1
|
Alevizos MK, Danoff SK, Pappas DA, Lederer DJ, Johnson C, Hoffman EA, Bernstein EJ, Bathon JM, Giles JT. Assessing predictors of rheumatoid arthritis-associated interstitial lung disease using quantitative lung densitometry. Rheumatology (Oxford) 2022; 61:2792-2804. [PMID: 34747452 PMCID: PMC9608004 DOI: 10.1093/rheumatology/keab828] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess predictors of subclinical RA-associated interstitial lung disease (RA-ILD) using quantitative lung densitometry (qLD). METHODS RA patients underwent multi-detector row CT scanning at baseline and after an average of 39 months. Scans were analysed with qLD for the percentage of lung parenchyma with high attenuation areas (%HAA: the percentage of voxels of -600 to -250 Hounsfield units). Additionally, a pulmonary radiologist calculated an expert radiologist scoring (ERS) for RA-ILD features. Generalized linear models were used to identify indicators of baseline %HAA and predictors of %HAA change. RESULTS Baseline %HAA was assessed in 193 RA patients and 106 had repeat qLD assessment. %HAA was correlated with ERS (Spearman's rho = 0.261; P < 0.001). Significant indicators of high baseline %HAA (>10% of lung parenchyma with high attenuation) included female sex, higher pack-years of smoking, higher BMI and anti-CCP ≥200 units, collectively contributing an area under the receiver operator curve of 0.88 (95% CI 0.81, 0.95). Predictors of %HAA increase, occurring in 49% with repeat qLD, included higher baseline %HAA, presence of mucin 5B (MUC5B) minor allele and absence of HLA-DRB1 shared epitope (area under the receiver operator curve = 0.69; 95% CI 0.58, 0.79). The association of the MUC5B minor allele with %HAA change was higher among men and those with higher cumulative smoking. Within the group with increased %HAA, anti-CCP level was significantly associated with a greater increase in %HAA. CONCLUSIONS %HAA, assessed with qLD, was linked to several known risk factors for RA-ILD and may represent a more quantitative method to identify RA-ILD and track progression than expert radiologist interpretation.
Collapse
Affiliation(s)
- Michail K Alevizos
- Division of Rheumatology, Columbia University Irving Medical Center, New York, NY
| | - Sonye K Danoff
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Dimitrios A Pappas
- Division of Rheumatology, Columbia University Irving Medical Center, New York, NY
| | - David J Lederer
- Division of Pulmonary and Critical Care, Columbia University Irving Medical Center, New York, NY
| | - Cheilonda Johnson
- Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Elana J Bernstein
- Division of Rheumatology, Columbia University Irving Medical Center, New York, NY
| | - Joan M Bathon
- Division of Rheumatology, Columbia University Irving Medical Center, New York, NY
| | - Jon T Giles
- Division of Rheumatology, Columbia University Irving Medical Center, New York, NY
| |
Collapse
|
2
|
Inter-Observer Agreement between Low-Dose and Standard-Dose CT with Soft and Sharp Convolution Kernels in COVID-19 Pneumonia. J Clin Med 2022; 11:jcm11030669. [PMID: 35160121 PMCID: PMC8836391 DOI: 10.3390/jcm11030669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
Computed tomography (CT) has been an essential diagnostic tool during the COVID-19 pandemic. The study aimed to develop an optimal CT protocol in terms of safety and reliability. For this, we assessed the inter-observer agreement between CT and low-dose CT (LDCT) with soft and sharp kernels using a semi-quantitative severity scale in a prospective study (Moscow, Russia). Two consecutive scans with CT and LDCT were performed in a single visit. Reading was performed by ten radiologists with 3–25 years’ experience. The study included 230 patients, and statistical analysis showed LDCT with a sharp kernel as the most reliable protocol (percentage agreement 74.35 ± 43.77%), but its advantage was marginal. There was no significant correlation between radiologists’ experience and average percentage agreement for all four evaluated protocols. Regarding the radiation exposure, CTDIvol was 3.6 ± 0.64 times lower for LDCT. In conclusion, CT and LDCT with soft and sharp reconstructions are equally reliable for COVID-19 reporting using the “CT 0-4” scale. The LDCT protocol allows for a significant decrease in radiation exposure but may be restricted by body mass index.
