Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa2285
sukhraj virdee, James Hogg, Jean Boudreau, Wan Tan, Miranda Kirby
Rationale: Cannabis use has been on the rise in countries where use is legalized, but little is known about the pathological changes that occur in the lungs of cannabis users. We hypothesize that cannabis use in concomitant tobacco smokers is associated with alveoli destruction, airway inflammation and pulmonary vessel pruning as measured using computed tomography (CT) imaging, independent of tobacco smoking. Method and Materials: Participants from the Canadian cohort obstructive lung disease study were investigated. Cannabis smoking history was defined as the number of joints smoked per day multiplied by the number of years smoked (joint-years). CT images were acquired at full-inspiration and measurements included: low-attenuation-area under -950 HU (LAA950), airway wall thickness (AWT), and pulmonary blood volume in vessels with a cross-section area below 5mm2 (BV5) (VIDA Diagnostics). A multivariate ridge regression was used to assess the association for joint-years with LAA950, AWT, and BV5 adjusted by covariates (age, sex, BMI, CT model, tobacco pack-years, smoking status and years of education). The model with BV5 was also adjusted by total blood vessel volume. Results: A total of 364 cannabis and tobacco smokers were investigated. The smokers had a mean age of 59±7yrs, mean pack-years and joint-years was 31±22 and 14±24, respectively, and 74% were male; mean FEV1 and FEV1/FVC were 87±20%pred and 68±11%, respectively. Joint-years was associated with CT LAA950 (p<0.0001), AWT (p=0.001) and TBV (p=0.003) measurements, independent of tobacco pack-years. Conclusion: Cannabis use is associated with CT measures reflecting emphysema, airway inflammation and vascular pruning, independent of tobacco use.
{"title":"Quantitative computed tomography assessment of pulmonary structure in cannabis smokers","authors":"sukhraj virdee, James Hogg, Jean Boudreau, Wan Tan, Miranda Kirby","doi":"10.1183/13993003.congress-2023.pa2285","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa2285","url":null,"abstract":"<b>Rationale:</b> Cannabis use has been on the rise in countries where use is legalized, but little is known about the pathological changes that occur in the lungs of cannabis users. We hypothesize that cannabis use in concomitant tobacco smokers is associated with alveoli destruction, airway inflammation and pulmonary vessel pruning as measured using computed tomography (CT) imaging, independent of tobacco smoking. Method and Materials: Participants from the Canadian cohort obstructive lung disease study were investigated. Cannabis smoking history was defined as the number of joints smoked per day multiplied by the number of years smoked (joint-years). CT images were acquired at full-inspiration and measurements included: low-attenuation-area under -950 HU (LAA<sub>950</sub>), airway wall thickness (AWT), and pulmonary blood volume in vessels with a cross-section area below 5mm<sup>2</sup> (BV5) (VIDA Diagnostics). A multivariate ridge regression was used to assess the association for joint-years with LAA<sub>950</sub>, AWT, and BV5 adjusted by covariates (age, sex, BMI, CT model, tobacco pack-years, smoking status and years of education). The model with BV5 was also adjusted by total blood vessel volume. <b>Results:</b> A total of 364 cannabis and tobacco smokers were investigated. The smokers had a mean age of 59±7yrs, mean pack-years and joint-years was 31±22 and 14±24, respectively, and 74% were male; mean FEV<sub>1</sub> and FEV<sub>1</sub>/FVC were 87±20%<sub>pred</sub> and 68±11%, respectively. Joint-years was associated with CT LAA<sub>950</sub> (p<0.0001), AWT (p=0.001) and TBV (p=0.003) measurements, independent of tobacco pack-years. <b>Conclusion:</b> Cannabis use is associated with CT measures reflecting emphysema, airway inflammation and vascular pruning, independent of tobacco use.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136200553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa2295
Wei Ling Chia, James Hull, Emily Bartlett, Sujal Desai, David Watchorn
Introduction: Large airway collapse(LAC) is a prevalent but often overlooked cause of complex breathlessness and refractory airway symptoms. The diagnostic criteria for LAC remain unclear and a variety of protocols are proposed. We compare likelihoods of detecting LAC on CT imaging dependent on the imaging acquisition protocol employed. Method:We retrospectively reviewed reports of CT scans performed to detect LAC over a 12-month period in a specialist severe asthma service by means of 2 CT manoeuvres; Dynamic(DE) and Forced Expiration(FE). Large airway collapse was defined as >/=70% reduction in cross sectional area at the trachea +/- main bronchi on expiration compared with end inspiration. Those who did not complete both expiratory CT manoeuvres and reports without indication of degree of collapse in % were excluded. Result:21 patients (n=19 female) out of a total of 105 undergoing CT were found to have LAC, with a mean age of 54.2±12.0 years and a mean BMI of 40.4± 6.8kg/m2 were found to have LAC. Of these, LAC was observed on both FE and DE in 7 cases, on FE only in 12 cases, and on DE only in 2 cases. Large airway collapse was detected in a significantly greater proportion of patients with FE 19(90%) than with DE 9(43%) (McNemar’s chi-square test, p=0.01). Conclusion: The inclusion of a forced expiratory protocol is associated with improved detection of LAC in patients referred with refractory airways disease.
