standardized subjective 5-point scales. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured by regions of interest. Disease severity was determined by spirometry, a well-evaluated chest MRI score, and by computational CT emphysema index (EI) for COPD. RESULTS Subjective image quality was diagnostic for all MRA at MRI1 and MRI2 (mean score = 4.7 ± 0.6). CNR and SNR were 4 43.8 ± 8.7 and 50.5 ± 8.7, respectively. Neither image quality score nor CNR or SNR correlated with FEV1% or chest MRI score for COPD and CF (r = 0.239-0.248). CNR and SNR did not change from MRI1 to MRI2 (P = 0.434-0.995). Further, insignificant differences in CNR and SNR between MRA at MRI1 and MRI2 did not correlate with FEV1% nor chest MRI score in COPD and CF (r = -0.238-0.183), nor with EI in COPD (r = 0.100-0.111). CONCLUSION MRA achieved diagnostic quality in COPD and CF patients and was highly reproducible irrespective of disease severity. This supports MRA as a robust alternative to CT in patients with underlying muco-obstructive lung disease.
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Affiliation(s)
- Lena Wucherpfennig
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Simon Mf Triphan
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Monika Eichinger
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Sabine Wege
- Department of Pulmonology and Respiratory Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Ralf Eberhardt
- Department of Pulmonology and Respiratory Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
- Department of Pulmonology and Internal intensive care, Asklepios Clinic Barmbek, Hamburg, Germany
| | - Michael U Puderbach
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology, Hufeland Hospital, Bad Langensalza, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Claus P Heussel
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Gudula Heussel
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
| | - Mark O Wielpütz
- Department of Diagnostic and Interventional Radiology, Subdivision of Pulmonary Imaging, 27178University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Lung Research Center (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, 27178University Hospital Heidelberg, Heidelberg, Germany
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9
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Kahnert K, Jörres RA, Kauczor HU, Alter P, Trudzinski FC, Herth F, Jobst B, Weinheimer O, Nauck S, Mertsch P, Kauffmann-Guerrero D, Behr J, Bals R, Watz H, Rabe KF, Welte T, Vogelmeier CF, Biederer J. Standardized airway wall thickness Pi10 from routine CT scans of COPD patients as imaging biomarker for disease severity, lung function decline, and mortality. Ther Adv Respir Dis 2023; 17:17534666221148663. [PMID: 36718763 PMCID: PMC9896094 DOI: 10.1177/17534666221148663] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Chest computed tomography (CT) is increasingly used for phenotyping and monitoring of patients with COPD. The aim of this work was to evaluate the association of Pi10 as a measure of standardized airway wall thickness on CT with exacerbations, mortality, and response to triple therapy. METHODS Patients of GOLD grades 1-4 of the COSYCONET cohort with prospective CT scans were included. Pi10 was automatically computed and analyzed for its relationship to COPD severity, comorbidities, lung function, respiratory therapy, and mortality over a 6-year period, using univariate and multivariate comparisons. RESULTS We included n = 433 patients (61%male). Pi10 was dependent on both GOLD grades 1-4 (p = 0.009) and GOLD groups A-D (p = 0.008); it was particularly elevated in group D, and ROC analysis yielded a cut-off of 0.26 cm. Higher Pi10 was associated to lower FEV1 % predicted and higher RV/TLC, moreover the annual changes of lung function parameters (p < 0.05), as well as to an airway-dominated phenotype and a history of myocardial infarction (p = 0.001). These associations were confirmed in multivariate analyses. Pi10 was lower in patients receiving triple therapy, in particular in patients of GOLD groups C and D. Pi10 was also a significant predictor for mortality (p = 0.006), even after including multiple other predictors. CONCLUSION In summary, Pi10 was found to be predictive for the course of the disease in COPD, in particular mortality. The fact that Pi10 was lower in patients with severe COPD receiving triple therapy might hint toward additional effects of this functional therapy on airway remodeling. REGISTRATION ClinicalTrials.gov, Identifier: NCT01245933.
