Project description:To explore the diagnostic method in assessing the malignancy of pulmonary adenocarcinoma characterized by ground glass opacities (GGO) on computed tomography (CT).Preoperative CT data for preinvasive and invasive lung adenocarcinomas were analyzed retrospectively. GGO lesions that were detected on lung windows but absent using the mediastinal window were subject to adjustment of the window width, which was reduced with the fixed interval of 100 HU until the lesions were no longer evident, with a fixed mediastinal window level of 40 HU. The shape, smoking habits, size of the lesion on the lung window, and window width at which lesions disappeared were compared and receiver operating characteristic curves were used to determine the optimal cut-off of the lesion size and window width to differentiate between these invasive and preinvasive lesions.Of the 209 lung adenocarcinomas, 102 were preinvasive (25 atypical adenomatous hyperplasia and 77 adenocarcinoma in situ), while 107 were invasive (78 minimally invasive adenocarcinoma and 29 invasive adenocarcinoma). The shape, lesion size, and window width at which lesions were no longer evident differed significantly between the two groups (P < 0.05). The size of 8.9 mm and a window width of 1250 HU were the optimal cut-off to differentiate between preinvasive and invasive lesions.The shape, size of the lesion, and window width on high-resolution CT may be useful in assessing the invasiveness of lung adenocarcinoma that manifests as GGO. Irregular lesions that disappear at window width <1250 HU, with a diameter of > 8.9 mm are more likely to be invasive.
Project description:ObjectiveTo explore the correlation between radiomic features and the pathology of pure ground-glass opacities (pGGOs), we established a radiomics model for predicting the pathological subtypes of minimally invasive adenocarcinoma (MIA) and precursor lesions.MethodsCT images of 1521 patients with lung adenocarcinoma or precursor lesions appearing as pGGOs on CT in our hospital (The Third Affiliated Hospital of Sun Yat-sen University) from January 2015 to March 2021 were analyzed retrospectively and selected based on inclusion and exclusion criteria. pGGOs were divided into an atypical adenomatous hyperplasia (AAH)/adenocarcinoma in situ (AIS) group and an MIA group. Radiomic features were extracted from the original and preprocessed images of the region of interest. ANOVA and least absolute shrinkage and selection operator feature selection algorithm were used for feature selection. Logistic regression algorithm was used to construct radiomics prediction model. Receiver operating characteristic curves were used to evaluate the classification efficiency.Results129 pGGOs were included. 2107 radiomic features were extracted from each region of interest. 18 radiomic features were eventually selected for model construction. The area under the curve of the radiomics model was 0.884 [95% confidence interval (CI), 0.818-0.949] in the training set and 0.872 (95% CI, 0.756-0.988) in the test set, with a sensitivity of 72.73%, specificity of 88.24% and accuracy of 79.47%. The decision curve indicated that the model had a high net benefit rate.ConclusionThe prediction model for pathological subtypes of MIA and precursor lesions in pGGOs demonstrated a high diagnostic accuracy.Advances in knowledgeWe focused on lesions appearing as pGGOs on CT and revealed the differences in radiomic features between MIA and precursor lesions. We constructed a radiomics prediction model and improved the diagnostic accuracy for the pathology of MIA and precursor lesions.
Project description:Objective: Pure ground-glass opacity (GGO) nodules have been detected with increasing frequency using computed tomography (CT). We performed a retrospective study to clarify whether lung cancer patient prognoses correlated with pure GGO nodules. We also analyzed the clinical characters of patients with pure GGO nodules to provide diagnostic guidance on lung cancer identification and treatment of patients in clinical practice. Methods: We enrolled 39 of 1422 patients with pure GGO nodules who accepted surgical treatment of the lung cancer nodules, and reviewed materials from 404 patients to verify our conclusions. To discover which factors were prognostically significant, we used the Kaplan-Meier method to estimate the overall survival (OS) and progression-free survival (PFS) curves. Age, gender, smoking history, histology, tumor size, and stage were the factors examined in our study. We also performed subgroup and matching group analyses to clarify the correlation between the presence of pure GGO nodules and prognoses. Results: Pure GGO nodules were associated with non-smoking females that had adenocarcinoma. The prognoses of patients in the pure GGO nodule group was better than those in the non-pure GGO nodule group (p = 0.046). Age, grade, and stage (including tumor size and lymph node metastases) were had prognostic significance. In the matching group stage assessments, although patient prognoses were not significantly different among patients of the GGO group compared with thoses of the other group in long-term, while in the short term, patients with pure GGO nodules had longer PFS. Non-smoking female patients with lung cancer were more likely to have adenocarcinoma. Conclusions: As a subgroup of GGO nodules, pure GGO nodules predict a better prognosis in all lung cancer patients. Wheras our study showed that lung patients with pure GGO nodules in similar stages were not significantly different in long-term prognoses, in the short term; patients with pure GGO nodules had longer PFS.
