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.
{"title":"Defining a CT phenotype of severe COPD patients who develop hypercapnia","authors":"Renzo Boersma, Peter Wijkstra, Jorine Hartman, Marieke Duiverman","doi":"10.1183/13993003.congress-2023.pa3999","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3999","url":null,"abstract":"<b>Background:</b> 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. <b>Aims:</b> To explore a CT phenotype which can be linked to hypercapnic COPD patients. <b>Methods:</b> 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. <b>Results:</b> 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). <b>Conclusions:</b> 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. <i>Table1. CT parameters in normocapnic and hypercapnic COPD patients.</i>","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"15 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":"136201697","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.pa4007
Nils Hoyer, Michael Brun Andersen, Lenne Collatz Laustrup, Saher Burhan Shaker
Introduction: Few studies describe whether the extent of radiologic fibrosis correlates with other measures of disease severity in patients with idiopathic pulmonary fibrosis (IPF). A direct correlation could confirm that the clinical and physiological limitations in these patients are attributed to the extent of fibrosis, rather than co-morbidities, such as emphysema, or subjective factors. Objectives: To assess the correlation between a visual fibrosis score and lung function, quality of life and symptoms. Methods: Patients with IPF were recruited from the Danish PFBIO cohort. The HRCT scans were scored by two experienced thoracic radiologists using a standardized form and blinded to patient data, each-others scores and the time of scan. The extents of reticulation, traction bronchiectasis and honeycombing were combined in a composite quantitative fibrosis score. Dyspnoea was assessed in a questionnaire on a scale from 0 to 5. Results: In the 66 included patients, fibrosis score was correlated with FVC (r=-0.35, p=0.005), DLCO (r=-0.53, p<0.001), St. George’s Respiratory Questionnaire (r=0.46, p=0.002) and dyspnoea (r=0.51, p<0.001). There was no significant difference between patients with or without concomitant emphysema. Conclusions: A visual fibrosis score in IPF correlates with lung function tests, quality of life and dyspnoea, further validating these measurements as directly related to the extent of lung fibrosis.
{"title":"HRCT composite fibrosis score correlates with clinical and physiological parameters in IPF","authors":"Nils Hoyer, Michael Brun Andersen, Lenne Collatz Laustrup, Saher Burhan Shaker","doi":"10.1183/13993003.congress-2023.pa4007","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa4007","url":null,"abstract":"<b>Introduction:</b> Few studies describe whether the extent of radiologic fibrosis correlates with other measures of disease severity in patients with idiopathic pulmonary fibrosis (IPF). A direct correlation could confirm that the clinical and physiological limitations in these patients are attributed to the extent of fibrosis, rather than co-morbidities, such as emphysema, or subjective factors. <b>Objectives:</b> To assess the correlation between a visual fibrosis score and lung function, quality of life and symptoms. <b>Methods:</b> Patients with IPF were recruited from the Danish PFBIO cohort. The HRCT scans were scored by two experienced thoracic radiologists using a standardized form and blinded to patient data, each-others scores and the time of scan. The extents of reticulation, traction bronchiectasis and honeycombing were combined in a composite quantitative fibrosis score. Dyspnoea was assessed in a questionnaire on a scale from 0 to 5. <b>Results:</b> In the 66 included patients, fibrosis score was correlated with FVC (r=-0.35, p=0.005), DLCO (r=-0.53, p<0.001), St. George’s Respiratory Questionnaire (r=0.46, p=0.002) and dyspnoea (r=0.51, p<0.001). There was no significant difference between patients with or without concomitant emphysema. <b>Conclusions:</b> A visual fibrosis score in IPF correlates with lung function tests, quality of life and dyspnoea, further validating these measurements as directly related to the extent of lung fibrosis.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"40 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":"136259162","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.pa3543
Jens Thomas Bakker, Jorine E. Hartman, Karin Klooster, David A. Lynch, Marieke C. Van Der Molen, Jean-Paul Charbonnier, Michail Tsiaousis, Rozemarijn Vliegenthart, Dirk-Jan Slebos
Introduction The relation between the degree of diaphragm flattening and lung function impairment in COPD remains largely unknown. We aim to develop a CT-based diaphragm analysis tool to investigate the association between diaphragm configuration and pulmonary function in COPD. Methods We developed a CT-based diaphragm analysis tool based on: 1) identification of the pulmonary lobes using an AI-based lung quantification platform (LungQ, Thirona, Nijmegen, The Netherlands), 2) extraction of a 3D-shape map of the lung-diaphragm intersection (Figure 1A), and 3) calculation of a diaphragm index (ratio of diaphragm surface area/projected surface area). Inspiratory CT scans from the first phase of the COPDGene study (n=9567) were used to evaluate the relation between the automatically extracted diaphragm index and FEV1 %-predicted, GOLD stages, and CT quantified emphysema (LAA<-950) (Figure 1). Results We found a significant association between the diaphragm index and emphysema (Figure 1C), FEV1 %- predicted (Figure 1D), and the COPD GOLD stages (Figure 1B). Conclusions With an in-house developed, automatic CT-based diaphragm analysis tool, we showed significant differences in diaphragm configuration relative to pulmonary function in COPD.
