Quantitative Image Analysis at Chronic Lung Allograft Dysfunction Onset Predicts Mortality.
Quantitative Image Analysis at Chronic Lung Allograft Dysfunction Onset Predicts Mortality.
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DOI：
10.1097/tp.0000000000003950
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发表时间：
2022-06-01
期刊：
影响因子：
6.2
通讯作者：
Goldin J
中科院分区：
文献类型：
--
作者：
Weigt SS;Kim GJ;Jones HD;Ramsey AL;Amubieya O;Abtin F;Pourzand L;Lee J;Shino MY;DerHovanessian A;Stripp B;Noble PW;Sayah DM;Saggar R;Britton I;Lynch JP 3rd;Belperio JA;Goldin J
慢性同种异体肺移植功能障碍（CLAD）表型决定预后并可能具有治疗意义。尽管最近的共识声明定义已经很明确，但它们对放射学解释的依赖引入了主观性。加州大学洛杉矶分校 (UCLA) 计算机视觉和成像生物标志物中心制定了基于胸部高分辨率计算机断层扫描 (HRCT) 的计算机辅助量化间质性疾病和空气滞留的方案。我们在 CLAD 发病时应用定量图像分析 (QIA)，以证明具有临床意义的放射学表型。我们研究了 UCLA 的 47 名首例双侧肺移植受者，他们在 CLAD 发病后 90 天内进行了胸部 HRCT，并研究了 47 名非 CLAD 对照 HRCT。 QIA 分别确定了受间质性疾病和空气滞留影响的肺容量在总肺容量和残余容量图像中的比例。我们比较了 no-CLAD 和 CLAD 之间以及表型之间的 QIA 评分。我们还仅根据 QIA 分配放射学表型，并比较其生存结果。与非 CLAD 对照相比，CLAD 发病 HRCT 受间质性疾病影响的肺部更多 (P = 0.003)。与可能的限制性同种异体移植综合征 (RAS) (P < 0.0001) 和混合 CLAD (P = 0.02) 表型相比，闭塞性细支气管炎综合征 (BOS) 病例的间质性疾病评分较低。 BOS 病例比可能的 RAS 病例有更多的空气滞留（P < 0.0001）。在 QIA 指定的表型中，混合型的相对死亡风险最大（相对风险 [RR] 11.81），其次是 RAS（RR 6.27）和 BOS（RR 3.15）。 CLAD 发病时的胸部 HRCT QIA 似乎有望作为一种精确确定具有生存意义的 CLAD 表型的方法。
Chronic lung allograft dysfunction (CLAD) phenotype determines prognosis and may have therapeutic implications. Despite the clarity achieved by recent consensus statement definitions, their reliance on radiologic interpretation introduces subjectivity. The Center for Computer Vision and Imaging Biomarkers at the University of California, Los Angeles (UCLA) has established protocols for chest high-resolution computed tomography (HRCT)-based computer-aided quantification of both interstitial disease and air-trapping. We applied quantitative image analysis (QIA) at CLAD onset to demonstrate radiographic phenotypes with clinical implications. We studied 47 first bilateral lung transplant recipients at UCLA with chest HRCT performed within 90 d of CLAD onset and 47 no-CLAD control HRCTs. QIA determined the proportion of lung volume affected by interstitial disease and air-trapping in total lung capacity and residual volume images, respectively. We compared QIA scores between no-CLAD and CLAD, and between phenotypes. We also assigned radiographic phenotypes based solely on QIA, and compared their survival outcomes. CLAD onset HRCTs had more lung affected by the interstitial disease (P = 0.003) than no-CLAD controls. Bronchiolitis obliterans syndrome (BOS) cases had lower scores for interstitial disease as compared with probable restrictive allograft syndrome (RAS) (P < 0.0001) and mixed CLAD (P = 0.02) phenotypes. BOS cases had more air-trapping than probable RAS (P < 0.0001). Among phenotypes assigned by QIA, the relative risk of death was greatest for mixed (relative risk [RR] 11.81), followed by RAS (RR 6.27) and BOS (RR 3.15). Chest HRCT QIA at CLAD onset appears promising as a method for precise determination of CLAD phenotypes with survival implications.