{"title":"Using CT to detect large airway collapse in severe asthma: worth the extra effort?","authors":"Wei Ling Chia, James Hull, Emily Bartlett, Sujal Desai, David Watchorn","doi":"10.1183/13993003.congress-2023.pa2295","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa2295","url":null,"abstract":"<b>Introduction:</b> Large airway collapse(LAC) is a prevalent but often overlooked cause of complex breathlessness and refractory airway symptoms. The diagnostic criteria for LAC remain unclear and a variety of protocols are proposed. We compare likelihoods of detecting LAC on CT imaging dependent on the imaging acquisition protocol employed. <b>Method</b>:We retrospectively reviewed reports of CT scans performed to detect LAC over a 12-month period in a specialist severe asthma service by means of 2 CT manoeuvres; Dynamic(DE) and Forced Expiration(FE). Large airway collapse was defined as >/=70% reduction in cross sectional area at the trachea +/- main bronchi on expiration compared with end inspiration. Those who did not complete both expiratory CT manoeuvres and reports without indication of degree of collapse in % were excluded. <b>Result:</b>21 patients (n=19 female) out of a total of 105 undergoing CT were found to have LAC, with a mean age of 54.2±12.0 years and a mean BMI of 40.4± 6.8kg/m2 were found to have LAC. Of these, LAC was observed on both FE and DE in 7 cases, on FE only in 12 cases, and on DE only in 2 cases. Large airway collapse was detected in a significantly greater proportion of patients with FE 19(90%) than with DE 9(43%) (McNemar’s chi-square test, p=0.01). <b>Conclusion:</b> The inclusion of a forced expiratory protocol is associated with improved detection of LAC in patients referred with refractory airways disease.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136200844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.oa4854
Bálint Ács, Miklós Zsiray, Diana Solymosi, Réka Gajdócsi, Tünde Harkó, Vivien Leskó-Jancsó, Anna Kerpel-Fronius
1. Introduction: The area of the affected lung parenchyma can influence mortality in any interstitial lung disease (ILD), so we analysed three groups - rheumatoid arthritis (RA) associated ILD, idiopathic pulmonary fibrosis (IPF) and idiopathic non-specific interstitial pneumonia (iNSIP) to identify measurable HRCT features. 2. Methods: All patients referred to MDTs with RA-ILD, iNSIP and IPF between 2016 - 2022, with high quality HRCT scans (both in- and expiration) were included in our study. 17 RA-ILD, 26 iNSIP and 72 IPF patients were identified. The scans were analyzed using the Syngo Via (vs60) PulmoAnalysis software, calculating areas of increased density. Data was analyzed using usual statistical methods. 3. Results: Lung parenchyma was evaluated by the percentage of opacity, opacity score and other relating values. In RA-ILD cases lower opacity percentage was detected compared to IPF and iNSIP cases (mean value of 10,04% vs 25,1% and 19,1% during inspiration in both lungs). This data was compared to concurrent pulmonary function test results. 4. Conclusions: The software aided data collection correlates well with clinical severity but further studies need to evaluate its position in the management of ILD patients.