{"title":"Late Breaking Abstract - CT-based diaphragm analysis to evaluate the diaphragm configuration with increasing COPD severity","authors":"Jens Thomas Bakker, Jorine E. Hartman, Karin Klooster, David A. Lynch, Marieke C. Van Der Molen, Jean-Paul Charbonnier, Michail Tsiaousis, Rozemarijn Vliegenthart, Dirk-Jan Slebos","doi":"10.1183/13993003.congress-2023.pa3543","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3543","url":null,"abstract":"<b>Introduction</b> The relation between the degree of diaphragm flattening and lung function impairment in COPD remains largely unknown. We aim to develop a CT-based diaphragm analysis tool to investigate the association between diaphragm configuration and pulmonary function in COPD. <b>Methods</b> We developed a CT-based diaphragm analysis tool based on: 1) identification of the pulmonary lobes using an AI-based lung quantification platform (LungQ, Thirona, Nijmegen, The Netherlands), 2) extraction of a 3D-shape map of the lung-diaphragm intersection (Figure 1A), and 3) calculation of a diaphragm index (ratio of diaphragm surface area/projected surface area). Inspiratory CT scans from the first phase of the COPDGene study (n=9567) were used to evaluate the relation between the automatically extracted diaphragm index and FEV1 %-predicted, GOLD stages, and CT quantified emphysema (LAA<-950) (Figure 1). <b>Results</b> We found a significant association between the diaphragm index and emphysema (Figure 1C), FEV1 %- predicted (Figure 1D), and the COPD GOLD stages (Figure 1B). <b>Conclusions</b> With an in-house developed, automatic CT-based diaphragm analysis tool, we showed significant differences in diaphragm configuration relative to pulmonary function in COPD.","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":"136259659","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.pa2286
Rodrigo Nava, François-Xavier Blé, Cosma Mirella Spalluto, Karl Staples, Tom Wilkinson, Kristoffer Ostridge
Introduction: Airway remodelling is a key feature in chronic respiratory diseases. Using CT imaging, shape analysis, and fractal dimension we aimed to investigate the structure and geometry of the tracheobronchial tree in COPD. Methods: Volumetric CT scans from 30 mild/moderate COPD subjects and 37 healthy controls were segmented. Experiments were divided into two categories: Compactness, eccentricity, and convexity were calculated at airway luminal level; whereas airway count along fractal-dimension rate, density, and airway length were used to quantify the tracheobronchial tree. More-routine CT airway measures such as Pi10 and wall area fraction were also extracted. XGBoost, a decision tree method, was used to score feature importance in predicting COPD. Results: There were significantly fewer airways in COPD subjects (233±88) compared to controls (359±89), with noticeable differences seen in all CT airway parameters (Fig. 1). Feature importance confirms that our novel descriptors strongly contribute to describing COPD and were more discriminant than the routine CT measures. Fig. 1 Mean and σ of CT airway measures. *Two categories were considered. Conclusion: We demonstrated significantly fewer airways and abnormal geometry and structure in our relatively mild COPD cohort. These new features have the potential to be a non-invasive biomarker of airway remodelling in COPD and potentially other respiratory disorders.
