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

项目摘要 9/11袭击后，世界贸易中心(WTC)现场的响应人员暴露在 有毒粉尘，这与呼吸系统和心血管疾病的风险增加有关。许多. 这些疾病，如肺癌、间皮瘤、间质性肺疾病和石棉肺，长期以来 20年以上的潜伏期，我们现在正在接近这个潜伏期。虽然已发表的研究 已经将WTC粉尘暴露与各种疾病风险增加联系在一起，很少有人研究这种关系 暴露在疾病程度和进展中的数量。呼吸系统和心血管 通过肺功能测试和接尘人数的测定，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)提供了一个机会，以了解早期 临床症状出现前肺部和心血管系统的结构变化。CT扫描是 用于筛查和评估呼吸系统疾病，如肺癌、间质性肺疾病、 和慢性阻塞性肺疾病，并可视化冠状动脉和量化数量 冠状动脉钙化；事实上，通过一次胸部CT可以检测到多种疾病 扫描。虽然放射科医生的手动评估通常是黄金标准，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种呼吸和心血管疾病 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 疾病和冠状动脉钙化。我们将把这些工具追溯应用于所有可用的胸腔 WTC一般应答者队列(GRC)成员的CT扫描和倾向匹配的队列 参与者参加了一项肺部筛查计划。两种疾病的程度和进程的比较 这两组人群中的疾病将提供有关WTC粉尘暴露的长期影响的信息。 我们假设在WTC成员中可以发现这些疾病的更高频率，并且他们 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 使用到达世贸中心现场的时间，以及这些疾病的程度和进展。结果是 这项研究可能会通过及早识别WTC GRC成员的 疾病和更新筛查指南。

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.