Collapse
|
3
|
Wu PH, Gupta T, Chang H, Petrenko D, Schafer A, Kazakia G. Soft tissue variations influence HR-pQCT density measurements in a spatially dependent manner. Bone 2020; 138:115505. [PMID: 32599223 PMCID: PMC7428203 DOI: 10.1016/j.bone.2020.115505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Significant weight loss following treatments for obesity undermines bone metabolism and increases bone turnover and fracture incidence. High resolution peripheral quantitative computed tomography (HR-pQCT) is widely used in skeletal heath assessment research to provide noninvasive bone parameter measurement (e.g. volumetric bone mineral density (vBMD)) with minimal radiation exposure. However, variation in body composition among study groups or longitudinal variations within individuals undergoing significant weight change will generate artifacts and errors in HR-pQCT data. The purpose of this study is to determine the influence of these artifacts on the measurement of vBMD. METHODS We designed a custom-made hydroxyapatite (HA)-polymer phantom surrounded by layers of reusable gel pack and hydrogenated fat to mimic the distal tibia and the surrounding lean and fat tissue. Four different thicknesses of fat were used to mimic the soft tissue of increasingly overweight individuals. We then evaluated how a change in soft tissue thickness influenced image quality and vBMD quantification within total, trabecular, and cortical bone compartments. Based on these data, we applied a data correction to previously acquired clinical data in a cohort of gastric bypass patients. RESULTS In the phantom measurements, total, trabecular, and cortical vBMD increased as soft tissue thickness decreased. The impact of soft tissue thickness on vBMD varied by anatomic quadrant. When applying the soft tissue data correction to a set of clinical data, we found that soft tissue reduction following bariatric surgery can lead to a clinically significant underestimation of bone loss in longitudinal data, and that the effect is most severe in the cortical compartment. CONCLUSION HR-pQCT-based vBMD measurement accuracy is influenced by soft tissue thickness and is spatially inhomogeneous. Our results suggest that variations in soft tissue thickness must be considered in HR-pQCT studies, particularly in studies enrolling cohorts with differing body composition or in studies of longitudinal weight change.
Collapse
Affiliation(s)
- Po-Hung Wu
- Department of Radiology and Biomedical Imaging at China Basin, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA.
| | - Tanvi Gupta
- Department of Radiology and Biomedical Imaging at China Basin, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA.
| | - Hanling Chang
- Department of Medicine, University of California - San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, 4150 Clement St, San Francisco, CA 94121, USA
| | - Dimitry Petrenko
- Department of Medicine, University of California - San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, 4150 Clement St, San Francisco, CA 94121, USA
| | - Anne Schafer
- Department of Medicine, University of California - San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; Department of Epidemiology and Biostatistics, University of California -San Francisco, 550 16th St 2nd floor, San Francisco, CA 94158, USA.
| | - Galateia Kazakia
- Department of Radiology and Biomedical Imaging at China Basin, University of California - San Francisco, 185 Berry Street, Suite 190, Lobby 6, San Francisco, CA 94107, USA.