{"title":"Comparison of parenchyma density scoring in RA-ILD vs IPF and iNSIP","authors":"Bálint Ács, Miklós Zsiray, Diana Solymosi, Réka Gajdócsi, Tünde Harkó, Vivien Leskó-Jancsó, Anna Kerpel-Fronius","doi":"10.1183/13993003.congress-2023.oa4854","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.oa4854","url":null,"abstract":"<b>1. Introduction:</b> The area of the affected lung parenchyma can influence mortality in any interstitial lung disease (ILD), so we analysed three groups - rheumatoid arthritis (RA) associated ILD, idiopathic pulmonary fibrosis (IPF) and idiopathic non-specific interstitial pneumonia (iNSIP) to identify measurable HRCT features. <b>2. Methods:</b> All patients referred to MDTs with RA-ILD, iNSIP and IPF between 2016 - 2022, with high quality HRCT scans (both in- and expiration) were included in our study. 17 RA-ILD, 26 iNSIP and 72 IPF patients were identified. The scans were analyzed using the Syngo Via (vs60) PulmoAnalysis software, calculating areas of increased density. Data was analyzed using usual statistical methods. <b>3. Results:</b> Lung parenchyma was evaluated by the percentage of opacity, opacity score and other relating values. In RA-ILD cases lower opacity percentage was detected compared to IPF and iNSIP cases (mean value of 10,04% vs 25,1% and 19,1% during inspiration in both lungs). This data was compared to concurrent pulmonary function test results. <b>4. Conclusions:</b> The software aided data collection correlates well with clinical severity but further studies need to evaluate its position in the management of ILD patients.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.oa4850
Tatiana Soldati, Margherita Vaselli, Kirsten Mooij - Kalverda, Erik Thunnissen, Michael Tanck, Onno Mets, Inge Van Den Berk, Jouke Annema, Peter Bonta, Johannes De Boer
Introduction: In interstitial lung diseases (ILD), early detection of the presence and progression of fibrosis is key. Endobronchial polarization sensitive optical coherence tomography (EB-PS-OCT) is a high resolution (10 μm), minimally invasive technique that detects collagen birefringence and has therefore the potential to detect and quantify pulmonary fibrosis. Aim: Investigate the ability of in-vivo EB-PS-OCT to quantify fibrosis in ILD. Methods: ILD patients underwent in-vivo EB-PS-OCT imaging of lung parenchyma prior to transbronchial cryo- or surgical lung biopsy. Asthma patients served as non-fibrotic control. Fibrosis was automatically quantified by assessing the mean birefringence area in EB-PS-OCT images of the alveolar compartment and compared to fibrotic content in HRCT and histology. Results: 19 patients were included (16 ILD; 3 asthma). In 49 out of 55 imaged segments EB-PS-OCT parenchymal birefringence was quantified, ranging from a mean fibrosis score of 2.54% (no to minimal fibrosis) to 21.01% (extensive fibrosis). EB-PS-OCT showed higher accuracy than HRCT in detecting fibrosis, using histology as reference standard. No adverse events occurred. Conclusion: In vivo EB-PS-OCT is a feasible, safe and minimally invasive imaging technique to detect and quantify pulmonary fibrosis. It could be used as an add-on bronchoscopic imaging technique to diagnosis and assess (progressive) fibrosis in ILD patients.
{"title":"In-vivo endobronchial-PS-OCT for fibrosis quantification in ILD","authors":"Tatiana Soldati, Margherita Vaselli, Kirsten Mooij - Kalverda, Erik Thunnissen, Michael Tanck, Onno Mets, Inge Van Den Berk, Jouke Annema, Peter Bonta, Johannes De Boer","doi":"10.1183/13993003.congress-2023.oa4850","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.oa4850","url":null,"abstract":"<b>Introduction:</b> In interstitial lung diseases (ILD), early detection of the presence and progression of fibrosis is key. Endobronchial polarization sensitive optical coherence tomography (EB-PS-OCT) is a high resolution (10 μm), minimally invasive technique that detects collagen birefringence and has therefore the potential to detect and quantify pulmonary fibrosis. <b>Aim:</b> Investigate the ability of in-vivo EB-PS-OCT to quantify fibrosis in ILD. <b>Methods:</b> ILD patients underwent in-vivo EB-PS-OCT imaging of lung parenchyma prior to transbronchial cryo- or surgical lung biopsy. Asthma patients served as non-fibrotic control. Fibrosis was automatically quantified by assessing the mean birefringence area in EB-PS-OCT images of the alveolar compartment and compared to fibrotic content in HRCT and histology. <b>Results:</b> 19 patients were included (16 ILD; 3 asthma). In 49 out of 55 imaged segments EB-PS-OCT parenchymal birefringence was quantified, ranging from a mean fibrosis score of 2.54% (no to minimal fibrosis) to 21.01% (extensive fibrosis). EB-PS-OCT showed higher accuracy than HRCT in detecting fibrosis, using histology as reference standard. No adverse events occurred. <b>Conclusion:</b> In vivo EB-PS-OCT is a feasible, safe and minimally invasive imaging technique to detect and quantify pulmonary fibrosis. It could be used as an add-on bronchoscopic imaging technique to diagnosis and assess (progressive) fibrosis in ILD patients.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa3544
