Humphries Stephen M, Yagihashi Kunihiro, Huckleberry Jason, Rho Byung-Hak, Schroeder Joyce D, Strand Matthew, Schwarz Marvin I, Flaherty Kevin R, Kazerooni Ella A, van Beek Edwin J R, Lynch David A
From the Department of Radiology (S.M.H., D.A.L.) and Division of Biostatistics and Bioinformatics (M.S.), National Jewish Health, 1440 Jackson St, Denver, CO 80206-2761; Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan (K.Y.); Department of Radiology, Kaiser Permanente, Denver, Colo (J.H.); Department of Radiology, Keimyung University School of Medicine, Daegu, Republic of Korea (B.H.R.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (J.D.S.); Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado, Aurora, Colo (M.I.S.); Departments of Pulmonology (K.R.F.) and Radiology (E.A.K.), University of Michigan, Ann Arbor, Mich; and Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, Scotland (E.J.R.v.B.).
Radiology. 2017 Oct;285(1):270-278. doi: 10.1148/radiol.2017161177. Epub 2017 May 10.
Purpose To evaluate associations between pulmonary function and both quantitative analysis and visual assessment of thin-section computed tomography (CT) images at baseline and at 15-month follow-up in subjects with idiopathic pulmonary fibrosis (IPF). Materials and Methods This retrospective analysis of preexisting anonymized data, collected prospectively between 2007 and 2013 in a HIPAA-compliant study, was exempt from additional institutional review board approval. The extent of lung fibrosis at baseline inspiratory chest CT in 280 subjects enrolled in the IPF Network was evaluated. Visual analysis was performed by using a semiquantitative scoring system. Computer-based quantitative analysis included CT histogram-based measurements and a data-driven textural analysis (DTA). Follow-up CT images in 72 of these subjects were also analyzed. Univariate comparisons were performed by using Spearman rank correlation. Multivariate and longitudinal analyses were performed by using a linear mixed model approach, in which models were compared by using asymptotic χ tests. Results At baseline, all CT-derived measures showed moderate significant correlation (P < .001) with pulmonary function. At follow-up CT, changes in DTA scores showed significant correlation with changes in both forced vital capacity percentage predicted (ρ = -0.41, P < .001) and diffusing capacity for carbon monoxide percentage predicted (ρ = -0.40, P < .001). Asymptotic χ tests showed that inclusion of DTA score significantly improved fit of both baseline and longitudinal linear mixed models in the prediction of pulmonary function (P < .001 for both). Conclusion When compared with semiquantitative visual assessment and CT histogram-based measurements, DTA score provides additional information that can be used to predict diminished function. Automatic quantification of lung fibrosis at CT yields an index of severity that correlates with visual assessment and functional change in subjects with IPF. RSNA, 2017.
目的 评估特发性肺纤维化（IPF）患者基线及15个月随访时肺功能与薄层计算机断层扫描（CT）图像定量分析和视觉评估之间的关联。材料与方法 本研究对2007年至2013年间在一项符合《健康保险流通与责任法案》（HIPAA）的前瞻性研究中收集的已有匿名数据进行回顾性分析，无需额外的机构审查委员会批准。对IPF网络登记的280名受试者的基线吸气胸部CT上的肺纤维化程度进行评估。视觉分析采用半定量评分系统。基于计算机的定量分析包括基于CT直方图的测量和数据驱动的纹理分析（DTA）。还对其中72名受试者的随访CT图像进行了分析。采用Spearman等级相关进行单变量比较。采用线性混合模型方法进行多变量和纵向分析，通过渐近χ检验比较模型。结果 在基线时，所有CT衍生指标与肺功能均呈中度显著相关（P < .001）。在随访CT时，DTA评分的变化与预测的用力肺活量百分比（ρ = -0.41，P < .001）和预测的一氧化碳弥散量百分比（ρ = -0.40，P < .001）的变化均呈显著相关。渐近χ检验表明，纳入DTA评分显著改善了基线和纵向线性混合模型在预测肺功能方面的拟合度（两者P均 < .001）。结论 与半定量视觉评估和基于CT直方图的测量相比，DTA评分提供了可用于预测功能减退的额外信息。CT上肺纤维化的自动定量产生了一个严重程度指数，该指数与IPF患者的视觉评估和功能变化相关。RSNA，2017年。
