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Visual vs Fully Automatic Histogram-Based Assessment of Idiopathic Pulmonary Fibrosis (IPF) Progression Using Sequential Multidetector Computed Tomography (MDCT).

Colombi D, Dinkel J, Weinheimer O, Obermayer B, Buzan T, Nabers D, Bauer C, Oltmanns U, Palmowski K, Herth F, Kauczor HU, Sverzellati N, Kreuter M, Heussel CP - PLoS ONE (2015)

Bottom Line: Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram.Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; p<0.001) as compared to Δ 80th percentile (r=0.58; p<0.001); closer correlation was found between Δ ground-glass extent and Δ 40th percentile (r=0.66, p<0.001) as compared to Δ 80th percentile (r=0.47, p=0.002), while the Δ reticulations correlated better with the Δ 80th percentile (r=0.56, p<0.001) in comparison to Δ 40th percentile (r=0.43, p=0.003).There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Sciences, Section of Diagnostic Imaging at University of Parma, Parma, Italy; Translational Lung Research Centre (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.

ABSTRACT

Objectives: To describe changes over time in extent of idiopathic pulmonary fibrosis (IPF) at multidetector computed tomography (MDCT) assessed by semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative evaluation and to test the relationship between these two methods of quantification.

Methods: Forty IPF patients (median age: 70 y, interquartile: 62-75 years; M:F, 33:7) that underwent 2 MDCT at different time points with a median interval of 13 months (interquartile: 10-17 months) were retrospectively evaluated. In-house software YACTA quantified automatically lung density histogram (10th-90th percentile in 5th percentile steps). Longitudinal changes in VSs and in the percentiles of attenuation histogram were obtained in 20 untreated patients and 20 patients treated with pirfenidone. Pearson correlation analysis was used to test the relationship between VSs and selected percentiles.

Results: In follow-up MDCT, visual overall extent of parenchymal abnormalities (OE) increased in median by 5%/year (interquartile: 0%/y; +11%/y). Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram. Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; p<0.001) as compared to Δ 80th percentile (r=0.58; p<0.001); closer correlation was found between Δ ground-glass extent and Δ 40th percentile (r=0.66, p<0.001) as compared to Δ 80th percentile (r=0.47, p=0.002), while the Δ reticulations correlated better with the Δ 80th percentile (r=0.56, p<0.001) in comparison to Δ 40th percentile (r=0.43, p=0.003).

Conclusions: There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities.

No MeSH data available.


Related in: MedlinePlus

Median density changes at 1-year follow-up in the range of 10th-90th percentile of the MDCT attenuation histogram for patients suffering from idiopathic pulmonary fibrosis (IPF) treated and untreated with pirfenidone.The largest difference with the lowest overlap between treated and untreated patients in longitudinal HU changes of the attenuation histogram was detected in the 40th and in the 80th percentiles. Black squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; black triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; grey squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone; grey triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone. (Δ HU/y = changes in Hounsfield units per year; MDCT = multidetector computed tomography).
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pone.0130653.g002: Median density changes at 1-year follow-up in the range of 10th-90th percentile of the MDCT attenuation histogram for patients suffering from idiopathic pulmonary fibrosis (IPF) treated and untreated with pirfenidone.The largest difference with the lowest overlap between treated and untreated patients in longitudinal HU changes of the attenuation histogram was detected in the 40th and in the 80th percentiles. Black squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; black triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; grey squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone; grey triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone. (Δ HU/y = changes in Hounsfield units per year; MDCT = multidetector computed tomography).

Mentions: For each MDCT the volume automatically segmented was considered satisfactory by the reader. Fig 2 shows the median HU increase over 1-year in each 5th percentile included in the range 10th-90th percentile of lung density histogram for both treated and untreated patients. The largest difference with the lowest overlap between treated and untreated patients in longitudinal HU changes of the attenuation histogram was detected in the 40th and in the 80th percentiles. The initial median density of the 40th percentile was -822 HU (interquartile: -861 HU; -777 HU), while the 80th percentile showed a median density of -595 HU (interquartile: -674 HU; -518 HU); at follow-up MDCT, the 40th percentile demonstrated a median increase of 22 HU (interquartile: -3 HU; +37 HU) and the density of the 80th percentile increased of 35 HU (interquartile: -3 HU; +65 HU). In particular, the median HU change of the 40th percentile was of 12 HU (interquartile: -3 HU; +39 HU) in patients with the anti-fibrotic treatment and equal to 26 HU (interquartile: -7 HU; +37 HU) in patients without specific anti-fibrotic therapy (Fig 3a). In the 80th percentile (Fig 3b), patients treated with pirfenidone showed a median density increment of 28 HU (interquartile: -5 HU; +59 HU) whereas the median density increase in patients without specific anti-fibrotic therapy was 44 HU (range: -3 HU; +70 HU).


Visual vs Fully Automatic Histogram-Based Assessment of Idiopathic Pulmonary Fibrosis (IPF) Progression Using Sequential Multidetector Computed Tomography (MDCT).

