An automated computed tomography score for the cystic fibrosis lung

Chassagnon, Guillaume; Martin, Clémence; Burgel, Pierre‐Régis; Hubert, D.; Fajac, Isabelle; Paragios, Nikos; Zacharaki, Evangelia I.; Legmann, P.; Coste, Joël; Revel, Marie‐Pierre

doi:10.1007/s00330-018-5516-x

Cited by 18 publications

(14 citation statements)

References 43 publications

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“…Although this is the most straightforward approach to quanti cation of bronchiectasis, it is very di cult to automatically identify the airways in these patients, especially because of its irregular dilation and distortion, association with parenchymal abnormalities and great variability of disease extension in these individuals. Considering these challenges, recent studies have used CT lung densitometry to quantify disease in CF (20,21) and primary ciliary dyskinesia (22), with a good correlation with PFT.…”

Section: Discussionmentioning

confidence: 99%

“…We believe that this heterogeneity compromises the use of mean lung density and the percentage of high and low attenuation areas in the cross-section evaluation of these patients, although there might be a role for these markers in longitudinal studies. On the other hand, skewness and kurtosis are parameters that account for both high and low attenuation areas, and are more suitable in the evaluation of bronchiectasis patients (20)(21)(22). Also, the average time required to obtain the automatic CT measures was substantially shorter than visual CT scoring, enabling its use in daily practice.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown a good correlation with emphysema quanti cation by CT lung densitometry and histopathology in resected specimens (10,11) and with pulmonary function tests (PFT) in chronic obstructive pulmonary disease (COPD) (12)(13)(14) and interstitial lung disease (15)(16)(17)(18)(19). However, few studies have investigated the role of CT lung densitometry in bronchiectasis patients, most of them in CF (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

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Automated Computed Tomography Lung Densitometry in Bronchiectasis Patients

Sawamura

Athanazio

Nucci

et al. 2022

Archivos de Bronconeumología

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Rationale: Bronchiectasis is a complex and heterogeneous disease. Visual computed tomography (CT) scoring systems are used to assess disease severity, disease progression and predict outcomes in bronchiectasis although they have some limitations such as subjectivity, requirement of previous training and are time-consuming.Objective: To correlate quantitative CT lung densitometry measurements with pulmonary function test (PFT) and multidimensional prognostic scores in patients with bronchiectasis. Materials and methods: From 2014 to 2017, 100 consecutive adult patients with non-cystic brosis bronchiectasis underwent inspiratory and expiratory volumetric chest CT and PFT (spirometry, plethysmograph, diffusing capacity of carbon monoxide measurement [DLCO]). Visual CT score (CF-CT score), CT lung densitometry parameters (kurtosis, skewness and expiratory/inspiratory mean lung density [E/I MLD]) and multidimensional prognostic scores (BSI and FACED) were calculated in all patients and correlated to PFT. Results: CT lung densitometry parameters (kurtosis and skewness), correlated with forced expiratory volume in 1 second (FEV1) (R=0.32; p=0.001 and R=0.34; p<0.001) and DLCO (R=0.41 and R=0.43; p<0.001). Automated CT air trapping quanti cation (E/I MLD) showed correlation with residual volume (RV), multidimensional score FACED (R=0.63 and R=0.53; p<0.001) and performed better than the CF-CT score in the diagnosis of high-risk patients and severe air trapping.Conclusion: CT lung densitometry parameters showed correlations with PFT in non-cystic brosis bronchiectasis patients. Automated CT air trapping quanti cation performed better than visual CT score in the identi cation of high-risk patients and severe air trapping, suggesting it could be a useful tool in the evaluation of these patients, although further studies are needed to con rm these ndings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Automated Computed Tomography Lung Densitometry in Bronchiectasis Patients

Sawamura

Athanazio

Nucci

et al. 2022

Archivos de Bronconeumología

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“…In addition, normal structures and, notably, the normal lung vessels may bias any threshold‐based quantitative measurement. In our implementation, the large central vessels were first removed as a potential intersubject bias 31,32 . In addition, T 2 w MRI can advantageously benefit from the susceptibility artifact from the lung parenchyma.…”

Section: Discussionmentioning

confidence: 99%

Quantification of MRI T2 Interstitial Lung Disease Signal‐Intensity Volume in Idiopathic Pulmonary Fibrosis: A Pilot Study