Project description:INTRODUCTION:Pulmonary sarcoidosis is a rare heterogeneous lung disease of unknown aetiology, with limited treatment options. Phenotyping relies on clinical testing including visual scoring of chest radiographs. Objective radiomic measures from high-resolution computed tomography (HRCT) may provide additional information to assess disease status. As the first radiomics analysis in sarcoidosis, we investigate the potential of radiomic measures as biomarkers for sarcoidosis, by assessing 1) differences in HRCT between sarcoidosis subjects and healthy controls, 2) associations between radiomic measures and spirometry, and 3) trends between Scadding stages. METHODS:Radiomic features were computed on HRCT in three anatomical planes. Linear regression compared global radiomic features between sarcoidosis subjects (n=73) and healthy controls (n=78), and identified associations with spirometry. Spatial differences in associations across the lung were investigated using functional data analysis. A subanalysis compared radiomic features between Scadding stages. RESULTS:Global radiomic measures differed significantly between sarcoidosis subjects and controls (p<0.001 for skewness, kurtosis, fractal dimension and Geary's C), with differences in spatial radiomics most apparent in superior and lateral regions. In sarcoidosis subjects, there were significant associations between radiomic measures and spirometry, with a large association found between Geary's C and forced vital capacity (FVC) (p=0.008). Global radiomic measures differed significantly between Scadding stages (p<0.032), albeit nonlinearly, with stage IV having more extreme radiomic values. Radiomics explained 71.1% of the variability in FVC compared with 51.4% by Scadding staging alone. CONCLUSIONS:Radiomic HRCT measures objectively differentiate disease abnormalities, associate with lung function and identify trends in Scadding stage, showing promise as quantitative biomarkers for pulmonary sarcoidosis.
Project description:ObjectiveThe aim of our study was to assess the effect of a short-term treatment with low-moderate corticosteroid (CS) doses by both a quantitative and qualitative assessment of chest HRCT of COVID-19 pneumonia.MethodsCORTICOVID is a single-center, cross-sectional, retrospective study involving severe/critical COVID-19 patients with mild/moderate ARDS. Lung total severity score was obtained according to Chung and colleagues. Moreover, the relative percentages of lung total severity score by ground glass opacities, consolidations, crazy paving, and linear bands were computed. Chest HRCT scores, P/F ratio, and laboratory parameters were evaluated before (pre-CS) and 7-10 days after (post-CS) methylprednisolone of 0.5-0.8 mg/kg/day.FindingsA total of 34 severe/critical COVID-19 patients were included in the study, of which 17 received Standard of Care (SoC) and 17 CS therapy in add-on. CS treatment disclosed a significant decrease in HRCT total severity score [median = 6 (IQR: 5-7.5) versus 10 (IQR: 9-13) in SoC, p < 0.001], as well in single consolidations [median = 0.33 (IQR: 0-0.92) versus 6.73 (IQR: 2.49-8.03) in SoC, p < 0.001] and crazy paving scores [mean = 0.19 (SD = 0.53) versus 1.79 (SD = 2.71) in SoC, p = 0.010], along with a significant increase in linear bands [mean = 2.56 (SD = 1.65) versus 0.97 (SD = 1.30) in SoC, p = 0.006]. GGO score instead did not significantly differ at the end of treatment between the two groups. Most post-CS GGO, however, derived from previous consolidations and crazy paving [median = 1.5 (0.35-3.81) versus 2 (1.25-3.8) pre-CS; p = 0.579], while pre-CS GGO significantly decreased after methylprednisolone therapy [median = 0.66 (0.05-1.33) versus 1.5 (0.35-3.81) pre-CS; p = 0.004]. CS therapy further determined a significant improvement in P/F levels [median P/F = 310 (IQR: 235.5-370) versus 136 (IQR: 98.5-211.75) in SoC; p < 0.001], and a significant increase in white blood cells, lymphocytes, and neutrophils absolute values.ConclusionThe improvement of all chest HRCT findings further supports the role of CS adjunctive therapy in severe/critical COVID-19 pneumonia.
