Department of Allergy, Pulmonology and Critical Care Medicine, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 115, Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
BMC Pulm Med. 2024 Oct 19;24(1):523. doi: 10.1186/s12890-024-03344-8.
The quantitative analysis of computed tomography (CT) and Krebs von den Lungen-6 (KL-6) serum level has gained importance in the diagnosis, monitoring, and prognostication of interstitial lung disease (ILD). However, the associations between quantitative analysis of CT and serum KL-6 level remain poorly understood.
In this retrospective observational study conducted at tertiary hospital between June 2020 and March 2022, quantitative analysis of CT was performed using the deep learning-based method including reticulation, ground glass opacity (GGO), honeycombing, and consolidation. We investigated the associations between CT-based phenotypes and serum KL-6 measured within three months of the CT scan. Furthermore, we evaluated the performance of the combined CT-based phenotypes and KL-6 levels in predicting hospitalizations due to respiratory reasons of ILD patients.
A total of 131 ILD patients (104 males) with a median age of 67 years were included in this study. Reticulation, GGO, honeycombing, and consolidation extents showed a positive correlation with KL-6 levels. [Reticulation, correlation coefficient (r) = 0.567, p < 0.001; GGO, r = 0.355, p < 0.001; honeycombing, r = 0.174, p = 0.046; and consolidation, r = 0.446, p < 0.001]. Additionally, the area under the ROC of the combined reticulation and KL-6 for hospitalizations due to respiratory reasons was 0.810 (p < 0.001).
Quantitative analysis of CT features and serum KL-6 levels ascertained a positive correlation between the two. In addition, the combination of reticulation and KL-6 shows potential for predicting hospitalizations of ILD patients due to respiratory causes. The combination of reticulation, focusing on phenotypic change in lung parenchyma, and KL-6, as an indicator of lung injury extent, could be helpful for monitoring and predicting the prognosis of various types of ILD.
计算机断层扫描（CT）和 Krebs von den Lungen-6（KL-6）血清水平的定量分析在间质性肺病（ILD）的诊断、监测和预后中变得越来越重要。然而，CT 定量分析与血清 KL-6 水平之间的相关性仍知之甚少。
本研究为 2020 年 6 月至 2022 年 3 月在三级医院进行的回顾性观察性研究，采用基于深度学习的方法对 CT 进行定量分析，包括网状影、磨玻璃影（GGO）、蜂窝影和实变影。我们研究了 CT 表现与 CT 扫描后三个月内测量的血清 KL-6 之间的相关性。此外，我们还评估了 CT 表现和 KL-6 水平联合在预测ILD 患者因呼吸原因住院方面的表现。
本研究共纳入 131 名ILD 患者（104 名男性），中位年龄为 67 岁。网状影、GGO、蜂窝影和实变影的范围与 KL-6 水平呈正相关。[网状影，相关系数（r）=0.567，p<0.001；GGO，r=0.355，p<0.001；蜂窝影，r=0.174，p=0.046；实变影，r=0.446，p<0.001]。此外，网状影和 KL-6 联合预测因呼吸原因住院的 ROC 曲线下面积为 0.810（p<0.001）。
CT 特征的定量分析和血清 KL-6 水平之间存在正相关。此外，网状影和 KL-6 的联合具有预测 ILD 患者因呼吸原因住院的潜力。网状影结合 KL-6，前者侧重于肺实质的表型变化，后者作为肺损伤程度的指标，可能有助于监测和预测各种类型 ILD 的预后。