Benlala

Albat

Blanchard

et al. 2020

Magnetic Resonance Imaging

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Background Imaging has played a pivotal role in the diagnosis of idiopathic pulmonary fibrosis (IPF). Recent reports suggest that T2‐weighted MRI could be sensitive to monitor signal‐intensity modifications of the lung parenchyma, which may relate to the disease activity in IPF. However, there is a lack of automated tools to reproducibly quantify the extent of the disease, especially using MRI. Purpose To assess the feasibility of T2 interstitial lung disease signal‐intensity volume quantification using a semiautomated method in IPF. Study Type Single center, retrospective. Population A total of 21 adult IPF patients and four control subjects without lung interstitial abnormalities. Field Strength/Sequence Both free‐breathing ultrashort echo time (TE) lung MRI using the spiral volume interpolated breath hold examination (VIBE) sequence (3D‐UTE) and T2‐BLADE at 1.5T. Assessment Semiautomated segmentation of the lung volume was done using 3D‐UTE and registered to the T2‐BLADE images. The interstitial lung disease signal‐intensity volume (ISIV) was quantified using a Gaussian mixture model clustering and then normalized to the lung volume to calculate T2‐ISIV. The composite physiological index (CPI) and forced vital capacity (FVC) were measured as known biomarkers of IPF severity. Measurements were performed independently by three readers and averaged. The reproducibility between measurements was also assessed. Statistical Tests Reproducibility was assessed using the intraclass correlation coefficient (ICC) and Bland–Altman analysis. Correlations were assessed using Spearman test. Comparison of median was assessed using the Mann–Whitney test. Results The reproducibility of T2‐ISIV was high, with ICCs = 0.99. Using Bland–Altman analysis, the mean differences were found between –0.8 to 0.1. T2‐ISIV significantly correlated with CPI and FVC (rho = 0.48 and 0.50, respectively; P < 0.05). T2‐ISIV was significantly higher in IPF than in controls (P < 0.05). Data Conclusion T2‐ISIV appears to be able to reproducibly assess the volumetric extent of abnormal interstitial lung signal‐intensity modifications in patients with IPF, and correlate with disease severity. Level of Evidence 4 Technical Efficacy Stage 1

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“…Biofabrication is especially promising to improve CF treatment due to medical imaging's sensitive assessment of reversible and irreversible paediatric pathologies [10,11], and routine use during long-term CF surveillance. Efforts to improve and standardise the image-based assessment of CF lung function using semi-automated computational algorithms for computed tomography (CT) [12] and magnetic resonance imaging (MRI) [13] have identified features (e.g. centribular opacity) that correlate with clinical course.…”

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confidence: 99%

Biofabrication of personalised anatomical models and tools for the clinic

Allenby

Woodruff

2019

Journal of Cystic Fibrosis

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Biofabrication of personalised anatomical models and tools for the clinic Biofabrication is a rapidly growing research field encompassing imaging, modelling, and printing technologies to produce personalised medical devices for patient anatomies [1,2]. Current cystic fibrosis (CF) treatment personalises physiotherapy and medications based on patient symptoms, genotype, and lifestyle [3]. Biofabrication could further individualise these treatments to CF's unique anatomical presentations, conveniently captured during routine medical imaging. For example, digital biofabrication models may prove useful to simulate and plan treatments, such as calculating dose and delivery of aerosol medications needed to reach the targeted airways. Physical models or personalised therapeutic devices can be rapidly printed into three-dimensional (3D) forms from a diverse array of materials and printing technologies to be leveraged for clinical diagnosis, planning, education, training, and treatment.As the clinical adoption of biofabrication technologies grows, with 3D printing available in 3% of hospitals worldwide in 2017 [4], a concise reference of useful 3D imaging, modelling, and printing technologies will encourage clinical translation. In Table 1, we present a brief biofabrication reference of currently available clinical imaging methods used for patients with CF [5], image modelling software tools used for anatomical reconstruction, analysis, and simulation, and several printing technologies that may be useful for CF anatomical models and medical devices [1,2]. Of specific interest to educational and training models are instrument resolution and cost. Additional enhancements include capturing images at appropriate contrast and the use of multi-material printers that can differentiate various tissue structures in final products. Biofabrication technologies can be used in clinical care as they are able to print biocompatible polymers, ceramics, and metals, as well as extracellular matrix and cells towards providing customised implants within the operating theatre. As a case study, Royal Perth Hospital expanded a popular rapid prototyping service into a medical engineering and physics unit, providing a 5-employee referral service for local and remote clinicians interested in bespoke anatomical models and surgical guides [6], as well as acellular implants [7] and cellularised grafts [8].In this issue of Journal of Cystic Fibrosis, Mirza et al have published a 3D printed CF lung model as a tool for patient and clinician education and to train particularly difficult CF bronchoscopies [9]. The lung was initially imaged using low radiation dose computerised tomography with intravenous contrast in full inspiration, these DICOM images were modelled by translation into standard tessellation language files suitable for 3D reconstruction and identification of pulmonary arteries, pulmonary veins, airways, and lung parenchyma separately. Finally, this 3D digital model was printed using a Stratasys J750, a full-colour 3D printer able to differ...

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An automated computed tomography score for the cystic fibrosis lung

Abstract: • Automated CT score shows moderate to good cross-sectional correlations with FEV %pred • CT score has potential to be integrated into the standard reporting workflow.

Cited by 18 publications

References 43 publications

Automated Computed Tomography Lung Densitometry in Bronchiectasis Patients

Automated Computed Tomography Lung Densitometry in Bronchiectasis Patients

Quantification of MRI T2 Interstitial Lung Disease Signal‐Intensity Volume in Idiopathic Pulmonary Fibrosis: A Pilot Study

Biofabrication of personalised anatomical models and tools for the clinic

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