Simon Walsh, Xiaodan Xing, John Mackintosh, Lucio Calandriello, Yingying Fang, Shiyi Wang, Sheng Zhang, Yang Nan, Mario Silva, Athol Wells, Guang Yang, Tamera Corte
{"title":"Late Breaking Abstract - Deep learning-based outcome prediction in pulmonary fibrosos using synthetic HRCT","authors":"Simon Walsh, Xiaodan Xing, John Mackintosh, Lucio Calandriello, Yingying Fang, Shiyi Wang, Sheng Zhang, Yang Nan, Mario Silva, Athol Wells, Guang Yang, Tamera Corte","doi":"10.1183/13993003.congress-2023.pa3544","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3544","url":null,"abstract":"","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136265096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa3536
Rajesh Agrawal, Rajat Agarwal, Javied Ahmad Malik
Introduction: The COVID-19 affected millions globally. Common residual symptoms on are fatigue, joint pain, dyspnoea and myalgia. Most common complications of COVID-19 in hospitalized patients include respiratory failure, thromboembolic events and new onset diabetes, Aim: To assess the residual clinical and radiological findings in post COVID-19 patients for 1-year period. Material and Methods: All RT-PCR confirmed post COVID-19 patients were clinically and radiologically followed and evaluated for a period of 1 year.. Results: Out of total 93 patients enrolled, 66%(n=61) were male and 34% (n=32) were females with Mean age of 32+/-12 years. 28% (n=25) patients had mild disease, 20% (n=20) had moderate and 52% (n=48) had severe disease. Average length of hospital stay was 10+-3 days in. Breathlessness, joint pain and fatigue were common residual symptoms. New onset diabetes was observed in 5 patients out of total 21 total diabetic patients and hypertension in 20%(n=18) patients. At 1st visit (4th week), CT severity CORAD score 2 was most common observed score in 36.5% of patients and majority had bilateral distribution of disease. At 48th week (last visit) CT severity CORAD score 1 was most common observed score in 62.9. GGO was the most common finding on 1st, 2nd and 3rd follow up visit. Fibrotic changes like inter lobular septal thickening (11.8%), reticular pattern (6.4%) and crazy paving pattern (9.6%) were present on 1st follow up Conclusion: Majority of the patients who had severe form of disease had persistent residual symptoms of fatigue, breathlessness and joint pain. Most of the patients had natural resolution of findings on HRCT thorax without any intervention like anti-fibrotic medication.
{"title":"Post COVID-19 HRCT Thorax sequalae, a one year follow up study","authors":"Rajesh Agrawal, Rajat Agarwal, Javied Ahmad Malik","doi":"10.1183/13993003.congress-2023.pa3536","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3536","url":null,"abstract":"<b>Introduction:</b> The COVID-19 affected millions globally. Common residual symptoms on are fatigue, joint pain, dyspnoea and myalgia. Most common complications of COVID-19 in hospitalized patients include respiratory failure, thromboembolic events and new onset diabetes, Aim: To assess the residual clinical and radiological findings in post COVID-19 patients for 1-year period. <b>Material and Methods:</b> All RT-PCR confirmed post COVID-19 patients were clinically and radiologically followed and evaluated for a period of 1 year.. <b>Results:</b> Out of total 93 patients enrolled, 66%(n=61) were male and 34% (n=32) were females with Mean age of 32+/-12 years. 28% (n=25) patients had mild disease, 20% (n=20) had moderate and 52% (n=48) had severe disease. Average length of hospital stay was 10+-3 days in. Breathlessness, joint pain and fatigue were common residual symptoms. New onset diabetes was observed in 5 patients out of total 21 total diabetic patients and hypertension in 20%(n=18) patients. At 1st visit (4th week), CT severity CORAD score 2 was most common observed score in 36.5% of patients and majority had bilateral distribution of disease. At 48th week (last visit) CT severity CORAD score 1 was most common observed score in 62.9. GGO was the most common finding on 1st, 2nd and 3rd follow up visit. Fibrotic changes like inter lobular septal thickening (11.8%), reticular pattern (6.4%) and crazy paving pattern (9.6%) were present on 1st follow up Conclusion: Majority of the patients who had severe form of disease had persistent residual symptoms of fatigue, breathlessness and joint pain. Most of the patients had natural resolution of findings on HRCT thorax without any intervention like anti-fibrotic medication.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136259414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa3530
Aleksandar Ivkovic, Tamara Milosavljevic, Ivana Svilarov, Stevan Ivkovic, Dusan Ivkovic
{"title":"Differences in CT presentation of covid 19 between vaccinated and unvaccinated patients","authors":"Aleksandar Ivkovic, Tamara Milosavljevic, Ivana Svilarov, Stevan Ivkovic, Dusan Ivkovic","doi":"10.1183/13993003.congress-2023.pa3530","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3530","url":null,"abstract":"","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136265428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.oa4849
