Evaluation of the extent of ground-glass opacity on high-resolution CT in patients with interstitial pneumonia associated with systemic sclerosis: Comparison between quantitative and qualitative analysis

Yabuuchi, Hidetake; Matsuo, Yoshio; Tsukamoto, Hiroshi; Horiuchi, Takahiko; Sunami, Shunya; Kamitani, Takeshi; Jinnouchi, Mikako; Nagao, Michinobu; Akashi, Koichi; Honda, Hiroshi

doi:10.1016/j.crad.2014.03.008

Cited by 28 publications

(29 citation statements)

References 29 publications

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“…HC may be prevalent in about 10-20% of SSc patients, depicting a UIP pattern. Despite the known difficulties in finding an ILD-reverting treatment, GGOs might represent a clinical and therapeutic challenge, in comparison with the irreversible HC features considered as the structural damage progression from GGO lesions [6,7]. This means that HRCT could be considered as not only a very useful tool for the diagnosis of pulmonary involvement, but also for the prognosis.…”

Section: Introductionmentioning

confidence: 99%

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Sambataro

Pignataro³

et al. 2020

Diagnostics

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Interstitial lung disease (ILD) is the main cause of death in systemic sclerosis (SSc) patients. Usually, patients have lung involvement characterized by ground glass opacities (GGOs), but honeycombing (HC) is also possible. The Wells score is a semi-quantitative index, which is able to assess ILD by distinguishing its main components. The aim of this work is to evaluate the Wells score in relation to the disease activity (DA) index. We enrolled 40 consecutive SSc-ILD patients (26 diffuse cutaneous form, dcSSc, and 14 limited form, lcSSc). All patients were evaluated by the European Scleroderma Study Group (ESSG) index, high-resolution computed tomography, transthoracic echocardiogram, pulmonary function tests (PTSs), and nailfold videocapillaroscopy for the number of microhemorrhages (NEMO) score. In our study, the total extent of ILD (TE-ILD), fibrosis and GGOs correlated with dyspnea (p = 0.03, 0.01 and 0.01 respectively), but not with the ESSG index. Considering only the dcSSc patients, TE-ILD and GGOs correlated with the ESSG index (r = 0.5 p = 0.009), while fibrosis grade correlated with disease duration and systolic pulmonary artery pressure. In conclusion, our data suggest that GGO correlates with DA, while fibrosis may be a sign of disease damage. The quantification of pulmonary involvement using the Wells score can be a useful tool for assessing the appropriate treatment in SSc patients.

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Section: Introductionmentioning

confidence: 99%

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Sambataro

Pignataro³

et al. 2020

Diagnostics

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“…[17][18][19] This value was calculated using a three-dimensional image analysis system (SYNAPSE VINCENT TM ; Fujifilm, Tokyo, Japan) in order to quantify the GGO. We calculated the mean %GGO of six images obtained from each scan.…”

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confidence: 99%

Low-dose CT screening using hybrid iterative reconstruction: confidence ratings of diagnoses of simulated lesions other than lung cancer

Sakai

Yabuuchi

Kondo

et al. 2015

BJR

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Objective: To evaluate the confidence ratings of diagnoses of simulated lesions other than lung cancer on low-dose screening CT with hybrid iterative reconstruction (IR). Methods: Simulated lesions (emphysema, mediastinal masses and interstitial pneumonia) in a chest phantom were scanned by a 320-row area detector CT. The scans were performed by 64-row and 160-row helical scans at various dose levels and were reconstructed by filtered back projection (FBP) and IR. Emphysema, honeycombing and reticular opacity were visually scored on a four-point scale by six thoracic radiologists. The ground-glass opacity as a percentage of total lung volume (%GGO), CT value and contrast-to-noise ratio (CNR) of mediastinal masses were calculated. These scores and values were compared between FBP and IR. Wilcoxon's signed-rank test was used (p , 0.05). Interobserver agreements were evaluated by k statistics.Results: There were no significant differences in visual assessment. Interobserver agreement was almost perfect. CT values were almost equivalent between FBP and IR, whereas CNR with IR was significantly higher than that with FBP. %GGO significantly increased at low-dose levels with FBP; however, IR suppressed the elevation. Conclusion: The confidence ratings of diagnoses of simulated lesions other than lung cancer on low-dose CT screening were not degraded with hybrid IR compared with FBP. Advances in knowledge: Hybrid IR did not degrade the confidence ratings of diagnoses on visual assessment and differential diagnoses based on CT value of mediastinal masses, and it showed the advantage of higher GGO conspicuity at low-dose level. Radiologists can analyse images of hybrid IR alone on low-dose CT screening for lung cancer. INTRODUCTIONRecently, there have been discussions regarding the efficacy of lung cancer screening using low-dose CT. For example, the National Lung Screening Trial research team's 1 randomized clinical trial comparing the efficacies of chest radiographs and low-dose CT. They found that lung cancer screening using low-dose CT reduces lung cancer-related mortality in groups at high risk of lung cancer. With regard to dose-reduction techniques in CT, a new method of image reconstruction, iterative reconstruction (IR), has been developed and is now widely used for various clinical purposes. This technique has an advantage over the filtered back projection (FBP) method of image reconstruction in that FBP contains quantum noise; IR reduces this quantum noise by repeatedly comparing projection data, including quantum noise or primary reconstruction image data, with ideal anatomical and statistical models.