| |
Collapse
|
4
|
Stepniak K, Ursani A, Paul N, Naguib H. Development of a phantom network for optimization of coronary artery disease imaging using computed tomography. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab2696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
5
|
Abazid RM, Smettei OA, Almeman A, Sayed S, Alsaqqa H, Abdelmageed SM, Alharbi FJ, Alhabib AM, Al-Mallah MH. Fat volume measurements as a predictor of image noise in coronary computed tomography angiography. J Saudi Heart Assoc 2018; 31:32-40. [PMID: 30559578 PMCID: PMC6289940 DOI: 10.1016/j.jsha.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/19/2018] [Accepted: 11/12/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction Image noise can negatively affect the overall quality of coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to evaluate the relationship between image noise and fat volumes in the chest wall. We also aimed to compare these with other patient-specific predictors of image noise, such as body weight (BW) and body mass index (BMI). Methods We undertook a cross-sectional, single-center study. A tube voltage of 100 kV was used for patients with BW <85 kg and 120 kV for BW ≥85 kg. The image noise in the aortic root, single-slice fat volume (SFV) at the level of the left main coronary artery and the total fat volume of the chest (TFV) were analyzed. Results A total of 132 consecutive patients were enrolled (mean age ± standard deviation, 51 ± 11 years; 64% male). The mean image noise was 30.5 ± 11 Hounsfield units (HU). We found that patients with image noise >30 HU had significantly higher SFV (75 ± 33 vs. 51 ± 24, p < 0.0001) and TFV (2206 ± 927 vs. 1815 ± 737, p < 0.01) compared with patients having noise ≤30 HU, whereas BW and BMI showed no significant difference (78 ± 13 vs. 81 ± 14, p < 0.34) and (28.7 ± 4.7 vs. 26.8 ± 3.8, p < 0.19), respectively. Linear regression analysis showed that image noise has better correlation with SFV (R = 0.399; p < 0.0001); and TFV (R = 0, p < 0.009) than BMI (R = 0.154, p < 0.039) and BW (R = -0.102, p = 0.12). Conclusions Fat volume measurements of the chest wall can predict CCTA image noise better than other patient-specific predictors, such as BW and BMI.
Collapse
Affiliation(s)
- Rami M. Abazid
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
- Corresponding author at: Department of Cardiology, Prince Sultan Cardiac Center–Qassim (PSCCQ), Postal Code 2290, Buraydah, Al-Qassim, Saudi Arabia.
| | - Osama A. Smettei
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Ahmad Almeman
- Department of pharmacology, Qassim University, Qassim, Buraydah, Saudi Arabia
| | - Sawsan Sayed
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Hanaa Alsaqqa
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Salma M. Abdelmageed
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Fahad J. Alharbi
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Abdullah M. Alhabib
- Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center–Qassim PSCCQ, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
| | - Mouaz H. Al-Mallah
- Department of Medicine, Wayne State University, Detroit, MI, USA
- Cardiac Imaging, King Abdul-Aziz Cardiac Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| |
Collapse
|
6
|
Tan SK, Yeong CH, Raja Aman RRA, Ng KH, Abdul Aziz YF, Chee KH, Sun Z. Low tube voltage prospectively ECG-triggered coronary CT angiography: a systematic review of image quality and radiation dose. Br J Radiol 2018; 91:20170874. [PMID: 29493261 DOI: 10.1259/bjr.20170874] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study aimed (1) to perform a systematic review on scanning parameters and contrast medium (CM) reduction methods used in prospectively electrocardiography (ECG-triggered low tube voltage coronary CT angiography (CCTA), (2) to compare the achievable dose reduction and image quality and (3) to propose appropriate scanning techniques and CM administration methods. METHODS A systematic search was performed in PubMed, the Cochrane library, CINAHL, Web of Science, ScienceDirect and Scopus, where 20 studies were selected for analysis of scanning parameters and CM reduction methods. RESULTS The mean effective dose (HE) ranged from 0.31 to 2.75 mSv at 80 kVp, 0.69 to 6.29 mSv at 100 kVp and 1.53 to 10.7 mSv at 120 kVp. Radiation dose reductions of 38 to 83% at 80 kVp and 3 to 80% at 100 kVp could be achieved with preserved image quality. Similar vessel contrast enhancement to 120 kVp could be obtained by applying iodine delivery rate (IDR) of 1.35 to 1.45 g s-1 with total iodine dose (TID) of between 10.9 and 16.2 g at 80 kVp and IDR of 1.08 to 1.70 g s-1 with TID of between 18.9 and 20.9 g at 100 kVp. CONCLUSION This systematic review found that radiation doses could be reduced to a rate of 38 to 83% at 80 kVp, and 3 to 80% at 100 kVp without compromising the image quality. Advances in knowledge: The suggested appropriate scanning parameters and CM reduction methods can be used to help users in achieving diagnostic image quality with reduced radiation dose.