Colombi D, Dinkel J, Weinheimer O, Obermayer B, Buzan T, Nabers D, Bauer C, Oltmanns U, Palmowski K, Herth F, Kauczor HU, Sverzellati N, Kreuter M, Heussel CP - PLoS ONE (2015)

Median density changes at 1-year follow-up in the range of 10th-90th percentile of the MDCT attenuation histogram for patients suffering from idiopathic pulmonary fibrosis (IPF) treated and untreated with pirfenidone.The largest difference with the lowest overlap between treated and untreated patients in longitudinal HU changes of the attenuation histogram was detected in the 40th and in the 80th percentiles. Black squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; black triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; grey squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone; grey triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone. (Δ HU/y = changes in Hounsfield units per year; MDCT = multidetector computed tomography).
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4482435&req=5

pone.0130653.g002: Median density changes at 1-year follow-up in the range of 10th-90th percentile of the MDCT attenuation histogram for patients suffering from idiopathic pulmonary fibrosis (IPF) treated and untreated with pirfenidone.The largest difference with the lowest overlap between treated and untreated patients in longitudinal HU changes of the attenuation histogram was detected in the 40th and in the 80th percentiles. Black squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; black triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients treated with pirfenidone; grey squares = median increase of each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone; grey triangles and circles = interquartile range of the increase in each 5th percentile step included in the 10th-90th range of the lung density histogram for patients not treated with pirfenidone. (Δ HU/y = changes in Hounsfield units per year; MDCT = multidetector computed tomography).
Mentions: For each MDCT the volume automatically segmented was considered satisfactory by the reader. Fig 2 shows the median HU increase over 1-year in each 5th percentile included in the range 10th-90th percentile of lung density histogram for both treated and untreated patients. The largest difference with the lowest overlap between treated and untreated patients in longitudinal HU changes of the attenuation histogram was detected in the 40th and in the 80th percentiles. The initial median density of the 40th percentile was -822 HU (interquartile: -861 HU; -777 HU), while the 80th percentile showed a median density of -595 HU (interquartile: -674 HU; -518 HU); at follow-up MDCT, the 40th percentile demonstrated a median increase of 22 HU (interquartile: -3 HU; +37 HU) and the density of the 80th percentile increased of 35 HU (interquartile: -3 HU; +65 HU). In particular, the median HU change of the 40th percentile was of 12 HU (interquartile: -3 HU; +39 HU) in patients with the anti-fibrotic treatment and equal to 26 HU (interquartile: -7 HU; +37 HU) in patients without specific anti-fibrotic therapy (Fig 3a). In the 80th percentile (Fig 3b), patients treated with pirfenidone showed a median density increment of 28 HU (interquartile: -5 HU; +59 HU) whereas the median density increase in patients without specific anti-fibrotic therapy was 44 HU (range: -3 HU; +70 HU).

Bottom Line: Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram.Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; p<0.001) as compared to Δ 80th percentile (r=0.58; p<0.001); closer correlation was found between Δ ground-glass extent and Δ 40th percentile (r=0.66, p<0.001) as compared to Δ 80th percentile (r=0.47, p=0.002), while the Δ reticulations correlated better with the Δ 80th percentile (r=0.56, p<0.001) in comparison to Δ 40th percentile (r=0.43, p=0.003).There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Sciences, Section of Diagnostic Imaging at University of Parma, Parma, Italy; Translational Lung Research Centre (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.

ABSTRACT

Objectives: To describe changes over time in extent of idiopathic pulmonary fibrosis (IPF) at multidetector computed tomography (MDCT) assessed by semi-quantitative visual scores (VSs) and fully automatic histogram-based quantitative evaluation and to test the relationship between these two methods of quantification.

Methods: Forty IPF patients (median age: 70 y, interquartile: 62-75 years; M:F, 33:7) that underwent 2 MDCT at different time points with a median interval of 13 months (interquartile: 10-17 months) were retrospectively evaluated. In-house software YACTA quantified automatically lung density histogram (10th-90th percentile in 5th percentile steps). Longitudinal changes in VSs and in the percentiles of attenuation histogram were obtained in 20 untreated patients and 20 patients treated with pirfenidone. Pearson correlation analysis was used to test the relationship between VSs and selected percentiles.

Results: In follow-up MDCT, visual overall extent of parenchymal abnormalities (OE) increased in median by 5%/year (interquartile: 0%/y; +11%/y). Substantial difference was found between treated and untreated patients in HU changes of the 40th and of the 80th percentiles of density histogram. Correlation analysis between VSs and selected percentiles showed higher correlation between the changes (Δ) in OE and Δ 40th percentile (r=0.69; p<0.001) as compared to Δ 80th percentile (r=0.58; p<0.001); closer correlation was found between Δ ground-glass extent and Δ 40th percentile (r=0.66, p<0.001) as compared to Δ 80th percentile (r=0.47, p=0.002), while the Δ reticulations correlated better with the Δ 80th percentile (r=0.56, p<0.001) in comparison to Δ 40th percentile (r=0.43, p=0.003).

Conclusions: There is a relevant and fully automatically measurable difference at MDCT in VSs and in histogram analysis at one year follow-up of IPF patients, whether treated or untreated: Δ 40th percentile might reflect the change in overall extent of lung abnormalities, notably of ground-glass pattern; furthermore Δ 80th percentile might reveal the course of reticular opacities.

No MeSH data available.


Related in: MedlinePlus