Quantitative high-resolution computed tomography fibrosis score: performance characteristics in idiopathic pulmonary fibrosis
Quantitative high-resolution computed tomography fibrosis score: performance characteristics in idiopathic pulmonary fibrosis
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DOI：
10.1183/13993003.01384-2018
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发表时间：
2018-09-01
影响因子：
24.3
通讯作者：
Lynch, David A.
中科院分区：
文献类型：
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作者：
Humphries, Stephen M.;Swigris, Jeffrey J.;Lynch, David A.
我们评估了特发性肺纤维化(IPF)受试者的数据驱动纹理分析(DTA)的表现特征和最小临床重要差异(MCID)，DTA是一种高分辨率计算机断层扫描(HRCT)肺纤维化的测量方法。研究对象包括来自两个干预性临床试验的141名IPF受试者，他们都进行了基线和名义上54或60周的HRCT随访。计算DTA评分，并与用力肺活量(FVC)、肺一氧化碳弥散量、6min步行试验距离和圣乔治呼吸问卷评分进行比较，以评估该方法的可靠性、有效性和反应性。采用基于锚变量和基于分布的方法来估计其MCID。DTA对于根据锚变量在随访中表现稳定的受试者具有可接受的可靠性。在基线时，DTA评分和其他临床测量之间的相关性是中等到微弱的，而且是在假设的方向上。DTA评分的变化和其他参数的变化之间的中等到微弱的相关性(在假设的方向上)表明了可接受的反应性。以FVC为指标，MCID估计为3.4%。用DTA对HRCT上的肺纤维化程度进行定量是可靠、有效和灵敏的，接近3.4%的增加代表了一个重要的临床变化。
We evaluated performance characteristics and estimated the minimal clinically important difference (MCID) of data-driven texture analysis (DTA), a high-resolution computed tomography (HRCT)-derived measurement of lung fibrosis, in subjects with idiopathic pulmonary fibrosis (IPF).The study population included 141 subjects with IPF from two interventional clinical trials who had both baseline and nominal 54- or 60-week follow-up HRCT. DTA scores were computed and compared with forced vital capacity (FVC), diffusing capacity of the lung for carbon monoxide, distance covered during a 6-min walk test and St George's Respiratory Questionnaire scores to assess the method's reliability, validity and responsiveness. Anchor- and distribution-based methods were used to estimate its MCID.DTA had acceptable reliability in subjects appearing stable according to anchor variables at follow-up. Correlations between the DTA score and other clinical measurements at baseline were moderate to weak and in the hypothesised directions. Acceptable responsiveness was demonstrated by moderate to weak correlations (in the directions hypothesised) between changes in the DTA score and changes in other parameters. Using FVC as an anchor, MCID was estimated to be 3.4%.Quantification of lung fibrosis extent on HRCT using DTA is reliable, valid and responsive, and an increase of similar to 3.4% represents a clinically important change.