Collapse
Affiliation(s)
- Sock Keow Tan
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Chai Hong Yeong
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | | | - Kwan Hoong Ng
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Yang Faridah Abdul Aziz
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Kok Han Chee
- 1 Department of Biomedical Imaging, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia.,2 Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Zhonghua Sun
- 3 Department of Medical Radiation Sciences, Curtin University , Perth, WA , Australia
| |
Collapse
|
7
|
da Silva Ramos FJ, Hovnanian A, Souza R, Azevedo LCP, Amato MBP, Costa ELV. Estimation of Stroke Volume and Stroke Volume Changes by Electrical Impedance Tomography. Anesth Analg 2018; 126:102-110. [PMID: 28742775 DOI: 10.1213/ane.0000000000002271] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Electrical impedance tomography (EIT) is a noninvasive imaging method that identifies changes in air and blood volume based on thoracic impedance changes. Recently, there has been growing interest in EIT to measure stroke volume (SV). The objectives of this study are as follows: (1) to evaluate the ability of systolic impedance variations (ΔZsys) to track changes in SV in relation to a baseline condition; (2) to assess the relationship of ΔZsys and SV in experimental subjects; and (3) to identify the influence of body dimensions on the relationship between ΔZsys and SV. METHODS Twelve Agroceres pigs were instrumented with transpulmonary thermodilution catheter and EIT and were mechanically ventilated in a random order using different settings of tidal volume (VT) and positive end-expiratory pressure (PEEP): VT 10 mL·kg and PEEP 10 cm H2O, VT 10 mL·kg and PEEP 5 cm H2O, VT 6 mL·kg and PEEP 10 cm H2O, and VT 6 mL·kg and PEEP 5 cm H2O. After baseline data collection, subjects were submitted to hemorrhagic shock and successive fluid challenges. RESULTS A total of 204 paired measurements of SV and ΔZsys were obtained. The 4-quadrant plot showed acceptable trending ability with a concordance rate of 91.2%. Changes in ΔZsys after fluid challenges presented an area under the curve of 0.83 (95% confidence interval, 0.74-0.92) to evaluate SV changes. Conversely, the linear association between ΔZsys and SV was poor, with R from linear mixed model of 0.35. Adding information on body dimensions improved the linear association between ΔZsys and SV up to R from linear mixed model of 0.85. CONCLUSIONS EIT showed good trending ability and is a promising hemodynamic monitoring tool. Measurements of absolute SV require that body dimensions be taken into account.