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Affiliation(s)
- Kathrin Kahnert
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr. 5, Munich 80336, Germany
| | - Rudolf A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Germany
| | - Peter Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - Franziska C Trudzinski
- Thoraxklinik-Heidelberg gGmbH, Translational Lung Research Centre.,Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Felix Herth
- Thoraxklinik-Heidelberg gGmbH, Translational Lung Research Centre.,Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Bertram Jobst
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Germany
| | - Sebastian Nauck
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Germany
| | - Pontus Mertsch
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Munich, Germany
| | - Diego Kauffmann-Guerrero
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Munich, Germany
| | - Jürgen Behr
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Munich, Germany
| | - Robert Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Homburg, Germany.,Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany
| | - Henrik Watz
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Klaus F Rabe
- Lung Clinic Grosshansdorf, Airway Research Center (ARCN), Grosshansdorf, German.,Faculty of Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Tobias Welte
- Department of Pneumology, Hannover Medical School, Hannover, Germany
| | - Claus F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
| | - Jürgen Biederer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Germany.,Faculty of Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.,University of Latvia, Faculty of Medicine, Raina bulvaris 19, Riga, LV-1586 Latvia
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10
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Kahnert K, Jörres RA, Jobst B, Wielpütz MO, Seefelder A, Hackl CM, Trudzinski FC, Watz H, Bals R, Behr J, Rabe KF, Vogelmeier CF, Alter P, Welte T, Herth F, Kauczor H, Biederer J. Association of coronary artery calcification with clinical and physiological characteristics in patients with COPD: Results from COSYCONET. Respir Med 2022; 204:107014. [DOI: 10.1016/j.rmed.2022.107014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/28/2022] [Accepted: 10/13/2022] [Indexed: 10/31/2022]
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11
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Pu Y, Zhou X, Zhang D, Guan Y, Xia Y, Tu W, Lu Y, Zhang W, Fu CC, Fang Q, de Bock GH, Liu S, Fan L. Re-Defining High Risk COPD with Parameter Response Mapping Based on Machine Learning Models. Int J Chron Obstruct Pulmon Dis 2022; 17:2471-2483. [PMID: 36217330 PMCID: PMC9547550 DOI: 10.2147/copd.s369904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/21/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose To explore optimal threshold of FEV1% predicted value (FEV1%pre) for high-risk chronic obstructive pulmonary disease (COPD) using the parameter response mapping (PRM) based on machine learning classification model. Patients and Methods A total of 561 consecutive non-COPD subjects who were screened for chest diseases in our hospital between August and October 2018 and who had complete questionnaire surveys, pulmonary function tests (PFT), and paired respiratory chest CT scans were enrolled retrospectively. The CT quantitative parameter for small airway remodeling was PRM, and 72 parameters were obtained at the levels of whole lung, left and right lung, and five lobes. To identify a more reasonable thresholds of FEV1% predicted value for distinguishing high-risk COPD patients from the normal, 80 thresholds from 50% to 129% were taken with a partition of 1% to establish a random forest classification model under each threshold, such that novel PFT-parameter-based high-risk criteria would be more consistent with the PRM-based machine learning classification model. Results Machine learning-based PRM showed that consistency between PRM parameters and PFT was better able to distinguish high-risk COPD from the normal, with an AUC of 0.84 when the threshold was 72%. When the threshold was 80%, the AUC was 0.72 and when the threshold was 95%, the AUC was 0.64. Conclusion Machine learning-based PRM is feasible for redefining high-risk COPD, and setting the optimal FEV1% predicted value lays the foundation for redefining high-risk COPD diagnosis.
