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Sun H, Yang X, Sun X, Meng X, Kang H, Zhang R, Zhang H, Liu M, Dai H, Wang C. Lung shrinking assessment on HRCT with elastic registration technique for monitoring idiopathic pulmonary fibrosis. Eur Radiol 2023; 33:2279-2288. [PMID: 36424500 PMCID: PMC10017651 DOI: 10.1007/s00330-022-09248-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Evaluation and follow-up of idiopathic pulmonary fibrosis (IPF) mainly rely on high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs). The elastic registration technique can quantitatively assess lung shrinkage. We aimed to investigate the correlation between lung shrinkage and morphological and functional deterioration in IPF. METHODS Patients with IPF who underwent at least two HRCT scans and PFTs were retrospectively included. Elastic registration was performed on the baseline and follow-up HRCTs to obtain deformation maps of the whole lung. Jacobian determinants were calculated from the deformation fields and after logarithm transformation, log_jac values were represented on color maps to describe morphological deterioration, and to assess the correlation between log_jac values and PFTs. RESULTS A total of 69 patients with IPF (male 66) were included. Jacobian maps demonstrated constriction of the lung parenchyma marked at the lung base in patients who were deteriorated on visual and PFT assessment. The log_jac values were significantly reduced in the deteriorated patients compared to the stable patients. Mean log_jac values showed positive correlation with baseline percentage of predicted vital capacity (VC%) (r = 0.394, p < 0.05) and percentage of predicted forced vital capacity (FVC%) (r = 0.395, p < 0.05). Additionally, the mean log_jac values were positively correlated with pulmonary vascular volume (r = 0.438, p < 0.01) and the number of pulmonary vascular branches (r = 0.326, p < 0.01). CONCLUSIONS Elastic registration between baseline and follow-up HRCT was helpful to quantitatively assess the morphological deterioration of lung shrinkage in IPF, and the quantitative indicator log_jac values were significantly correlated with PFTs. KEY POINTS • The elastic registration on HRCT was helpful to quantitatively assess the deterioration of IPF. • Jacobian logarithm was significantly reduced in deteriorated patients and mean log_jac values were correlated with PFTs. • The mean log_jac values were related to the changes of pulmonary vascular volume and the number of vascular branches.
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Affiliation(s)
- Haishuang Sun
- Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, 130021, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China.,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xiaoyan Yang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China
| | - Xuebiao Sun
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Xiapei Meng
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Han Kang
- Institute of Advanced Research, Infervision Medical Technology Co., Ltd., Beijing, 100025, China
| | - Rongguo Zhang
- Institute of Advanced Research, Infervision Medical Technology Co., Ltd., Beijing, 100025, China
| | - Haoyue Zhang
- Institute of Advanced Research, Infervision Medical Technology Co., Ltd., Beijing, 100025, China.,Department of Radiology, University of California, Los Angeles, Los Angeles, 90095, USA
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Huaping Dai
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China. .,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Chen Wang
- Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, 130021, China. .,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China. .,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Rea G, Giacobbe G, Caroppo D, Iovine S, Lieto R, Bocchino M, Valente T, Maglio A, Vatrella A. DPO: Diffuse Pulmonary Ossification - A Diagnostic Challenge. Transl Med UniSa 2021; 24:30-34. [PMID: 36447744 PMCID: PMC9673915 DOI: 10.37825/2239-9754.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 06/16/2023] Open
Abstract
Diffuse pulmonary ossification (DPO) is a rare condition of DLD (diffuse lung disease) characterized by the presence of metaplastic ectopic bone in the lungs and is less frequent in patients without a clear background of lung diseases. DPO is characterized by very small calcific nodules, often with bone mature located in both lungs and often in peripheral areas of the lungs. Two patterns of DPO have been recognized dendriform and nodular. The dendriform type is less common and is characterized by a coral-like network of bone spiculae along the alveolar septa and is often related to interstitial fibrosis or chronic obstructive lung disease [1]. Recent literature papers indicate that DPO may be a predictor of pulmonary fibrosis, is related to Usual Interstitial Pneumonia (UIP) pattern, and has a higher correlation with Idiopathic Pulmonary Fibrosis (IPF). We present a case of a 41-years-old male with persistent bronchitis who underwent a chest X-ray (CXR) that showed multiple pulmonary small calcified nodules in both lungs. These findings were then defined with a high-resolution computed tomography of the chest (HRCT) that showed multiple small nodules spread in both lungs with a "tree-like pattern". A lung biopsy was performed to confirm the radiological diagnostic hypothesis of DPO, and further pathological examination showed multifocal areas of mature bone tissue within the lung parenchyma.
