Diagnosis of chronic obstructive pulmonary disease in lung cancer screening Computed Tomography scans: independent contribution of emphysema, air trapping and bronchial wall thickening.
Diagnosis of chronic obstructive pulmonary disease in lung cancer screening Computed Tomography scans: independent contribution of emphysema, air trapping and bronchial wall thickening.
复制标题
DOI：
10.1186/1465-9921-14-59
复制
发表时间：
2013-05-27
影响因子：
5.8
通讯作者：
de Jong PA
中科院分区：
文献类型：
--
作者：
Mets OM;Schmidt M;Buckens CF;Gondrie MJ;Isgum I;Oudkerk M;Vliegenthart R;de Koning HJ;van der Aalst CM;Prokop M;Lammers JW;Zanen P;Mohamed Hoesein FA;Mali WP;van Ginneken B;van Rikxoort EM;de Jong PA
除肺癌外，CT筛查还包含其他与吸烟有关的疾病（如慢性阻塞性肺疾病）的额外信息。由于肺功能检测不定期纳入肺癌筛查，COPD的成像生物标志物可能为疾病评估提供重要的替代措施。因此，本研究旨在确定CT肺气肿、CT气陷、CT支气管壁厚在低剂量筛查CT扫描中对COPD的独立诊断价值。在同一天对1140名男性肺癌筛查参与者进行支气管扩张剂前肺活量测定和容积吸气和呼气胸部CT。在CT扫描中自动量化肺气肿、气陷和支气管壁厚度。采用Logistic回归分析推导COPD诊断模型。使用自举技术对模型进行内部验证。除了年龄、体重指数、吸烟史和吸烟状况外，三种CT生物标志物中的每一种都独立贡献了COPD的诊断价值。包含所有三种CT生物标志物的诊断模型的敏感性和特异性分别为73.2%和88。分别为%。阳性预测值为80.2%，阴性预测值为84.2%。在所有参与者中，82.8%的人被分配了正确的状态。c统计量为0.87，与不含CT生物标志物的模型相比，净重分类指数为44.4%。然而，呼气CT数据的附加价值有限，与仅吸气CT数据的模型相比，净重分类指数增加了4.5%。定量评估的CT肺气肿、空气捕获和支气管壁厚度都包含COPD的独立诊断信息，这些成像生物标志物可能在缺乏肺功能检测的情况下被证明是有用的，并可能影响肺癌筛查策略。在肺癌筛查中，单独的吸气CT生物标志物可能足以识别COPD患者。
Beyond lung cancer, screening CT contains additional information on other smoking related diseases (e.g. chronic obstructive pulmonary disease, COPD). Since pulmonary function testing is not regularly incorporated in lung cancer screening, imaging biomarkers for COPD are likely to provide important surrogate measures for disease evaluation. Therefore, this study aims to determine the independent diagnostic value of CT emphysema, CT air trapping and CT bronchial wall thickness for COPD in low-dose screening CT scans. Prebronchodilator spirometry and volumetric inspiratory and expiratory chest CT were obtained on the same day in 1140 male lung cancer screening participants. Emphysema, air trapping and bronchial wall thickness were automatically quantified in the CT scans. Logistic regression analysis was performed to derivate a model to diagnose COPD. The model was internally validated using bootstrapping techniques. Each of the three CT biomarkers independently contributed diagnostic value for COPD, additional to age, body mass index, smoking history and smoking status. The diagnostic model that included all three CT biomarkers had a sensitivity and specificity of 73.2% and 88.%, respectively. The positive and negative predictive value were 80.2% and 84.2%, respectively. Of all participants, 82.8% was assigned the correct status. The C-statistic was 0.87, and the Net Reclassification Index compared to a model without any CT biomarkers was 44.4%. However, the added value of the expiratory CT data was limited, with an increase in Net Reclassification Index of 4.5% compared to a model with only inspiratory CT data. Quantitatively assessed CT emphysema, air trapping and bronchial wall thickness each contain independent diagnostic information for COPD, and these imaging biomarkers might prove useful in the absence of lung function testing and may influence lung cancer screening strategy. Inspiratory CT biomarkers alone may be sufficient to identify patients with COPD in lung cancer screening setting.
登录
查看更多内容
影响因子：
5.9
作者：
Mets OM;Murphy K;Zanen P;Gietema HA;Lammers JW;van Ginneken B;Prokop M;de Jong PA
通讯作者：
de Jong PA
影响因子：
10
作者：
O'Donnell, RA;Peebles, C;Djukanovic, R
通讯作者：
Djukanovic, R
影响因子：
4.3
作者：
Mair, Grant;Maclay, John;MacNee, William
通讯作者：
MacNee, William
DOI：
10.1164/ajrccm.162.3.9907120
发表时间：
2000-09-01
影响因子：
24.7
作者：
Nakano, Y;Muro, S;Mishima, M
通讯作者：
Mishima, M
影响因子：
24.3
作者：
Miller, MR;Hankinson, J;Wanger, J
通讯作者：
Wanger, J