{"title":"Can tracheobronchial tree and luminal descriptors be used as objective imaging biomarkers in COPD?","authors":"Rodrigo Nava, François-Xavier Blé, Cosma Mirella Spalluto, Karl Staples, Tom Wilkinson, Kristoffer Ostridge","doi":"10.1183/13993003.congress-2023.pa2286","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa2286","url":null,"abstract":"<b>Introduction:</b> Airway remodelling is a key feature in chronic respiratory diseases. Using CT imaging, shape analysis, and fractal dimension we aimed to investigate the structure and geometry of the tracheobronchial tree in COPD. <b>Methods:</b> Volumetric CT scans from 30 mild/moderate COPD subjects and 37 healthy controls were segmented. Experiments were divided into two categories: Compactness, eccentricity, and convexity were calculated at airway luminal level; whereas airway count along fractal-dimension rate, density, and airway length were used to quantify the tracheobronchial tree. More-routine CT airway measures such as Pi10 and wall area fraction were also extracted. XGBoost, a decision tree method, was used to score feature importance in predicting COPD. <b>Results:</b> There were significantly fewer airways in COPD subjects (233±88) compared to controls (359±89), with noticeable differences seen in all CT airway parameters (<i>Fig. 1</i>). Feature importance confirms that our novel descriptors strongly contribute to describing COPD and were more discriminant than the routine CT measures. <i>Fig. 1</i> Mean and σ of CT airway measures. *Two categories were considered. <b>Conclusion:</b> We demonstrated significantly fewer airways and abnormal geometry and structure in our relatively mild COPD cohort. These new features have the potential to be a non-invasive biomarker of airway remodelling in COPD and potentially other respiratory disorders.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"37 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":"136193309","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.pa3534
Dušan Ivković, Stevan Ivković, Aleksandar Ivković
Purpose: to explore medical management strategies for Covid-19 and future pandemic are designed to modify consumer and provider behavior to improve the quality and outcome of healthcare delivery. Method: we had 15874 patients with covid 19. All of them had at least CT examination, there were x-ray examinations, laboratory and MR for patients with different symptoms. A new and rapidly changing health care environment is forcing usage of more and more strategies. Results: To create competitive advantage, enterprise architecture and technology innovation leaders must evaluate top trends to identify opportunities that their organizations can exploit. These are strategies we use for managing private diagnostic center. Future trends for medical managements are AI foundation, Intelligent apps and analytics, intelligent things, Augmented Analytics Will Enable Users to Spend More Time Acting on Insights Digital twins, Cloud to the edge, Edge Computing Brings Distributed Computing Into the Cloud Style conversational platforms, Integration With Third-Party Services Will Further Increase Usefulness, Immersive Experience, Blockchain Offers Significant Potential Long-Term Benefits Despite Its Challenges, Event-Driven Model, Events Will Become More Important in the Intelligent Digital Mesh, Continuous Adaptive Risk and Trust, Barriers Must Come Down Between Security and Application Teams. The old way management is no useful. Implementing of this technique is vital for private hospitals. Our result is visualized in cost control, health improvement and positive consumer experiences. Conclusion: Any of these strategies have great value but together bring success in the management of epidemic.
{"title":"Medical managment strategies in epidemic","authors":"Dušan Ivković, Stevan Ivković, Aleksandar Ivković","doi":"10.1183/13993003.congress-2023.pa3534","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3534","url":null,"abstract":"<b>Purpose:</b> to explore medical management strategies for Covid-19 and future pandemic are designed to modify consumer and provider behavior to improve the quality and outcome of healthcare delivery. Method: we had 15874 patients with covid 19. All of them had at least CT examination, there were x-ray examinations, laboratory and MR for patients with different symptoms. A new and rapidly changing health care environment is forcing usage of more and more strategies. <b>Results:</b> To create competitive advantage, enterprise architecture and technology innovation leaders must evaluate top trends to identify opportunities that their organizations can exploit. These are strategies we use for managing private diagnostic center. Future