Sarah Scharm, Jonathan Ehmig, Cornelia Schaefer-Prokop, Anton Schreuder, Jan Fuge, Frank Wacker, Antje Prasse, Hoen-Oh Shin
Purpose: To investigate whether alveolar collapse detected by an extension of Parametric Response Maps (PRM) can be used as a predictive marker in IPF. Methods: A CT scan was performed in inspiration and expiration on 66 IPF patients. PRMs were created as scatterplots of the voxel-wise attenuation values of the paired inspiration and expiration scans. The PRMs were used to calculate lung parenchymal subvolumes as a function of their attenuation changes during inspiration and expiration. Volumes of “collapsed” lung tissue on expiration were calculated as a percentage of Normal Attenuation Areas (NAA) and High Attenuation Areas (HAA) per patient (NAAcollapse/NAA; HAAcollapse/HAA, respectively). After each respective 3-year period of observation, patients were divided into two subgroups based on their status (endpoints: death and transplantation or still under clinical observation). To compare the named CT parameters obtained at baseline, a Mann-Whitney U test was used. Results: At the end of the 3-year individual follow-up, 37 patients were still under clinical surveillance, whereas 29 patients had died or undergone transplantation. NAAcollapse/NAA and HAAcollapse/HAA differed significantly between subgroups (p = 0.001 and p = 0.002, respectively). Conclusion: The PRM technique can be used to demonstrate the concept of alveolar collapse as a prognostic marker in IPF patients.
{"title":"Alveolar collapse as a prognostic marker in patients with IPF: A CT-based assessment using an extended parametric response mapping technique","authors":"Sarah Scharm, Jonathan Ehmig, Cornelia Schaefer-Prokop, Anton Schreuder, Jan Fuge, Frank Wacker, Antje Prasse, Hoen-Oh Shin","doi":"10.1183/13993003.congress-2023.oa4849","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.oa4849","url":null,"abstract":"<b>Purpose:</b> To investigate whether alveolar collapse detected by an extension of Parametric Response Maps (PRM) can be used as a predictive marker in IPF. <b>Methods:</b> A CT scan was performed in inspiration and expiration on 66 IPF patients. PRMs were created as scatterplots of the voxel-wise attenuation values of the paired inspiration and expiration scans. The PRMs were used to calculate lung parenchymal subvolumes as a function of their attenuation changes during inspiration and expiration. Volumes of “collapsed” lung tissue on expiration were calculated as a percentage of Normal Attenuation Areas (NAA) and High Attenuation Areas (HAA) per patient (NAAcollapse/NAA; HAAcollapse/HAA, respectively). After each respective 3-year period of observation, patients were divided into two subgroups based on their status (endpoints: death and transplantation or still under clinical observation). To compare the named CT parameters obtained at baseline, a Mann-Whitney U test was used. <b>Results:</b> At the end of the 3-year individual follow-up, 37 patients were still under clinical surveillance, whereas 29 patients had died or undergone transplantation. NAAcollapse/NAA and HAAcollapse/HAA differed significantly between subgroups (p = 0.001 and p = 0.002, respectively). <b>Conclusion:</b> The PRM technique can be used to demonstrate the concept of alveolar collapse as a prognostic marker in IPF patients.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136200468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa4001
Rachel Burton, Michael Cheung, Ryan Robinson, Fred Fyles, Thomas Fitzmaurice, Hassan Burhan
Introduction: Dynamic Chest Radiography (DCR) uses sequential radiographs during the respiratory cycle to generate moving images of the thorax. Automated border-detection algorithms can track moving structures. Change in projected lung area (ΔPLA) – the change in visible lung area between maximal inspiration and expiration– may be related to pulmonary function testing (PFT). Objectives: To assess whether ∆PLA differs between patients with interstitial lung disease (ILD), chronic obstructive pulmonary disease (COPD), and asthma. Methods: Three patients with a classical history, examination, and radiology of ILD, COPD or asthma underwent PFTs and DCR. Posteroanterior (PA) and lateral (L) DCR sequences were taken during tidal and deep breathing. Analysis performed using proprietary software calculated ∆PLA at maximal inspiration and end-expiration. Results: PFT results were in keeping with the patients’ disease processes. DCR-derived ∆PLA increased across the three disease groups, with the smallest in ILD (consistent with fibrosis), reduced ∆PLA in COPD (consistent with air trapping), and the largest ∆PLA in asthma. DCR measured ∆PLA provides additional information that supports PFT findings. *Post-bronchodilatorConclusion: DCR-derived ∆PLA reflect important underlying disease processes, which are not easily obtainable from standard spirometry. Further work is needed to assess inter-disease variability of DCR-derived measurements and correlate with PFT.
