High-resolution computed tomography features associated with differentiation of tuberculosis among elderly patients with community-acquired pneumonia: a multi-institutional propensity-score matched study

Komiya, Kosaku; Yamasue, Mari; Goto, Akihiko; Nakamura, Yuta; Hiramatsu, Kazufumi; Kadota, Jun‐ichi; Kato, Seiya

doi:10.1038/s41598-022-11625-7

Cited by 6 publications

(8 citation statements)

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“…Therefore, in the elderly with pulmonary TB, chest computed tomography features include parenchymal density, cavitary lung lesions, ground glass opacities, and miliary nodules [ 29 ]. In addition, more segments distributed with lesions have been found in the elderly with pulmonary TB compared to those with community-acquired pneumonia [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission: a preliminary report

Yang

Zhang

et al. 2023

BMC Infect Dis

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Background Pulmonary tuberculosis (TB) can impair pulmonary function (PF), especially in the elderly. The risk factors associated with the severity of PF impairment in the elderly with pulmonary TB remain unclear. Hence, this retrospective study aimed to address this issue to help improve the management of TB in the elderly population. Methods From January 2019 to February 2022, the elderly who were admitted to our hospital for pulmonary TB and underwent PF testing were included in this analysis. The forced expiratory volume in one second percent of predicted (FEV1% predicted) and clinical characteristics were collected and analyzed retrospectively. The extent of impaired PF was then categorized based on the FEV1% predicted and classified as grade 1–5. Logistic regression analysis was used to analyze the risk factors for impaired PF. Results A total of 249 patients who met the enrollment criteria were included in this analysis. According to the results of FEV1% predicted, all patients were classified as grade 1 (n = 37), grade 2 (n = 46), grade 3 (n = 55), grade 4 (n = 56), or grade 5 (n = 55). Statistical analysis showed that albumin (adjusted odds ratio (aOR) = 0.928, P = 0.013), body mass index (BMI) < 18.5 kg/m2 (aOR = 4.968, P = 0.046), lesion number ≥ 3 (aOR = 4.229, P < 0.001), male (aOR = 2.252, P = 0.009), respiratory disease (aOR = 1.669, P = 0.046), and cardiovascular disease (aOR = 2.489, P = 0.027) were related to the impairment of PF. Conclusions PF impairment is common in the elderly with pulmonary TB. The male sex, BMI < 18.5 kg/m2, lesion number ≥ 3, hypoproteinemia, and respiratory and cardiovascular comorbidities were identified as risk factors for significant PF impairment. Our findings highlight the risk factors associated with PF impairment, which may be helpful to improve the current management of pulmonary TB in the elderly to save their lung function.

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Section: Discussionmentioning

confidence: 99%

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission: a preliminary report

Yang

Zhang

et al. 2023

BMC Infect Dis

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“…The above results show that some image features can provide a structural basis for the differential diagnosis of the two diseases. Komiya et al [ 25 ] compared the high-resolution CT findings of pulmonary tuberculosis and CAP in the elderly population (age > 65 years). These CT findings were obtained from the visual evaluation of two respiratory physicians.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a 3D-convolutional neural network model based on chest CT for differentiating active pulmonary tuberculosis from community-acquired pneumonia

Han

Chen

et al. 2022

Radiol med

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Purpose To develop and validate a 3D-convolutional neural network (3D-CNN) model based on chest CT for differentiating active pulmonary tuberculosis (APTB) from community-acquired pneumonia (CAP). Materials and methods Chest CT images of APTB and CAP patients diagnosed in two imaging centers ( n = 432 in center A and n = 61 in center B) were collected retrospectively. The data in center A were divided into training, validation and internal test sets, and the data in center B were used as an external test set. A 3D-CNN was built using Keras deep learning framework. After the training, the 3D-CNN selected the model with the highest accuracy in the validation set as the optimal model, which was applied to the two test sets in centers A and B. In addition, the two test sets were independently diagnosed by two radiologists. The 3D-CNN optimal model was compared with the discrimination, calibration and net benefit of the two radiologists in differentiating APTB from CAP using chest CT images. Results The accuracy of the 3D-CNN optimal model was 0.989 and 0.934 with the internal and external test set, respectively. The area-under-the-curve values with the 3D-CNN model in the two test sets were statistically higher than that of the two radiologists (all P < 0.05), and there was a high calibration degree. The decision curve analysis showed that the 3D-CNN optimal model had significantly higher net benefit for patients than the two radiologists. Conclusions 3D-CNN has high classification performance in differentiating APTB from CAP using chest CT images. The application of 3D-CNN provides a new automatic and rapid diagnosis method for identifying patients with APTB from CAP using chest CT images.

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“…Therefore, in the elderly with pulmonary TB, chest computed tomography features include parenchymal density, cavitary lung lesions, ground glass opacities, and miliary nodules [21]. In addition, more segments distributed with lesions have been found in the elderly with pulmonary TB compared to those with community-acquired pneumonia [22].…”

Section: Discussionmentioning

confidence: 99%

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission

He¹,

Yang²,

Zhang³

et al. 2022

Preprint

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Background: Pulmonary tuberculosis (TB) can impair pulmonary function (PF), especially in the elderly. However, little is known regarding which risk factors contribute to impaired PF among the elderly with pulmonary TB.Methods: From January 2019 to February 2022, the elderly who were admitted to our hospital for pulmonary TB and underwent PF testing were included in this analysis. The forced expiratory volume in one second (FEV1) and clinical characteristics were collected and analyzed retrospectively. The extent of impaired PF was then categorized based on the FEV1 and classified as grade 1–5. Logistic regression analysis was used to analyze the risk factors for impaired PF.Results: A total of 249 patients who met the enrollment criteria were included in this analysis. According to the results of FEV1%, all patients were classified as grade 1 (n=37), grade 2 (n=46), grade 3 (n=55), grade 4 (n=56), or grade 5 (n=55). Statistical analysis showed that albumin (OR=0.928, P=0.013), body mass index (BMI)<18.5 kg/m2 (OR=4.968, P=0.046), lesion number≥3 (OR=4.229, P<0.001), male (OR=2.252, P=0.009), respiratory disease (OR=1.669, P=0.046), and cardiovascular disease (OR=2.489, P=0.027) were related to airway obstruction.Conclusions: A decline in PF is common in the elderly with pulmonary TB. The male sex, BMI<18.5 kg/m2, lesion number≥3, hypoproteinemia, and respiratory and cardiovascular comorbidities were identified as risk factors for a significant decline in PF. Our findings may be helpful to improve the current management of pulmonary TB in the elderly to save their lung function.

show abstract

High-resolution computed tomography features associated with differentiation of tuberculosis among elderly patients with community-acquired pneumonia: a multi-institutional propensity-score matched study

Cited by 6 publications

References 28 publications

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission: a preliminary report

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission: a preliminary report

Development and validation of a 3D-convolutional neural network model based on chest CT for differentiating active pulmonary tuberculosis from community-acquired pneumonia

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission

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