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Affiliation(s)
- Yu Pu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Xiuxiu Zhou
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Di Zhang
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Yu Guan
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Yi Xia
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Wenting Tu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
| | - Yang Lu
- Department of Scientific Research, Shanghai Aitrox Technology Corporation Limited, Shanghai, People’s Republic of China
| | - Weidong Zhang
- Department of Scientific Research, Shanghai Aitrox Technology Corporation Limited, Shanghai, People’s Republic of China
| | - Chi-Cheng Fu
- Department of Scientific Research, Shanghai Aitrox Technology Corporation Limited, Shanghai, People’s Republic of China
| | - Qu Fang
- Department of Scientific Research, Shanghai Aitrox Technology Corporation Limited, Shanghai, People’s Republic of China
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands
| | - Shiyuan Liu
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China,Correspondence: Shiyuan Liu; Li Fan, Department of Radiology, ChangZheng Hospital, Naval Medical University, No. 415 Fengyang Road, Shanghai, 200003, People’s Republic of China, Tel +86 21 81886012; Tel +86 21 81886012, Fax +86 21 63587668, Email ;
| | - Li Fan
- Department of Radiology, Changzheng Hospital, Naval Medical University, Shanghai, People’s Republic of China
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12
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Kim T, Lim MN, Kim WJ, Ho TT, Lee CH, Chae KJ, Bak SH, Jin GY, Park EK, Choi S. Structural and functional alterations of subjects with cement dust exposure: A longitudinal quantitative computed tomography-based study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 837:155812. [PMID: 35550893 DOI: 10.1016/j.scitotenv.2022.155812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/13/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Cement dust exposure (CDE) can be a risk factor for pulmonary disease, causing changes in segmental airways and parenchymal lungs. This study investigates longitudinal alterations in quantitative computed tomography (CT)-based metrics due to CDE. We obtained CT-based airway structural and lung functional metrics from CDE subjects with baseline CT and follow-up CT scans performed three years later. From the CT, we extracted wall thickness (WT) and bifurcation angle (θ) at total lung capacity (TLC) and functional residual capacity (FRC), respectively. We also computed air volume (Vair), tissue volume (Vtissue), global lung shape, percentage of emphysema (Emph%), and more. Clinical measures were used to associate with CT-based metrics. Three years after their baseline, the pulmonary function tests of CDE subjects were similar or improved, but there were significant alterations in the CT-based structural and functional metrics. The follow-up CT scans showed changes in θ at most of the central airways; increased WT at the subgroup bronchi; smaller Vair at TLC at all except the right upper and lower lobes; smaller Vtissue at all lobes in TLC and FRC except for the upper lobes in FRC; smaller global lung shape; and greater Emph% at the right upper and lower lobes. CT-based structural and functional variables are more sensitive to the early identification of CDE subjects, while most clinical lung function changes were not noticeable. We speculate that the significant long-term changes in CT are uniquely observed in CDE subjects, different from smoking-induced structural changes.
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Affiliation(s)
- Taewoo Kim
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Myoung-Nam Lim
- Biomedical Research Institute, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Thao Thi Ho
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Chang Hyun Lee
- Department of Radiology, College of Medicine, Seoul National University, Seoul, Republic of Korea; Department of Radiology, College of Medicine, The University of Iowa, Iowa City, IA, USA
| | - Kum Ju Chae
- Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - So Hyeon Bak
- Department of Radiology, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Gong Yong Jin
- Department of Radiology, College of Medicine, The University of Iowa, Iowa City, IA, USA
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, Republic of Korea
| | - Sanghun Choi
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea.
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13
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Do TD, Skornitzke S, Merle U, Kittel M, Hofbaur S, Melzig C, Kauczor HU, Wielpütz MO, Weinheimer O. COVID-19 pneumonia: Prediction of patient outcome by CT-based quantitative lung parenchyma analysis combined with laboratory parameters. PLoS One 2022; 17:e0271787. [PMID: 35905122 PMCID: PMC9337660 DOI: 10.1371/journal.pone.0271787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/07/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives To evaluate the prognostic value of fully automatic lung quantification based on spectral computed tomography (CT) and laboratory parameters for combined outcome prediction in COVID-19 pneumonia. Methods CT images of 53 hospitalized COVID-19 patients including virtual monochromatic reconstructions at 40-140keV were analyzed using a fully automated software system. Quantitative CT (QCT) parameters including mean and percentiles of lung density, fibrosis index (FIBI-700, defined as the percentage of segmented lung voxels ≥-700 HU), quantification of ground-glass opacities and well-aerated lung areas were analyzed. QCT parameters were correlated to laboratory and patient outcome parameters (hospitalization, days on intensive care unit, invasive and non-invasive ventilation). Results Best correlations were found for laboratory parameters LDH (r = 0.54), CRP (r = 0.49), Procalcitonin (r = 0.37) and partial pressure of oxygen (r = 0.35) with the QCT parameter 75th percentile of lung density. LDH, Procalcitonin, 75th percentile of lung density and FIBI-700 were the strongest independent predictors of patients’ outcome in terms of days of invasive ventilation. The combination of LDH and Procalcitonin with either 75th percentile of lung density or FIBI-700 achieved a r2 of 0.84 and 1.0 as well as an area under the receiver operating characteristic curve (AUC) of 0.99 and 1.0 for the prediction of the need of invasive ventilation. Conclusions QCT parameters in combination with laboratory parameters could deliver a feasible prognostic tool for the prediction of invasive ventilation in patients with COVID-19 pneumonia.
