Long-term effects of WTC exposure on respiratory and cardiovascular diseases using automated CT image analysis

使用自动 CT 图像分析分析世贸中心暴露对呼吸系统和心血管疾病的长期影响

• 批准号: 10459206
• 负责人: Artit Jirapatnakul
• 金额: $ 24.93万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10459206
• 关键词: Long; term; effects; WTC; exposure

Project Summary Responders to the World Trade Center (WTC) site in the aftermath of the 9/11 attacks were exposed to toxic dust, which has been linked to an increased risk of respiratory and cardiovascular disease. Many of these diseases, such as lung cancer, mesothelioma, interstitial lung disease, and asbestosis, have long latency periods of upwards of twenty years, which we are now approaching. While published studies have linked WTC dust exposure to increased risk of various diseases, few have examined the relationship of the amount of exposure to the extent and progression of disease. The respiratory and cardiovascular effects of WTC dust exposure have been studied using pulmonary function tests and the number of cardiovascular events, but computed tomography (CT) scans provide an opportunity to see the early structural changes in the lungs and cardiovascular system before clinical symptoms appear. CT scans are used in the screening and evaluation of respiratory diseases such as lung cancer, interstitial lung disease, and chronic obstructive pulmonary disease, and to visualize coronary arteries and quantify the amount of coronary artery calcifications; in fact, it is possible to detect multiple diseases from a single chest CT scan. While manual evaluation by a radiologist is often the gold standard, automated image analysis tools are able to quickly and accurately quantify these diseases. We propose to apply automated image analysis tools to quantify four respiratory and cardiovascular diseases thought to be related to toxic dust exposure: emphysema, pleural thickening, interstitial lung disease, and coronary artery calcifications. We will apply these tools retrospectively to all available chest CT scans of members of the WTC general responders cohort (GRC) and a propensity-matched cohort of participants enrolled in a lung screening program. The comparison of the extent and progression of diseases in these two cohorts will provide information on the long-term effects of WTC dust exposure. We hypothesize that a higher frequency of these diseases can be found in WTC members and that they will also have a more rapid disease course compared to non-WTC members. We can further analyze the results of the WTC GRC to assess the relationship between WTC dust exposure, which we will estimate using the arrival time to the WTC site, and the extent and progression of these diseases. The results of this research will potentially improve the care of WTC GRC members through the early identification of diseases and updating of screening guidelines.

项目摘要 9/11袭击后，世界贸易中心（WTC）现场的反应人员暴露在 有毒粉尘，这与呼吸道和心血管疾病的风险增加有关。许多 这些疾病，例如肺癌、间皮瘤、间质性肺病和石棉肺， 潜伏期长达20年，我们现在正在接近。虽然已发表的研究 虽然有学者将WTC粉尘暴露与各种疾病风险增加联系起来，但很少有人研究这种关系 暴露量与疾病的程度和进展有关。呼吸系统和心血管 已经使用肺功能测试和WTC粉尘暴露的数量研究了WTC粉尘暴露的影响。 心血管事件，但计算机断层扫描（CT）扫描提供了一个机会，看到早期 在临床症状出现之前，肺部和心血管系统的结构变化。CT扫描 用于呼吸系统疾病如肺癌，间质性肺病， 和慢性阻塞性肺病，并可视化冠状动脉和量化的量， 冠状动脉钙化;事实上，从一个胸部CT可以检测多种疾病 扫描.虽然放射科医生的手动评估通常是金标准，但自动图像分析 工具能够快速准确地量化这些疾病。 我们建议应用自动图像分析工具来量化四个呼吸和心血管 被认为与接触有毒粉尘有关的疾病：肺气肿、胸膜增厚、间质性肺 冠状动脉钙化。我们将回顾性地将这些工具应用于所有可用的胸部 WTC一般应答者队列（GRC）成员和一个倾向匹配队列的CT扫描结果显示， 参与者参加了肺部筛查项目。的程度和进展的比较， 这两个队列中的疾病将提供关于WTC粉尘暴露的长期影响的信息。 我们假设，这些疾病的发生率更高，可以发现在世界贸易中心的成员，他们 与非WTC成员相比，他们的病程也会更快。我们可以进一步分析 WTC GRC的结果，以评估WTC粉尘暴露之间的关系，我们将估计 使用到达世贸中心地点的时间，以及这些疾病的程度和进展。的结果 这项研究将有可能通过早期识别来改善WTC GRC成员的护理 疾病和更新筛查指南。