Collapse
Affiliation(s)
- Fernando José da Silva Ramos
- From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil
| | - André Hovnanian
- From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.,Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Rogério Souza
- Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Luciano C P Azevedo
- From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Marcelo B P Amato
- Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Eduardo L V Costa
- From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.,Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil
| |
Collapse
|
8
|
Low-Tube Voltage Computed Tomography During Hepatic Arterial Phase: The Effect of Body Habitus on Image Quality. J Comput Assist Tomogr 2016; 41:401-406. [PMID: 27879528 DOI: 10.1097/rct.0000000000000519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to evaluate the impact of body habitus factors on image quality of low-tube voltage computed tomography (CT) during the hepatic arterial phase. MATERIALS AND METHODS Ninety-seven patients (66 men, 31 women; age range, 26-78 years) who underwent clinically indicated liver dynamic CT examination were enrolled in the study. Analysis with 80-kVp CT and intermediate tube current (277-337 mA) was performed in the late hepatic arterial phase using a 320-detector row scanner with adaptive iterative dose reduction 3-dimensional reconstruction. Patient body habitus was measured using body weight (BW), body mass index (BMI), lateral width (LW) of the abdomen, and muscle volume (MV) of the abdominal wall. On hepatic arterial phase, the mean image noise and contrast-to-noise ratio (CNR) for the aorta and liver were assessed. The correlations between body habitus factors and image quality parameters were evaluated. RESULTS In all patients, MV showed the strongest correlation with image noise, followed by BW and LW (r = 0.684, 0.570, and 0.555, respectively). The BMI showed the fourth strongest correlation with image noise among all body habitus factors (r = 0.377). With respect to CNR of the aorta, MV and BW showed the strongest inverse correlation (r = -0.590 and -0.600, respectively), followed by LW and BMI (r = -0.557 and -0.423, respectively). Regarding the CNR of the liver, MV showed the strongest inverse correlation (r = -0.279), although the correlation efficiency was weak compared with other correlations. CONCLUSIONS Among various body habitus factors, MV showed the strongest association with image noise and CNR in the hepatic arterial phase using 80-kVp CT.
Collapse
|
9
|
Kliment CR, Araki T, Doyle TJ, Gao W, Dupuis J, Latourelle JC, Zazueta OE, Fernandez IE, Nishino M, Okajima Y, Ross JC, Estépar RSJ, Diaz AA, Lederer DJ, Schwartz DA, Silverman EK, Rosas IO, Washko GR, O'Connor GT, Hatabu H, Hunninghake GM. A comparison of visual and quantitative methods to identify interstitial lung abnormalities. BMC Pulm Med 2015; 15:134. [PMID: 26514822 PMCID: PMC4625729 DOI: 10.1186/s12890-015-0124-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 10/12/2015] [Indexed: 11/10/2022] Open
Abstract
Background Evidence suggests that individuals with interstitial lung abnormalities (ILA) on a chest computed tomogram (CT) may have an increased risk to develop a clinically significant interstitial lung disease (ILD). Although methods used to identify individuals with ILA on chest CT have included both automated quantitative and qualitative visual inspection methods, there has been not direct comparison between these two methods. To investigate this relationship, we created lung density metrics and compared these to visual assessments of ILA. Methods To provide a comparison between ILA detection methods based on visual assessment we generated measures of high attenuation areas (HAAs, defined by attenuation values between −600 and −250 Hounsfield Units) in >4500 participants from both the COPDGene and Framingham Heart studies (FHS). Linear and logistic regressions were used for analyses. Results Increased measures of HAAs (in ≥10 % of the lung) were significantly associated with ILA defined by visual inspection in both cohorts (P < 0.0001); however, the positive predictive values were not very high (19 % in COPDGene and 13 % in the FHS). In COPDGene, the association between HAAs and ILA defined by visual assessment were modified by the percentage of emphysema and body mass index. Although increased HAAs were associated with reductions in total lung capacity in both cohorts, there was no evidence for an association between measurement of HAAs and MUC5B promoter genotype in the FHS. Conclusion Our findings demonstrate that increased measures of lung density may be helpful in determining the severity of lung volume reduction, but alone, are not strongly predictive of ILA defined by visual assessment. Moreover, HAAs were not associated with MUC5B promoter genotype.
