Lung densitometry: why, how and when

Mascalchi, Mario; Camiciottoli, Gianna; Diciotti, Stefano

doi:10.21037/jtd.2017.08.17

Cited by 99 publications

(88 citation statements)

References 132 publications

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“…The recently introduced densitometric- and histogram-based analysis of CT images provides data on mean lung attenuation, skewness, and kurtosis. These parameters have been reported to show associations with parameters of pulmonary function and disease progression in various lung diseases [ 56 ]. In addition, some objective CT measurements have been found to be useful for the long-term monitoring of patients with emphysematous and fibrotic lung disease [ 25 , 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…Third, the inner spaces of honeycombing and airspace enlargement associated with fibrosis might have been assessed as LAA. However, reports on the measurement of honeycombing with a background of fibrotic lesions are rare, and methodologies for distinguishing between honeycombing and LAA have not been elucidated [ 56 ]. Additionally, pulmonary vessels were partially included in the HAA values.…”

Section: Discussionmentioning

confidence: 99%

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Objective quantitative multidetector computed tomography assessments in patients with combined pulmonary fibrosis with emphysema: Relationship with pulmonary function and clinical events

et al. 2020

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Background Combined pulmonary fibrosis with emphysema (CPFE) is a clinically meaningful syndrome characterized by coexisting upper-lobe emphysema and lower-lobe interstitial fibrosis. However, ambiguous diagnostic criteria and, particularly, the absence of objective methods to quantify emphysematous/fibrotic lesions in patients with CPFE confound the interpretation of the pathophysiology of this syndrome. We analyzed the relationship between objectively quantified computed tomography (CT) measurements and the results of pulmonary function testing (PFT) and clinical events in CPFE patients. Materials and methods We enrolled 46 CPFE patients who underwent CT and PFT. The extent of emphysematous lesions was obtained by calculating the percent of low attenuation area (%LAA). The extent of fibrotic lesions was calculated as the percent of high attenuation area (%HAA). %LAA and %HAA values were combined to yield the percent of abnormal area (%AA). We assessed the relationships between CT parameters and other clinical indices, including PFT results. Multivariate analysis was performed to examine the association between the CT parameters and clinical events. Results A greater negative correlation with percent predicted diffusing capacity of the lung for carbon monoxide (DL CO %predicted) existed for %AA (r = -0.73, p < 0.001) than for %LAA or %HAA alone. The %HAA value was inversely correlated with percent predicted forced vital capacity (r = -0.48, p < 0.001), percent predicted total lung capacity (r = -0.48, p < 0.01), and DL CO %predicted (r = -0.47, p < 0.01). Multivariate logistic regression analysis found that %AA showed the strongest association with hospitalization events (odds ratio = 1.20, 95% confidence interval = 1.01–1.54, p = 0.029). Conclusion Quantitative CT measurements reflected deterioration in pulmonary function and were associated with hospitalization in patients with CPFE. This approach could serve as a useful method to determine the extent of lung morphology, pathophysiology, and the clinical course of patients with CPFE.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Objective quantitative multidetector computed tomography assessments in patients with combined pulmonary fibrosis with emphysema: Relationship with pulmonary function and clinical events

et al. 2020

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“…21,49,50,[52][53][54][55][56][57] Disease can impact lung density, 58 for example, decreased lung attenuation typically occurs in emphysema or cystic lung diseases, whereas focal increased attenuation occurs in fibrosis. 59 Often, disease can lead to variable lung attenuation, as shown by example in Fig. 6.…”

Section: Challenges In the Lungmentioning

confidence: 99%

PET/MRI attenuation estimation in the lung: A review of past, present, and potential techniques

et al. 2020

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Positron emission tomography/magnetic resonance imaging (PET/MRI) potentially offers several advantages over positron emission tomography/computed tomography (PET/CT), for example, no CT radiation dose and soft tissue images from MR acquired at the same time as the PET. However, obtaining accurate linear attenuation correction (LAC) factors for the lung remains difficult in PET/MRI. LACs depend on electron density and in the lung, these vary significantly both within an individual and from person to person. Current commercial practice is to use a single‐valued population‐based lung LAC, and better estimation is needed to improve quantification. Given the under‐appreciation of lung attenuation estimation as an issue, the inaccuracy of PET quantification due to the use of single‐valued lung LACs, the unique challenges of lung estimation, and the emerging status of PET/MRI scanners in lung disease, a review is timely. This paper highlights past and present methods, categorizing them into segmentation, atlas/mapping, and emission‐based schemes. Potential strategies for future developments are also presented.

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“…Additionally, research has shown that the visual evaluation of CT scans has low reproducibility [ 48 ]. However, the use of densitometric evaluation improves the utility of CT scans in diagnosing chronic lung disease [ 49 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular imaging of pulmonary diseases

2018

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Imaging holds an important role in the diagnosis of lung diseases. Along with clinical tests, noninvasive imaging techniques provide complementary and valuable information that enables a complete differential diagnosis. Various novel molecular imaging tools are currently under investigation aimed toward achieving a better understanding of lung disease physiopathology as well as early detection and accurate diagnosis leading to targeted treatment. Recent research on molecular imaging methods that may permit differentiation of the cellular and molecular components of pulmonary disease and monitoring of immune activation are detailed in this review. The application of molecular imaging to lung disease is currently in its early stage, especially compared to other organs or tissues, but future studies will undoubtedly reveal useful pulmonary imaging probes and imaging modalities.

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Lung densitometry: why, how and when

Cited by 99 publications

References 132 publications

Objective quantitative multidetector computed tomography assessments in patients with combined pulmonary fibrosis with emphysema: Relationship with pulmonary function and clinical events

Objective quantitative multidetector computed tomography assessments in patients with combined pulmonary fibrosis with emphysema: Relationship with pulmonary function and clinical events

PET/MRI attenuation estimation in the lung: A review of past, present, and potential techniques

Molecular imaging of pulmonary diseases

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