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Affiliation(s)
- G. Rea
- Dipartimento di Radiologia, Ospedale Monaldi, A.O. dei Colli, Napoli,
Italy
| | - G. Giacobbe
- Dipartimento di Medicina Clinica e Sperimentale, F. Magrassi A Lanzara, Seconda Università di Napoli,
Italy
| | - D. Caroppo
- Dipartimento di Anatomia Patologica, A.O. dei Colli, Napoli,
Italy
| | - S. Iovine
- Dipartimento di Medicina Clinica e Sperimentale, F. Magrassi A Lanzara, Seconda Università di Napoli,
Italy
| | - R. Lieto
- Dipartimento di Radiologia, Ospedale Monaldi, A.O. dei Colli, Napoli,
Italy
| | - M. Bocchino
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie Respiratorie, Università Federico II, Napoli,
Italy
| | - T. Valente
- Dipartimento di Radiologia, Ospedale Monaldi, A.O. dei Colli, Napoli,
Italy
| | - A. Maglio
- Dipartimento di Medicina e Chirurgia, Sezione Malattie Apparato Respiratorio, Università di Salerno, Salerno,
Italy
| | - A. Vatrella
- Dipartimento di Medicina e Chirurgia, Sezione Malattie Apparato Respiratorio, Università di Salerno, Salerno,
Italy
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Huang SF, Huang CC, Chou KT, Chan YJ, Yang YY, Wang FD. Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome. J Fungi (Basel) 2021; 7:jof7100842. [PMID: 34682263 PMCID: PMC8537715 DOI: 10.3390/jof7100842] [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: 09/05/2021] [Revised: 10/02/2021] [Accepted: 10/03/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: The presentation of chronic pulmonary aspergillosis (CPA) ranges from single granuloma to fibrosis in the affected lung. CPA can be divided into five categories according to European Respirology Society (ERS) guidance but is usually assessed by clinical physicians. Computer-based quantitative lung parenchyma analysis in CPA and its correlation with clinical manifestations, systemic inflammation, and angiogenesis have never been investigated. (2) Method: Forty-nine patients with CPA and 36 controls were prospectively enrolled. Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FCV) and biomarkers in the peripheral blood (the chemokines interleukin (IL)-1B, IL-6, IL-10, IL-8, CRP, ESR, MMP1, MMP7, MMP8, TNF-α, calprotectin, SDF-1α, and VEGFA) were measured before antifungal treatment. The disease severity was categorized into mild, moderate, and severe based on chest computed tomography (CT) images. The oxygen demand and overall mortality until the end of the study were recorded. Quantitative parenchyma analysis was performed using the free software 3Dslicer. (3) Results: The results of quantitative parenchyma analysis concorded with the visual severity from the chest CT, oxygen demand, FVC, and FEV1 in the study subjects. The decrease in kurtosis and skewness of the lung density histograms on CT, increase in high attenuation area (HAA), and reduced lung volume were significantly correlated with increases in the PMN %, CRP, IL-1B, SDF-1α, MMP1, and Calprotectin in peripheral blood in the multivariable regression analysis. TNF-α and IL-1B at study entry and the CPA severity from either a visual method or computer-based evaluation were predictors of long-term mortality. (4) Conclusion: The computer-based parenchyma analysis in CPA agreed with the categorization on a visual basis and was associated with the clinical outcomes, chemokines, and systemic proinflammation profiles.
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Affiliation(s)
- Shiang-Fen Huang
- Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan;
- Correspondence:
| | - Chia-Chang Huang
- Division of Endocrinology and Metabolism, Department of Medicine, Veterans General Hospital, Taipei 112201, Taiwan;
- Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
| | - Kun-Ta Chou
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan;
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Yu-Jiun Chan
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
| | - Ying-Ying Yang
- Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
- Department of Medicine, Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan
| | - Fu-Der Wang
- Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan;
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan;
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