CT Assessment of Lung Fissures: Anatomy and Correlated Function

描述（由申请人提供）：在美国，肺部疾病在主要死亡原因中排名第三。高分辨率MDCT的可用性使得能够以以前无法获得的细节对体内肺结构进行成像，从而激发了使用影像学对肺异常进行表型分析的极大兴趣，从而更好地了解肺解剖及其与肺功能的相关性。这可能导致早期发现和诊断，以及可能更有效的个体化患者管理。有迹象表明，裂缝的完整性和形态可能与肺功能相关，并可能在个体对特定肺部疾病如COPD（慢性阻塞性肺疾病）和ILD（间质性肺疾病）发展的易感性中发挥作用。裂隙完整性也可能是决定诸如肺炎等疾病进展的主要因素。然而，通常由放射科医生和肺科医生对裂隙的完整性、形态以及周围组织进行主观评估，这些评估既耗时又容易出错。为了利用现有的先进CT成像技术，并提供一种非侵入性的方法来评估这些关系，我们建议开发自动化的计算机方案，以可视化和定量测量和分类肺裂缝的结构和完整性，然后评估已建立的肺功能测量和肺结构差异之间的相关性（如果有的话）。为了实现这些目标，我们将(1)组建一个庞大而多样化的CT数据库，其中包括超过1000个肺部CT检查，涵盖了广泛的肺部疾病；(2)优化先前开发的肺裂缝检测和肺叶分割的原型计算机方案，并测试其通用性；(3)开发一个自动化的定量计算机化工具，用于计算裂缝形态和裂缝不完整性的综合指数。(4)通过与三位经验丰富的放射科医生的主观结果进行比较来评估我们的计算机方案，(5)使用统计分析来评估肺解剖和肺功能之间的相关性（如果有的话）。本项目的独特优势包括但不限于：(1)使用计算几何分析在三维几何空间中进行肺裂/肺叶分析和可视化，因此对肺结构的解剖学知识的依赖最小；(2)通过分析从高分辨率CT图像中逐叶或全肺重建的肺结构，可以无创地研究肺功能。我们初步研究的成功支持了我们方法的可行性，这使我们感到鼓舞。

DESCRIPTION (provided by applicant): Pulmonary diseases rank third among the leading causes of death in the United States. The availability of high resolution MDCT makes it possible to image in-vivo lung structures in previously unattainable details, thus stimulating great interest of using imaging to phenotype lung abnormalities for better understanding of lung anatomy and its correlation to lung function. This may lead to earlier detection and diagnosis as well as possibly to more efficacious individualized patient management. There are indications that fissures integrity and configuration may be correlated with lung function and may play a role in the susceptibility of individuals to the development of specific lung diseases such as COPD (Chronic Obstructive Pulmonary Disease) and ILD (Interstitial Lung Disease). Fissure integrity may also be a primary factor in determining progression of diseases such as pneumonia. However, subjective assessments of fissures completeness and configuration as well as surrounding tissues are typically done subjectively by radiologists and pulmonologists and these assessments are both time consuming and error prone. To take advantages of available advanced CT imaging techniques and to provide a non-invasive way for assessing these relationships, we propose to develop automated computerized schemes to visualize and quantitatively measure and classify pulmonary fissures structure and completeness and then assess correlations, if any, between established lung function measures and differences in lung structures. To achieve these objectives, we will (1) assemble a large and diverse CT database of over 1000 lung CT examinations that cover a wide range of depicted lung diseases, (2) optimize a previously developed prototype computerized scheme for lung fissure detection and lobe segmentation and test its generalizeability, (3) develop an automated quantitative computerized tool for computing a summary index for fissure configuration and fissure incompleteness, (4) evaluate our computerized schemes by comparing it with the subjective results of three experienced radiologists, and (5) assess the correlation, if any, between lung anatomy and lung function using statistical analyses. The unique advantages of this project include but are not limited to: (1) pulmonary fissure/lobe analysis is performed, analyzed and visualized in three-dimensional geometric space using computational geometry analysis and as a result have minimum dependence on anatomical knowledge of lung structure, and (2) lung functions may be studied non-invasively by analyzing pulmonary structures reconstructed from high resolution CT images on either a lobe-by-lobe or a whole lung basis. We are encouraged by the success of our preliminary studies that supports the feasibility of our approach.