Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis
Automated quantification of radiological patterns predicts survival in idiopathic pulmonary fibrosis
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DOI：
10.1183/09031936.00071812
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发表时间：
2014-01-01
影响因子：
24.3
通讯作者：
Ryu, Jay H.
中科院分区：
文献类型：
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作者：
Maldonado, Fabien;Moua, Teng;Ryu, Jay H.
由于个体放射学和生理学的显著差异，特发性肺纤维化预后的准确评估仍然难以捉摸。我们假设短期的放射学变化可能是生存的预测。我们探索了由位于美国明尼苏达州罗切斯特的梅奥诊所的生物医学成像资源实验室开发的用于在高分辨率计算机断层扫描上分析和量化肺实质异常的新型软件工具CALIPER(计算机辅助肺信息学用于病理评估和评级)的使用。我们评估了选择的55名特发性肺纤维化患者的基线和随访(时间点1和2)高分辨率CT扫描，并与放射科专家的评估和临床结果进行了相关的管径量化测量。网状密度(风险比1.91，p=0.006)、间质异常总体积(风险比1.70，p=0.003)和总间质异常百分比(风险比1.52，p=0.017)的间隔变化(平均289d)可以预测中位2.4年随访后的生存。放射科医生对全球间质性肺疾病短期进展的解释，但不是特定的放射学特征，也是对死亡率的预测。这些数据证明了在高分辨率CT上量化间期短期变化的可行性，以及它们可能作为特发性肺纤维化患者生存的独立预测因子。
Accurate assessment of prognosis in idiopathic pulmonary fibrosis remains elusive due to significant individual radiological and physiological variability. We hypothesised that short-term radiological changes may be predictive of survival.We explored the use of CALIPER (Computer-Aided Lung Informatics for Pathology Evaluation and Rating), a novel software tool developed by the Biomedical Imaging Resource Laboratory at the Mayo Clinic Rochester (Rochester, MN, USA) for the analysis and quantification of parenchymal lung abnormalities on high-resolution computed tomography. We assessed baseline and follow-up (time-points 1 and 2, respectively) high-resolution computed tomography scans in 55 selected idiopathic pulmonary fibrosis patients and correlated CALIPER-quantified measurements with expert radiologists' assessments and clinical outcomes.Findings of interval change (mean 289 days) in volume of reticular densities (hazard ratio 1.91, p=0.006), total volume of interstitial abnormalities (hazard ratio 1.70, p = 0.003) and per cent total interstitial abnormalities (hazard ratio 1.52, p=0.017) as quantified by CALIPER were predictive of survival after a median follow-up of 2.4 years. Radiologist interpretation of short-term global interstitial lung disease progression, but not specific radiological features, was also predictive of mortality.These data demonstrate the feasibility of quantifying interval short-term changes on high-resolution computed tomography and their possible use as independent predictors of survival in idiopathic pulmonary fibrosis.