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“…As treatments for idiopathic pulmonary fibrosis such as nintedanib (21) and pirfenidone (22) have been approved recently, assessment of disease severity by CT is mandated in clinical trials. Volumetric LDCT is expected to be useful for this longitudinal monitoring of DILD by facilitating quantitative assessment (2324) and by allowing a more comprehensive assessment of DILD (25) compared to conventional HRCT scans with sequential scanning at 10-mm intervals which provide only a reduced number of sections. With the development of IR technique, it has become possible to perform a submillisievert-dose volumetric CT scan.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Iterative Reconstruction in Low-Dose Computed Tomography on the Evaluation of Diffuse Interstitial Lung Disease

et al. 2016

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ObjectiveTo evaluate the impact of iterative reconstruction (IR) on the assessment of diffuse interstitial lung disease (DILD) using CT.Materials and MethodsAn American College of Radiology (ACR) phantom (module 4 to assess spatial resolution) was scanned with 10–100 effective mAs at 120 kVp. The images were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), with blending ratios of 0%, 30%, 70% and 100%, and model-based iterative reconstruction (MBIR), and their spatial resolution was objectively assessed by the line pair structure method. The patient study was based on retrospective interpretation of prospectively acquired data, and it was approved by the institutional review board. Chest CT scans of 23 patients (mean age 64 years) were performed at 120 kVp using 1) standard dose protocol applying 142–275 mA with dose modulation (high-resolution computed tomography [HRCT]) and 2) low-dose protocol applying 20 mA (low dose CT, LDCT). HRCT images were reconstructed with FBP, and LDCT images were reconstructed using FBP, ASIR, and MBIR. Matching images were randomized and independently reviewed by chest radiologists. Subjective assessment of disease presence and radiological diagnosis was made on a 10-point scale. In addition, semi-quantitative results were compared for the extent of abnormalities estimated to the nearest 5% of parenchymal involvement.ResultsIn the phantom study, ASIR was comparable to FBP in terms of spatial resolution. However, for MBIR, the spatial resolution was greatly decreased under 10 mA. In the patient study, the detection of the presence of disease was not significantly different. The values for area under the curve for detection of DILD by HRCT, FBP, ASIR, and MBIR were as follows: 0.978, 0.979, 0.972, and 0.963. LDCT images reconstructed with FBP, ASIR, and MBIR tended to underestimate reticular or honeycombing opacities (-2.8%, -4.1%, and -5.3%, respectively) and overestimate ground glass opacities (+4.6%, +8.9%, and +8.5%, respectively) compared to the HRCT images. However, the reconstruction methods did not differ with respect to radiologic diagnosis.ConclusionThe diagnostic performance of LDCT with MBIR was similar to that of HRCT in typical DILD cases. However, caution should be exercised when comparing disease extent, especially in follow-up studies with IR.

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Evaluation of the extent of ground-glass opacity on high-resolution CT in patients with interstitial pneumonia associated with systemic sclerosis: Comparison between quantitative and qualitative analysis

Cited by 28 publications

References 29 publications

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Quantification of Ground Glass Opacities Can Be Useful to Describe Disease Activity in Systemic Sclerosis

Low-dose CT screening using hybrid iterative reconstruction: confidence ratings of diagnoses of simulated lesions other than lung cancer

The Impact of Iterative Reconstruction in Low-Dose Computed Tomography on the Evaluation of Diffuse Interstitial Lung Disease

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