{"title":"Inter-disease variability in Dynamic Chest Radiography measurements and Pulmonary Function Tests in patients with Asthma, COPD and ILD","authors":"Rachel Burton, Michael Cheung, Ryan Robinson, Fred Fyles, Thomas Fitzmaurice, Hassan Burhan","doi":"10.1183/13993003.congress-2023.pa4001","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa4001","url":null,"abstract":"<b>Introduction:</b> Dynamic Chest Radiography (DCR) uses sequential radiographs during the respiratory cycle to generate moving images of the thorax. Automated border-detection algorithms can track moving structures. Change in projected lung area (ΔPLA) – the change in visible lung area between maximal inspiration and expiration– may be related to pulmonary function testing (PFT). <b>Objectives:</b> To assess whether ∆PLA differs between patients with interstitial lung disease (ILD), chronic obstructive pulmonary disease (COPD), and asthma. <b>Methods:</b> Three patients with a classical history, examination, and radiology of ILD, COPD or asthma underwent PFTs and DCR. Posteroanterior (PA) and lateral (L) DCR sequences were taken during tidal and deep breathing. Analysis performed using proprietary software calculated ∆PLA at maximal inspiration and end-expiration. <b>Results:</b> PFT results were in keeping with the patients’ disease processes. DCR-derived ∆PLA increased across the three disease groups, with the smallest in ILD (consistent with fibrosis), reduced ∆PLA in COPD (consistent with air trapping), and the largest ∆PLA in asthma. DCR measured ∆PLA provides additional information that supports PFT findings. <sub>*Post-bronchodilator</sub> <b>Conclusion:</b> DCR-derived ∆PLA reflect important underlying disease processes, which are not easily obtainable from standard spirometry. Further work is needed to assess inter-disease variability of DCR-derived measurements and correlate with PFT.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-09DOI: 10.1183/13993003.congress-2023.pa3999
Renzo Boersma, Peter Wijkstra, Jorine Hartman, Marieke Duiverman
Background: Chronic hypercapnic respiratory failure (CHRF) is common in patients with severe COPD. However, not all patients become hypercapnic. A better understanding of the underlying pathophysiology contributing to the development of CHRF in COPD is needed. Aims: To explore a CT phenotype which can be linked to hypercapnic COPD patients. Methods: 909 COPD patients from 2 previously established COPD cohorts were included (NCT04023409 + NCT03053973). Patients were grouped as normocapnic (PaCO2 <6kPa) or hypercapnic (PaCO2 ≥6kPa). Quantitative assessment of the CT-scans allowed for the distinction between different CT phenotypes, based on air trapping-, emphysema-, and airway pathology parameters. Results: Expiratory lung volume, emphysema- and air trapping scores were similar in both groups (table 1). Pi10 on the other hand, a measure of airway wall thickness, was found to be significantly higher in the hypercapnic patients. The correlation between Pi10 and PaCO2 was also significant (p=0.001). Conclusions: It appears that a higher average airway wall thickness is associated with the presence of hypercapnia in COPD, while scores related to emphysema were not. This might imply that predominant airway disease might predispose to chronic hypercapnia. Future research is needed to investigate whether selection of patients for therapeutic options, such as chronic non-invasive ventilation, might be improved by including CT phenotyping. Table1. CT parameters in normocapnic and hypercapnic COPD patients.
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