Collapse
Affiliation(s)
- Corrine R Kliment
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Tetsuro Araki
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
| | - Tracy J Doyle
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Wei Gao
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. .,The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, Boston, MA, USA.
| | - Jeanne C Latourelle
- Department of Medicine, Boston University, Boston, MA, USA. .,Department of Neurology, Boston University, Boston, MA, USA.
| | - Oscar E Zazueta
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Isis E Fernandez
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA. .,Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, USA.
| | - Yuka Okajima
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
| | - James C Ross
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA. .,Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
| | - Raúl San José Estépar
- Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, USA. .,Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
| | - Alejandro A Diaz
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Pulmonary Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - David J Lederer
- Division of Pulmonary and Critical Care, College of Physicians and Surgeons, Columbia University, New York, NY, USA. .,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - David A Schwartz
- Department of Medicine, University of Colorado, Denver, CO, USA.
| | - Edwin K Silverman
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Ivan O Rosas
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - George R Washko
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, USA.
| | - George T O'Connor
- The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, Boston, MA, USA. George.O'.,Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, MA, USA. George.O'
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA. .,Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, USA.
| | - Gary M Hunninghake
- From the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, USA.
| |
Collapse
|
10
|
Kim H, Park CH, Han KH, Kim TH. Predicting the image noise level of prospective ECG-triggered coronary computed tomography angiography: quantitative measurement of thoracic component versus body mass index. Int J Cardiovasc Imaging 2015; 31 Suppl 2:213-21. [PMID: 26507324 DOI: 10.1007/s10554-015-0796-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 10/19/2015] [Indexed: 11/28/2022]
Abstract
We evaluated the feasibility of using quantitatively measured thoracic components, as compared to body mass index (BMI), for predicting the image noise of coronary computed tomography angiography (CCTA). One hundred subjects (M:F = 64:36; mean age, 55 ± 8.8 years) who underwent prospective electrocardiography-gated CCTA and low-dose chest computed tomography (CT) were analyzed retrospectively. The image noise of the CCTA was determined by the standard deviation of the attenuation value in a region of interest on the aortic root level. On the low-dose chest CT, the areas of the thoracic components were measured at the aortic root level. An auto-segmentation technique with the following threshold levels was used: quantitatively measured area of total thorax [QMAtotal: -910 to 1000 Hounsfield units (HU)], lung (QMAlung: -910 to -200 HU), fat (QMAfat: -200 to 0 HU), muscle (QMAmuscle: 0-300 HU), soft tissue (fat + muscle, QMAsoft tissue: -200 to 300 HU), bone (QMAbone: 300-1000 HU) and solid tissue (fat + muscle + bone, QMAsolid tissue: -200 to 1000 HU). The relationship between image noise and variable biometric parameters including QMA was analyzed, and the linear correlation coefficients were used as indicators of the strength of association. Among the variable biometric parameters, including BMI, QMAsolid tissue showed the highest correlation coefficient with image noise in all subjects (r = 0.804), males (r = 0.716), females (r = 0.889), the overweight (r = 0.556), and the non-overweight subgroups (r = 0.783). QMAsolid tissue can be used as a potential surrogate predictor of the image noise level in low tube voltage CCTA.
Collapse
Affiliation(s)
- Hyeongmin Kim
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Hwan Park
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
| | - Kyung Hwa Han
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Hoon Kim
- Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
11
|
Renker M, Geyer LL, Krazinski AW, Silverman JR, Ebersberger U, Schoepf UJ. Iterative image reconstruction: a realistic dose-saving method in cardiac CT imaging? Expert Rev Cardiovasc Ther 2014; 11:403-9. [DOI: 10.1586/erc.12.178] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
