Longitudinal high-resolution computed tomography (HRCT) assessment and disease progression in patients with Idiopathic Pulmonary Fibrosis (IPF) on antifibrotic therapy

High-Resolution Computed Tomography (HRCT) plays a central role in diagnosing Idiopathic Pulmonary Fibrosis (IPF) while its role in monitoring disease progression is not clearly defined. Given the variable clinical course of the disease, we evaluated whether HRCT abnormalities predict disease behavior and correlate with functional decline in untreated IPF patients. Forty-nine patients (with HRCT1) were functionally categorized as rapid or slow progressors. Twenty-one had a second HRCT2. Thirteen patients underwent lung transplantation and pathology was quantified. HRCT Alveolar (AS) and Interstitial Scores (IS) were assessed and correlated with Forced Vital Capacity (FVC) decline between HRCT1 and HRCT2. At baseline, AS was greater in rapids than in slows, while IS was similar in the two groups. In the 21 subjects with HRCT2, IS increased over time in both slows and rapids, while AS increased only in rapids. The IS change from HRCT1 to HRCT2 normalized per month correlated with FVC decline/month in the whole population, but the change in AS did not. In the 13 patients with pathology, the number of total lymphocytes was higher in rapids than in slows and correlated with AS. Quantitative estimation of HRCTs AS and IS reflects the distinct clinical and pathological behavior of slow and rapid decliners. Furthermore, AS, which reflects the immune/inflammatory infiltrate in lung tissue, could be a useful tool to differentiate rapid from slow progressors at presentation.

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Serial Evaluation of High-Resolution Computed Tomography Findings in Patients with Idiopathic Pulmonary Fibrosis in Usual Interstitial Pneumonia

Respiration ◽

10.1159/000064006 ◽

2002 ◽

Vol 69 (5) ◽

pp. 413-419 ◽

Cited By ~ 36

Author(s):

Taishi Nagao ◽

Sonoko Nagai ◽

Yoshihide Hiramoto ◽

Kunio Hamada ◽

Michio Shigematsu ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Interstitial Pneumonia ◽

Usual Interstitial Pneumonia ◽

High Resolution Computed Tomography ◽

Serial Evaluation

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Domain Knowledge-Assisted Automatic Diagnosis of Idiopathic Pulmonary Fibrosis (IPF) Using High Resolution Computed Tomography (HRCT) (Student Abstract)

Proceedings of the AAAI Conference on Artificial Intelligence ◽

10.1609/aaai.v34i10.7262 ◽

2020 ◽

Vol 34 (10) ◽

pp. 13979-13980

Author(s):

Wenxi Yu ◽

Hua Zhou ◽

Jonathan G. Goldin ◽

Grace Hyun J. Kim

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Optimal Design ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Domain Knowledge ◽

Population Level ◽

Design Criterion ◽

High Resolution Computed Tomography ◽

Ct Slices

Domain knowledge acquired from pilot studies is important for medical diagnosis. This paper leverages the population-level domain knowledge based on the D-optimal design criterion to judiciously select CT slices that are meaningful for the disease diagnosis task. As an illustrative example, the diagnosis of idiopathic pulmonary fibrosis (IPF) among interstitial lung disease (ILD) patients is used for this work. IPF diagnosis is complicated and is subject to inter-observer variability. We aim to construct a time/memory-efficient IPF diagnosis model using high resolution computed tomography (HRCT) with domain knowledge-assisted data dimension reduction methods. Four two-dimensional convolutional neural network (2D-CNN) architectures (MobileNet, VGG16, ResNet, and DenseNet) are implemented for an automatic diagnosis of IPF among ILD patients. Axial lung CT images are acquired from five multi-center clinical trials, which sum up to 330 IPF patients and 650 non-IPF ILD patients. Model performance is evaluated using five-fold cross-validation. Depending on the model setup, MobileNet achieved satisfactory results with overall sensitivity, specificity, and accuracy greater than 90%. Further evaluation of independent datasets is underway. Based on our knowledge, this is the first work that (1) uses population-level domain knowledge with optimal design criterion in selecting CT slices and (2) focuses on patient-level IPF diagnosis.

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Assessment of Lung Cancer Development in Idiopathic Pulmonary Fibrosis Patients Using Quantitative High-Resolution Computed Tomography

Journal of Thoracic Imaging ◽

10.1097/rti.0000000000000468 ◽

2020 ◽

Vol 35 (2) ◽

pp. 115-122 ◽

Cited By ~ 1

Author(s):

Stefano Palmucci ◽

Sebastiano E. Torrisi ◽

Daniele Falsaperla ◽

Alessandro Stefano ◽

Alfredo G. Torcitto ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

High Resolution ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Cancer Development ◽

High Resolution Computed Tomography

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High-Resolution Computed Tomography in Idiopathic Pulmonary Fibrosis

American Journal of Respiratory and Critical Care Medicine ◽

10.1164/rccm.200412-1756oc ◽

2005 ◽

Vol 172 (4) ◽

pp. 488-493 ◽

Cited By ~ 305

Author(s):

David A. Lynch ◽

J. David Godwin ◽

Sharon Safrin ◽

Karen M. Starko ◽

Phil Hormel ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

High Resolution Computed Tomography

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Comparative analysis of density histograms and visual scores in incremental and volumetric high-resolution computed tomography of the chest in idiopathic pulmonary fibrosis patients

La radiologia medica ◽

10.1007/s11547-020-01307-7 ◽

2020 ◽

Author(s):

Gaetano Rea ◽

Marina De Martino ◽

Annalisa Capaccio ◽

Pasquale Dolce ◽

Tullio Valente ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Lung Function ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Ct Scans ◽

High Resolution Computed Tomography ◽

Disease Extent ◽

Single Breath ◽

Volumetric Ct

Abstract Background Volumetric high-resolution computed tomography (HRCT) of the chest has recently replaced incremental CT in the diagnostic workup of idiopathic pulmonary fibrosis (IPF). Concomitantly, visual and quantitative scores have been proposed for disease extent assessment to ameliorate disease management. Purpose To compare the performance of density histograms (mean lung attenuation, skewness, and kurtosis) and visual scores, along with lung function correlations, in IPF patients submitted to incremental or volumetric thorax HRCT. Material and methods Clinical data and CT scans of 89 newly diagnosed and therapy-naive IPF patients were retrospectively evaluated. Results Forty-six incremental and 43 volumetric CT scans were reviewed. No differences of density histograms and visual scores estimates were found by comparing two HRCT techniques, with an optimal inter-operator agreement (concordance correlation coefficient >0.90 in all instances). Single-breath diffusing lung capacity for carbon monoxide (DLCOsb) was inversely related with the Best score (r = −00.416; p = 0.014), the Kazerooni fibrosis extent (r = −0.481; p = 0.004) and the mean lung attenuation (r = −0.382; p = 0.026), while a positive correlation was observed with skewness (r = 0.583; p = 0.001) and kurtosis (r = 0.543; p = 0.001) in the incremental HRCT sub-group. Similarly, in the volumetric CT sub-cohort, DLCOsb was significantly associated with skewness (r = 0.581; p = 0.007) and kurtosis (r = 0.549; p = 0.018). Correlations with visual scores were not confirmed. Forced vital capacity significantly related to all density indices independently on HRCT technique. Conclusions Density histograms and visual scores similarly perform in incremental and volumetric HRCT. Density quantification displays an optimal reproducibility and proves to be superior to visual scoring as more strongly correlated with lung function.

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