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Affiliation(s)
- Thuy D. Do
- Clinic for Diagnostic and Interventional Radiology (DIR), University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Stephan Skornitzke
- Clinic for Diagnostic and Interventional Radiology (DIR), University Hospital Heidelberg, Heidelberg, Germany
| | - Uta Merle
- Department of Internal Medicine IV (Gastroenterology and Infectious Disease), University Hospital Heidelberg, Heidelberg, Germany
| | - Maximilian Kittel
- Institute for Clinical Chemistry, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - Stefan Hofbaur
- Clinic for Gastroenterology and Nephrology, Landshut Hospital, Landshut, Germany
| | - Claudius Melzig
- Clinic for Diagnostic and Interventional Radiology (DIR), University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Clinic for Diagnostic and Interventional Radiology (DIR), University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University Hospital Heidelberg, Heidelberg, Germany
| | - Mark O. Wielpütz
- Clinic for Diagnostic and Interventional Radiology (DIR), University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University Hospital Heidelberg, Heidelberg, Germany
| | - Oliver Weinheimer
- Clinic for Diagnostic and Interventional Radiology (DIR), University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- * E-mail:
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14
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Zhu L, Duerr J, Zhou-Suckow Z, Wagner WL, Weinheimer O, Salomon JJ, Leitz D, Konietzke P, Yu H, Ackermann M, Stiller W, Kauczor HU, Mall MA, Wielpütz MO. µCT to quantify muco-obstructive lung disease and effects of neutrophil elastase knockout in mice. Am J Physiol Lung Cell Mol Physiol 2022; 322:L401-L411. [PMID: 35080183 DOI: 10.1152/ajplung.00341.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Muco-obstructive lung diseases are characterized by airway obstruction and hyperinflation, which can be quantified by imaging. Our aim was to evaluate µCT for longitudinal quantification of muco-obstructive lung disease in β-epithelial Na+ channel overexpressing (Scnn1b-TG) mice and of the effects of neutrophil elastase (NE) knockout on its progression. Lungs from wild-type (WT), NE-/-, Scnn1b-TG, and Scnn1b-TG/NE-/- mice were scanned with 9 µm resolution at 0, 5, 14 and 60 days of age, and airway and parenchymal disease was quantified. Mucus adhesion lesions (MAL) were persistently increased in Scnn1b-TG compared to WT mice from 0 days (20.25±6.50 vs. 9.60±2.07, P<0.05), and this effect was attenuated in Scnn1b-TG/NE-/- mice (5.33±3.67, P<0.001). Airway wall area percentage (WA%) was increased in Scnn1b-TG mice compared to WT from 14 days onward (59.2±6.3% vs. 49.8±9.0%, P<0.001) but was similar in Scnn1b-TG/NE-/- compared to WT at 60 days (46.4±9.2% vs. 45.4±11.5%, P=0.97). Air proportion (Air%) and mean linear intercept (Lm) were persistently increased in Scnn1b-TG compared to WT from 5 days on (53.9±4.5% vs. 30.0±5.5% and 78.82±8.44µm vs. 65.66±4.15µm, respectively, P<0.001), whereas in Scnn1b-TG/NE-/- Air% and Lm were similar to WT from birth (27.7±5.5% vs.27.2±5.9%, P =0.92 and 61.48±9.20µm vs. 61.70±6.73µm, P=0.93, respectively). Our results suggest that µCT is sensitive to detect the onset and progression of muco-obstructive lung disease and effects of genetic deletion of NE on morphology of airways and lung parenchyma in Scnn1b-TG mice, and that it may serve as a sensitive endpoint for preclinical studies of novel therapeutic interventions for muco-obstructive lung diseases.