Project description:RationaleThe development of early lung disease in patients with cystic fibrosis (CF) remains poorly defined.ObjectiveDetermine whether asymptomatic infants with CF have evidence for changes in airway structure when assessed by high-resolution computed tomography, and whether airway structure correlates with airway function in this age group.MethodsThirteen infants with CF (8-33 mo) and 13 control infants (7-25 mo) were evaluated. Airway wall and lumen areas were measured from three 1-mm-thick cross-sectional images obtained from upper, middle, and lower lobes during a respiratory pause with the lungs inflated to an airway pressure of 20 cm H2O. Lung tissue density was measured from images obtained during a respiratory pause at FRC. Forced expiratory flows were measured by the rapid thoracic compression technique in 11 infants with CF.ResultsAirway wall area increased more per unit increase in airway size, whereas airway lumen area increased less per unit increase in airway size in the CF than in the control group. Among infants with CF, a greater ratio of wall to lumen area correlated with lower airway function. In addition, lung density at relaxed (passive) FRC was lower for infants with CF than for control infants (0.38 vs. 0.43 g/ml; p < 0.02).ConclusionsOur results indicate that infants with CF have thickened airway walls, narrowed airway lumens, and air trapping, when assessed by high-resolution computed tomography, and measurements of airway structure correlated with airway function.
Project description:Chest computed tomography (CT) is the gold standard for detecting structural abnormalities in patients with primary ciliary dyskinesia (PCD) such as bronchiectasis, bronchial wall thickening and mucus plugging. There are no studies on quantitative assessment of airway and artery abnormalities in children with PCD. The objectives of the present study were to quantify airway and artery dimensions on chest CT in a cohort of children with PCD and compare these with control children to analyse the influence of covariates on airway and artery dimensions. Chest CTs of 13 children with PCD (14 CT scans) and 12 control children were collected retrospectively. The bronchial tree was segmented semi-automatically and reconstructed in a three-dimensional view. All visible airway-artery (AA) pairs were measured perpendicular to the airway centre line, annotating per branch inner and outer airway and adjacent artery diameter and computing inner airway diameter/artery ratio (AinA ratio), outer airway diameter/artery ratio (AoutA ratio), wall thickness (WT), WT/outer airway diameter ratio (Awt ratio) and WT/artery ratio. In the children with PCD (38.5% male, mean age 13.5 years, range 9.8-15.3) 1526 AA pairs were measured versus 1516 in controls (58.3% male, mean age 13.5 years, range 8-14.8). AinA ratio and AoutA ratio were significantly higher in children with PCD than in control children (both p<0.001). Awt ratio was significantly higher in control children than in children with PCD (p<0.001). Our study showed that in children with PCD airways are more dilated than in controls and do not show airway wall thickening.
Project description:We assessed the CT attenuation density of the pulmonary tissue adjacent to the heart in patients with acute non-ST segment elevation myocardial infarction (J.T. Kuhl, T.S. Kristensen, A.F. Thomsen et al., 2016) [1]. This data was related to the level of ground-glass opacification evaluated by a radiologist, and data on the interobserver variability of semi-automated assessment of pulmonary attenuation density was provided.
Project description:OBJECTIVES: High-resolution computed tomography (HRCT) can detect the structural abnormalities in asthma. This study attempts to correlate these abnormalities with clinical and pulmonary function test (PFT) data. METHODS: Consecutive stable asthma patients attending Mubarak Al Kabeer Hospital, Kuwait, were subjected to HRCT during a six month period from July 2004 to December 2004, after initial evaluation and PFT. RESULTS: Of the 28 cases, sixteen (57.1%) had moderate, 6 (21.4%) had mild and 6 (21.4%) had severe persistent asthma. Thirteen (46.4%) patients had asthma for 1 to 5 years and 12 (42.9%) were having asthma for >10 years. Bronchial wall thickening (57.1%), bronchiectasis (28.6%), mucoid impaction (17.9%), mosaic attenuation (10.7%), air trapping (78.6%) and plate like atelectasis (21.4%) were noted. Bronchial wall thickening (p=0.044) and bronchiectasis (p=0.063) were most prevalent in males. Ten (35.7%) patients exhibited mild, 9 (32.1%) had moderate and 3 (10.7%) had severe air trapping. The difference in Hounsfield units between expiratory and inspiratory slices (air trapping) when correlated with percent-predicted FEV1 in right upper (r=0.25; p=0.30), left upper (r=0.20; p=0.41), right mid (r=0.15; p=0.53), left mid (r=-0.04; p=0.60), right lower (r=0.04; p=0.86) and left lower zones (r=-0.13; p=0.58) showed no relation. The same when correlated as above with the percent predicted FEF 25-75 did not show any significant association. The presence of air trapping was compared with sex (p=0.640), nationality (p=1.000), disease duration (p=1.000) and severity of symptoms (p=0.581). CONCLUSION: Abnormal HRCT findings are common in asthma; however, air trapping when present was not related to the duration or severity of the illness or to the FEV1.