12
|
Odedra D, Blobel J, AlHumayyd S, Durand M, Jimenez-Juan L, Paul N. Image noise-based dose adaptation in dynamic volume CT of the heart: dose and image quality optimisation in comparison with BMI-based dose adaptation. Eur Radiol 2013; 24:86-94. [DOI: 10.1007/s00330-013-2980-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 06/29/2013] [Accepted: 07/13/2013] [Indexed: 11/28/2022]
|
13
|
Williams MC, Weir NW, Mirsadraee S, Millar F, Baird A, Minns F, Uren NG, McKillop G, Bull RK, van Beek EJR, Reid JH, Newby DE. Iterative reconstruction and individualized automatic tube current selection reduce radiation dose while maintaining image quality in 320-multidetector computed tomography coronary angiography. Clin Radiol 2013; 68:e570-7. [PMID: 23838086 PMCID: PMC3807656 DOI: 10.1016/j.crad.2013.05.098] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/13/2013] [Accepted: 05/29/2013] [Indexed: 01/22/2023]
Abstract
AIM To assess the effect of two iterative reconstruction algorithms (AIDR and AIDR3D) and individualized automatic tube current selection on radiation dose and image quality in computed tomography coronary angiography (CTCA). MATERIALS AND METHODS In a single-centre cohort study, 942 patients underwent electrocardiogram-gated CTCA using a 320-multidetector CT system. Images from group 1 (n = 228) were reconstructed with a filtered back projection algorithm (Quantum Denoising Software, QDS+). Iterative reconstruction was used for group 2 (AIDR, n = 379) and group 3 (AIDR3D, n = 335). Tube current was selected based on body mass index (BMI) for groups 1 and 2, and selected automatically based on scout image attenuation for group 3. Subjective image quality was graded on a four-point scale (1 = excellent, 4 = non-diagnostic). RESULTS There were no differences in age (p = 0.975), body mass index (p = 0.435), or heart rate (p = 0.746) between the groups. Image quality improved with iterative reconstruction and automatic tube current selection [1.3 (95% confidence intervals (CI): 1.2-1.4), 1.2 (1.1-1.2) and 1.1 (1-1.2) respectively; p < 0.001] and radiation dose decreased [274 (260-290), 242 (230-253) and 168 (156-180) mGy cm, respectively; p < 0.001]. CONCLUSION The application of the latest iterative reconstruction algorithm and individualized automatic tube current selection can substantially reduce radiation dose whilst improving image quality in CTCA.
Collapse
Affiliation(s)
- M C Williams
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, UK.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Image quality of low-dose CCTA in obese patients: impact of high-definition computed tomography and adaptive statistical iterative reconstruction. Int J Cardiovasc Imaging 2013; 29:1565-74. [PMID: 23624958 DOI: 10.1007/s10554-013-0228-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Abstract
The accuracy of coronary computed tomography angiography (CCTA) in obese persons is compromised by increased image noise. We investigated CCTA image quality acquired on a high-definition 64-slice CT scanner using modern adaptive statistical iterative reconstruction (ASIR). Seventy overweight and obese patients (24 males; mean age 57 years, mean body mass index 33 kg/m(2)) were studied with clinically-indicated contrast enhanced CCTA. Thirty-five patients underwent a standard definition protocol with filtered backprojection reconstruction (SD-FBP) while 35 patients matched for gender, age, body mass index and coronary artery calcifications underwent a novel high definition protocol with ASIR (HD-ASIR). Segment by segment image quality was assessed using a four-point scale (1 = excellent, 2 = good, 3 = moderate, 4 = non-diagnostic) and revealed better scores for HD-ASIR compared to SD-FBP (1.5 ± 0.43 vs. 1.8 ± 0.48; p < 0.05). The smallest detectable vessel diameter was also improved, 1.0 ± 0.5 mm for HD-ASIR as compared to 1.4 ± 0.4 mm for SD-FBP (p < 0.001). Average vessel attenuation was higher for HD-ASIR (388.3 ± 109.6 versus 350.6 ± 90.3 Hounsfield Units, HU; p < 0.05), while image noise, signal-to-noise ratio and contrast-to noise ratio did not differ significantly between reconstruction protocols (p = NS). The estimated effective radiation doses were similar, 2.3 ± 0.1 and 2.5 ± 0.1 mSv (HD-ASIR vs. SD-ASIR respectively). Compared to a standard definition backprojection protocol (SD-FBP), a newer high definition scan protocol in combination with ASIR (HD-ASIR) incrementally improved image quality and visualization of distal coronary artery segments in overweight and obese individuals, without increasing image noise and radiation dose.
Collapse
|