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Affiliation(s)
- Lin Zhu
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Julia Duerr
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner Berlin, Germany
| | - Zhe Zhou-Suckow
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany
| | - Willi L Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Johanna Jessica Salomon
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dominik Leitz
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner Berlin, Germany
| | - Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Hong Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Institute of Pathology and Department of Molecular Pathology, Helios University Clinic Wuppertal, University of Witten-Herdecke, Wuppertal, Germany
| | - Wolfram Stiller
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
| | - Marcus A Mall
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.,Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), associated partner Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Mark Oliver Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University Hospital of Heidelberg, Heidelberg, Germany
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15
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Yoon YJ, Lee MS, Jang KW, Ahn JB, Hurh K, Park EC. Association between smoking cessation and obstructive spirometry pattern among Korean adults aged 40-79 years. Sci Rep 2021; 11:18667. [PMID: 34548552 PMCID: PMC8455662 DOI: 10.1038/s41598-021-98156-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/01/2021] [Indexed: 11/09/2022] Open
Abstract
Smoking cessation aids in restoring lung function. However, whether long-term cessation can fully restore lung function has not been studied thoroughly, especially in Asian countries. This study aimed to evaluate the association between smoking cessation status and obstructive spirometry pattern among Koreans aged 40-79 years. In total, 6298 men and 8088 women aged 40-79 years from the Korea National Health and Nutrition Examination Survey (2015-2019) were analyzed for smoking cessation status, including the duration after quitting. Current-smokers showed a higher likelihood of having an obstructive spirometry pattern than never-smokers among both men (odds ratio [OR]: 3.15, 95% confidence interval [CI]: 2.32-4.29) and women (OR: 2.60, 95% CI: 1.59-4.23). In men, the effect tended to decrease with longer duration after cessation, but male ex-smokers who had quit smoking ≥ 20 years ago still showed a higher likelihood of having an obstructive spirometry pattern than male never-smokers (OR: 1.40, 95% CI: 1.05-1.89). In female ex-smokers, there was no significant association with the obstructive spirometry pattern, compared to that in female never-smokers. This study emphasizes the benefits of smoking cessation, possibility of long-lasting harm to lung function due to tobacco smoking, and importance of smoking prevention.
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Affiliation(s)
- Yeo Jun Yoon
- Premedical Course, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Soo Lee
- Premedical Course, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyu Won Jang
- Premedical Course, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Bum Ahn
- Department of Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyungduk Hurh
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Institute of Health Services Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,Institute of Health Services Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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16
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Guo HH, Persson M, Weinheimer O, Rosenberg J, Robinson TE, Wang J. A calibration CT mini-lung-phantom created by 3-D printing and subtractive manufacturing. J Appl Clin Med Phys 2021; 22:183-190. [PMID: 33949078 PMCID: PMC8200432 DOI: 10.1002/acm2.13263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/15/2021] [Accepted: 03/30/2021] [Indexed: 11/06/2022] Open
Abstract
We describe the creation and characterization of a calibration CT mini‐lung‐phantom incorporating simulated airways and ground‐glass densities. Ten duplicate mini‐lung‐phantoms with Three‐Dimensional (3‐D) printed tubes simulating airways and gradated density polyurethane foam blocks were designed and built. Dimensional accuracy and CT numbers were measured using micro‐CT and clinical CT scanners. Micro‐CT images of airway tubes demonstrated an average dimensional variation of 0.038 mm from nominal values. The five different densities of incorporated foam blocks, simulating ground‐glass, showed mean CT numbers (±standard deviation) of −897.0 ± 1.5, −844.1 ± 1.5, −774.1 ± 2.6, −695.3 ± 1.6, and −351.0 ± 3.7 HU, respectively. Three‐Dimensional printing and subtractive manufacturing enabled rapid, cost‐effective production of ground‐truth calibration mini‐lung‐phantoms with low inter‐sample variation that can be scanned simultaneously with the patient undergoing lung quantitative CT.
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Affiliation(s)
- H Henry Guo
- Department of Radiology, Stanford Medical Center, Stanford, CA, USA
| | - Mats Persson
- Department of Physics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Oliver Weinheimer
- Department of Radiology, University of Heidelberg, Heidelberg, Germany
| | | | - Terry E Robinson
- Emeritus, Department of Pediatrics, Stanford Medical Center, Stanford, CA, USA
| | - Jia Wang
- Environmental Health and Safety, Stanford University, Stanford, CA, USA
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17
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Schmitt VH, Schmitt C, Hollemann D, Mamilos A, Wagner W, Weinheimer O, Brochhausen C. Comparison of histological and computed tomographic measurements of pig lung bronchi. ERJ Open Res 2020; 6:00500-2020. [PMID: 33313303 PMCID: PMC7720685 DOI: 10.1183/23120541.00500-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/14/2020] [Indexed: 12/03/2022] Open
Abstract
AIM Light microscopy is used as template in the evaluation and further development of medical imaging methods. Tissue shrinkage caused by histological processing is known to influence lung tissue dimensions. In diagnosis of COPD, computed tomography (CT) is widely used for automated airway measurement. The aim of this study was to compare histological and computed tomographic measurements of pig lung bronchi. METHODS Airway measurements of pig lungs were performed after freezing under controlled inflation pressure in a liquid nitrogen bath. The wall thickness of seven bronchi was measured via Micro-CT and CT using the integral-based method (IBM) and the full-width-at-half-maximum method (FWHM) automatically and histologically on frozen and paraffin sections. Statistical analysis was performed using the Wilcoxon test, Pearson's correlation coefficient with a significance level at p<0.05, scatter plots and Bland-Altman plots. RESULTS Bronchial wall thickness was smallest in frozen sections (median 0.71 mm) followed by paraffin sections (median 0.75 mm), Micro-CT (median 0.84 mm), and CT measurements using IBM (median 0.68 mm) and FWHM (median 1.69 mm). Statistically significant differences were found among all tested groups (p<0.05) except for CT IBM and paraffin and frozen sections and Micro-CT. There was high correlation between all parameters with statistical significance (p<0.05). CONCLUSIONS Significant differences in airway measurement were found among the different methods. The absolute measurements with CT IBM were closest to the histological results followed by Micro-CT, whereas CT FWHM demonstrated a distinct divergence from the other groups.
