Quantitative Evaluation of Fibrosis in IPF Patients: Meaning of Diffuse Pulmonary Ossification

Palermo, Monica; Tiralongo, Francesco; Distefano, Giulio; Vancheri, Ada; Giuffrè, Mauro; Pino, Fabio; Foti, Pietro Valerio; Sambataro, Gianluca; Vancheri, Carlo; Palmucci, Stefano; Basile, Antonio

doi:10.3390/diagnostics11010113

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…Lower Skewness, together with lower Kurtosis and high-er MLA, were associated with worse transplant free survival in patients with idiopathic pulmonary fibrosis (IPF) (31). More recently, a negative correlation between Skewness, presence of fibrosis in HRCT, and presence of diffuse pulmonary ossification in IPF was described (32). Moreover, Skewness was proposed as the best QCT index for prediction of mortality in IPF (33).…”

Section: Discussionmentioning

confidence: 99%

Quantitative chest tomography indexes are related to disease activity in systemic sclerosis: results from a cross-sectional study

Sambataro

Battisti

et al. 2021

Clinical and Experimental Rheumatology

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The aim of this study is to verify if there are correlations between quantitative chest tomography (QCT) indexes and disease activity (DA) in a cohort of patients with systemic sclerosis (SSc). MethodsSSc patients were assessed for DA and underwent high resolution chest tomography (CT). CT images were analysed with an operator-independent algorithm extracting the QCT indexes. DA assessment was conducted according to the EUSTAR index, where a score ≥2.5 indicates high DA (hDA). Correlations between clinical data and QCT indexes were investigated with the Spearman's test. The Mann-Whitney test assessed the distribution of the QCT indexes among the groups. Receiver operating characteristics (ROC) curve and linear regression analysis were conducted in order to identify the best cut-off value and contribution for each QCT index in assessing hDA in SSc patients. Results Sixtypatients (52 females, mean age 53.2 years, mean disease duration 5.3 years) were enrolled. A significant difference was found in QCT indexes distribution between patients with hDA and those with low DA. A mild strength correlation between QCT indexes and DA was observed. Once performed ROC curves and linear regression, Skewness on parenchymal lung <1.85 gave a significant contribution to the model in identifying subjects with hDA (p<0.001), showing sensitivity 79.5%, specificity 68.7%, and accuracy 76.6%. Conclusion QCT indexes correlate with SSc DA. These data introduce new possibilities for QCT application in clinical practice, especially in patient's follow-up. Moreover, QCT could be implemented in a new SSc DA score based on operatorindependent parameters.

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Section: Discussionmentioning

confidence: 99%

Quantitative chest tomography indexes are related to disease activity in systemic sclerosis: results from a cross-sectional study

Sambataro

Battisti

et al. 2021

Clinical and Experimental Rheumatology

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“…Computer-based lung parenchyma analysis has been widely used to estimate lung volume and disease severity with fibrosis [2] either in chronic obstructive pulmonary disease (COPD) or in interstitial lung disease (ILD) [3,4]. For example, in pulmonary fibrosis (PF), the result of texture analysis of the lung parenchyma is related to disease severity, quality of life, and overall survival [4].…”

Section: Introductionmentioning

confidence: 99%

“…The texture of the lung parenchyma is also correlated with systemic inflammatory biomarkers in PF patients [5] and can be evaluated by means of free software, namely, 3Dslicer© (https://www.slicer.org/, accessed on 1 Oct 2021), which can automatically or interactively perform lung segmentation, followed by lung parenchyma analysis using a chest imaging platform (CIP, https://chestimagingplatform.org/, accessed on 1 Oct 2021). The skewness and kurtosis of the lung density histogram, lung attenuation (Hounsfield unit, HU), and lung volume can be automatically analyzed by means of CIP and used to evaluate the severity of IPF [2].…”

Section: Introductionmentioning

confidence: 99%

Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome

Huang

Chou

et al. 2021

JoF

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(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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Lung shrinking assessment on HRCT with elastic registration technique for monitoring idiopathic pulmonary fibrosis

et al. 2022

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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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Quantitative Evaluation of Fibrosis in IPF Patients: Meaning of Diffuse Pulmonary Ossification

Cited by 3 publications

References 32 publications

Quantitative chest tomography indexes are related to disease activity in systemic sclerosis: results from a cross-sectional study

Quantitative chest tomography indexes are related to disease activity in systemic sclerosis: results from a cross-sectional study

Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome

Lung shrinking assessment on HRCT with elastic registration technique for monitoring idiopathic pulmonary fibrosis

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