Stefano Alessandro, Gioè Mauro, Russo Giorgio, Palmucci Stefano, Torrisi Sebastiano Emanuele, Bignardi Samuel, Basile Antonio, Comelli Albert, Benfante Viviana, Sambataro Gianluca, Falsaperla Daniele, Torcitto Alfredo Gaetano, Attanasio Massimo, Yezzi Anthony, Vancheri Carlo
Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), 90015 Cefalù, Italy.
Department of Economics, Business, and Statistics (DSEAS), University of Palermo, 90133 Palermo, Italy.
Diagnostics (Basel). 2020 May 15;10(5):306. doi: 10.3390/diagnostics10050306.
Our study assesses the diagnostic value of different features extracted from high resolution computed tomography (HRCT) images of patients with idiopathic pulmonary fibrosis. These features are investigated over a range of HRCT lung volume measurements (in Hounsfield Units) for which no prior study has yet been published. In particular, we provide a comparison of their diagnostic value at different Hounsfield Unit (HU) thresholds, including corresponding pulmonary functional tests.
We consider thirty-two patients retrospectively for whom both HRCT examinations and spirometry tests were available. First, we analyse the HRCT histogram to extract quantitative lung fibrosis features. Next, we evaluate the relationship between pulmonary function and the HRCT features at selected HU thresholds, namely -200 HU, 0 HU, and +200 HU. We model the relationship using a Poisson approximation to identify the measure with the highest log-likelihood.
Our Poisson models reveal no difference at the -200 and 0 HU thresholds. However, inferential conclusions change at the +200 HU threshold. Among the HRCT features considered, the percentage of normally attenuated lung at -200 HU shows the most significant diagnostic utility.
The percentage of normally attenuated lung can be used together with qualitative HRCT assessment and pulmonary function tests to enhance the idiopathic pulmonary fibrosis (IPF) diagnostic process.
我们的研究评估了从特发性肺纤维化患者的高分辨率计算机断层扫描（HRCT）图像中提取的不同特征的诊断价值。这些特征是在一系列HRCT肺容积测量值（以亨氏单位计）范围内进行研究的，此前尚无相关研究发表。特别是，我们比较了它们在不同亨氏单位（HU）阈值下的诊断价值，包括相应的肺功能测试。
我们回顾性研究了32例同时进行了HRCT检查和肺活量测定的患者。首先，我们分析HRCT直方图以提取定量肺纤维化特征。接下来，我们评估在选定的HU阈值（即-200 HU、0 HU和+200 HU）下肺功能与HRCT特征之间的关系。我们使用泊松近似对这种关系进行建模，以确定对数似然值最高的指标。
我们的泊松模型显示在-200和0 HU阈值下没有差异。然而，在+200 HU阈值下推断结论发生了变化。在所考虑的HRCT特征中，-200 HU处正常衰减肺的百分比显示出最显著的诊断效用。
正常衰减肺的百分比可与HRCT定性评估和肺功能测试一起用于加强特发性肺纤维化（IPF）的诊断过程。