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Affiliation(s)
- Volker H. Schmitt
- Dept of Cardiology, University Medical Centre, Johannes Gutenberg University of Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
- Joint first authors
| | | | - David Hollemann
- Institute of Clinical and Molecular Pathology, State Hospital Horn, Horn, Austria
| | - Andreas Mamilos
- REPAIR-lab, Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Willi Wagner
- Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
| | - Oliver Weinheimer
- Dept of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Centre Heidelberg (TLRC), German Lung Research Centre (DZL), Heidelberg, Germany
- Joint senior authors
| | - Christoph Brochhausen
- REPAIR-lab, Institute of Pathology, University of Regensburg, Regensburg, Germany
- Central Biobank Regensburg, University Regensburg and University Hospital Regensburg, Regensburg, Germany
- Joint senior authors
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18
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Konietzke P, Weinheimer O, Wagner WL, Wuennemann F, Hintze C, Biederer J, Heussel CP, Kauczor HU, Wielpütz MO. Optimizing airway wall segmentation and quantification by reducing the influence of adjacent vessels and intravascular contrast material with a modified integral-based algorithm in quantitative computed tomography. PLoS One 2020; 15:e0237939. [PMID: 32813730 PMCID: PMC7437894 DOI: 10.1371/journal.pone.0237939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/05/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Quantitative analysis of multi-detector computed tomography (MDCT) plays an increasingly important role in assessing airway disease. Depending on the algorithms used, airway dimensions may be over- or underestimated, primarily if contrast material was used. Therefore, we tested a modified integral-based method (IBM) to address this problem. Methods Temporally resolved cine-MDCT was performed in seven ventilated pigs in breath-hold during iodinated contrast material (CM) infusion over 60s. Identical slices in non-enhanced (NE), pulmonary-arterial (PA), systemic-arterial (SA), and venous phase (VE) were subjected to an in-house software using a standard and a modified IBM. Total diameter (TD), lumen area (LA), wall area (WA), and wall thickness (WT) were measured for ten extra- and six intrapulmonary airways. Results The modified IBM significantly reduced TD by 7.6%, LA by 12.7%, WA by 9.7%, and WT by 3.9% compared to standard IBM on non-enhanced CT (p<0.05). Using standard IBM, CM led to a decrease of all airway parameters compared to NE. For example, LA decreased from 80.85±49.26mm2 at NE, to 75.14±47.96mm2 (-7.1%) at PA (p<0.001), 74.96±48.55mm2 (-7.3%) at SA (p<0.001), and to 78.95±48.94mm2 (-2.4%) at VE (p = 0.200). Using modified IBM, the differences were reduced to -3.1% at PA, -2.9% at SA and -0.7% at VE (p<0.001; p<0.001; p = 1.000). Conclusions The modified IBM can optimize airway wall segmentation and reduce the influence of CM on quantitative CT. This allows a more precise measurement as well as potentially the comparison of enhanced with non-enhanced scans in inflammatory airway disease.
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Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
- * E-mail:
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Willi L. Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Felix Wuennemann
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Christian Hintze
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Kiel, Germany
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Radiologie Rein-Nahe, Bingen, Germany
| | - Juergen Biederer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Claus P. Heussel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Mark O. Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
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