trends for medical managements are AI foundation, Intelligent apps and analytics, intelligent things, Augmented Analytics Will Enable Users to Spend More Time Acting on Insights Digital twins, Cloud to the edge, Edge Computing Brings Distributed Computing Into the Cloud Style conversational platforms, Integration With Third-Party Services Will Further Increase Usefulness, Immersive Experience, Blockchain Offers Significant Potential Long-Term Benefits Despite Its Challenges, Event-Driven Model, Events Will Become More Important in the Intelligent Digital Mesh, Continuous Adaptive Risk and Trust, Barriers Must Come Down Between Security and Application Teams. The old way management is no useful. Implementing of this technique is vital for private hospitals. Our result is visualized in cost control, health improvement and positive consumer experiences. <b>Conclusion:</b> Any of these strategies have great value but together bring success in the management of epidemic.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"37 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":"136259541","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.pa3527
Aleksandar Ivkovic, Tamara Milosavljevic, Ivana Svilarov, Stevan Ivkovic, Dusan Ivkovic
{"title":"CT findings as prediction of long covid","authors":"Aleksandar Ivkovic, Tamara Milosavljevic, Ivana Svilarov, Stevan Ivkovic, Dusan Ivkovic","doi":"10.1183/13993003.congress-2023.pa3527","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3527","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":"136265383","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.pa2283
Laura C. Bell, Alexandre Fernandez Coimbra, Yixuan Zou, Colin Dimond, Jaime Mata, John Muglar, Yun Michael Shim, David Mummy, Bastiaan Driehuys, Yuh-Chin Huang, Peter Niedbalski, Mario Castro, Yonni Friedlander, Norm Konyer, Sarah Svenningsen, Parameswaran Nair, Terence Ho, Andrew Hahn, Sean Fain, Eric A. Hoffman, Guilhem J. Collier, Jim M. Wild, Robert Thormen, Talissa Altes, Paula Belloni
Background: Sensitive markers of COPD progression are needed. Xe-MRI ventilation defect % (VDP) and gas-exchange metrics (membrane/gas (MDP), red-blood-cells/gas (RDP)) may be more sensitive to early progression than current clinical endpoints. Objectives: 1) Validate a harmonized Xe-MRI protocol in multicenter setting, and 2) Evaluate suitability of Xe-MRI metrics as measures of progression and predictors of acute exacerbations (AEx). Methods: Effectiveness of a Xe-MRI protocol for Siemens and GE MRI systems [1] was tested in healthy volunteers (HV) at 7 sites with a standardized quality check via a reproducibility assessment. Patient cohorts (n = 11 ongoing) included GOLD II-IV with history of AEx treated with SOC ± azithromycin, and GOLD I. Xe-MRI and PFTs were done at 0, 6, 12, 24, and 48 weeks. Quantitative CT exams at 0, 24 and 48 weeks for volume %normal, %emphysema, and %gas-trapping [2]. Results: In HVs homogeneous gas exchange and repeatability was observed (n = 5, r=0.98, p<.001). In COPD patients, baseline VDP correlated with FEV1 (-0.78, p<.05) and %normal CT (-0.72, p<.05). MDP correlated with %emphysema (0.81, p<.05). A GOLD III patient who experienced AExs and COVID during the 48 weeks showed an increase in MDP & RDP, and decrease in FEV1 (Fig1). Conclusions: A harmonized multicenter Xe-MRI protocol was successful. Early results in COPD patients show correlations between Xe-MRI, HRCT, and PFT.
{"title":"Multisite implementation of 129Xe-MRI assessment of COPD disease progression: XeCITE early results","authors":"Laura C. Bell, Alexandre Fernandez Coimbra, Yixuan Zou, Colin Dimond, Jaime Mata, John Muglar, Yun Michael Shim, David Mummy, Bastiaan Driehuys, Yuh-Chin Huang, Peter Niedbalski, Mario Castro, Yonni Friedlander, Norm Konyer, Sarah Svenningsen, Parameswaran Nair, Terence Ho, Andrew Hahn, Sean Fain, Eric A. Hoffman, Guilhem J. Collier, Jim M. Wild, Robert Thormen, Talissa Altes, Paula Belloni","doi":"10.1183/13993003.congress-2023.pa2283","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa2283","url":null,"abstract":"<b>Background</b>: Sensitive markers of COPD progression are needed. Xe-MRI ventilation defect % (VDP) and gas-exchange metrics (membrane/gas (MDP), red-blood-cells/gas (RDP)) may be more sensitive to early progression than current clinical endpoints. <b>Objectives</b>: 1) Validate a harmonized Xe-MRI protocol in multicenter setting, and 2) Evaluate suitability of Xe-MRI metrics as measures of progression and predictors of acute exacerbations (AEx). <b>Methods</b>: Effectiveness of a Xe-MRI protocol for Siemens and GE MRI systems [1] was tested in healthy volunteers (HV) at 7 sites with a standardized quality check via a reproducibility assessment. Patient cohorts (n = 11 ongoing) included GOLD II-IV with history of AEx treated with SOC ± azithromycin, and GOLD I. Xe-MRI and PFTs were done at 0, 6, 12, 24, and 48 weeks. Quantitative CT exams at 0, 24 and 48 weeks for volume %normal, %emphysema, and %gas-trapping [2]. <b>Results</b>: In HVs homogeneous gas exchange and repeatability was observed (n = 5, r=0.98, p<.001). In COPD patients, baseline VDP correlated with FEV1 (-0.78, p<.05) and %normal CT (-0.72, p<.05). MDP correlated with %emphysema (0.81, p<.05). A GOLD III patient who experienced AExs and COVID during the 48 weeks showed an increase in MDP & RDP, and decrease in FEV1 (Fig1). <b>Conclusions</b>: A harmonized multicenter Xe-MRI protocol was successful. Early results in COPD patients show correlations between Xe-MRI, HRCT, and PFT.","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":"136193317","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}
Background-aim: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has a negative impact on the prognosis of the disease. Radiological findings might be a helpful assessment tool to predict future exacerbations. Here we identified quantitative computerized tomography (CT) findings in relation to AECOPD. Methods: Thorax CT features of COPD patients who applied to our clinic during the last 5 years were retrospectively evaluated and analyzed based on voxel attenuation. Subjects were divided into two groups according to the presence of acute severe exacerbation during the last 12 months after the date of the CT scan. Thus, groups are named GOLD A-B and GOLD E according to GOLD 2023. Quantitative voxel-based attenuation analysis was done by Myrian® Expert software (Intrasense SA-1231, Montpellier, France). Emphysema was defined as attenuation values<-950 Hounsfield Unit (HU). Results: Of 106, 24 subjects had at least one severe AECOPD in the following year of CT. Emphysema percentage was significantly higher in GOLD E in the GOLD A-B group (3% vs 10%, p=0.001) (Table 1). However, both groups displayed similar values in lung volume and mean attenuation. Conclusion: Higher emphysema percentage might indicate increased AECOPD risk. Quantitative CT analysis could be a helpful assessment tool to evaluate exacerbation risk.
背景目的:慢性阻塞性肺疾病急性加重(AECOPD)对疾病的预后有负面影响。放射检查结果可能是预测未来恶化的有用评估工具。在这里，我们确定了与AECOPD相关的定量计算机断层扫描(CT)结果。方法:回顾性分析我院近5年COPD患者胸部CT表现，采用体素衰减法。根据CT扫描后12个月内是否存在急性严重恶化，将受试者分为两组。因此，根据《GOLD 2023》，分组被命名为GOLD A-B和GOLD e。基于体素的定量衰减分析由Myrian®Expert软件(Intrasense SA-1231，法国蒙彼利埃)完成。肺气肿定义为衰减值(Hounsfield Unit, HU)为-950。结果:106例患者中，24例患者在CT后一年至少发生一次严重AECOPD。在GOLD A-B组中，GOLD E组的肺气肿百分比明显更高(3% vs 10%， p=0.001)(表1)。然而，两组在肺体积和平均衰减方面显示相似的值。结论:肺气肿比例越高，AECOPD风险越高。定量CT分析可作为评估急性加重风险的有效评估工具。
{"title":"Radiologic features of COPD exacerbations: quantitative analysis of thorax computerised tomography","authors":"Selin Ercan, Ali Canturk, Emre Ruhat Avci, Naciye Sinem Gezer, Saliha Selin Ozuygur Ermis, Gozde Tokatli, Gokcen Omeroglu Simsek, Pinar Balci, Aylin Ozgen Alpaydin","doi":"10.1183/13993003.congress-2023.pa3998","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa3998","url":null,"abstract":"<b>Background-aim:</b> Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has a negative impact on the prognosis of the disease. Radiological findings might be a helpful assessment tool to predict future exacerbations. Here we identified quantitative computerized tomography (CT) findings in relation to AECOPD. <b>Methods:</b> Thorax CT features of COPD patients who applied to our clinic during the last 5 years were retrospectively evaluated and analyzed based on voxel attenuation. Subjects were divided into two groups according to the presence of acute severe exacerbation during the last 12 months after the date of the CT scan. Thus, groups are named GOLD A-B and GOLD E according to GOLD 2023. Quantitative voxel-based attenuation analysis was done by Myrian® Expert software (Intrasense SA-1231, Montpellier, France). Emphysema was defined as attenuation values<-950 Hounsfield Unit (HU). <b>Results:</b> Of 106, 24 subjects had at least one severe AECOPD in the following year of CT. Emphysema percentage was significantly higher in GOLD E in the GOLD A-B group (3% vs 10%, <i>p</i>=0.001) (Table 1). However, both groups displayed similar values in lung volume and mean attenuation. <b>Conclusion:</b> Higher emphysema percentage might indicate increased AECOPD risk. Quantitative CT analysis could be a helpful assessment tool to evaluate exacerbation risk.","PeriodicalId":34850,"journal":{"name":"Imaging","volume":"9 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":"136201387","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}
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