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Automated CT scan scores of bronchiectasis and air trapping in cystic fibrosis.
Chest 2014; 145(3):593-603Chest

Abstract

BACKGROUND

Computer analysis of high-resolution CT (HRCT) scans may improve the assessment of structural lung injury in children with cystic fibrosis (CF). The goal of this cross-sectional pilot study was to validate automated, observer-independent image analysis software to establish objective, simple criteria for bronchiectasis and air trapping.

METHODS

HRCT scans of the chest were performed in 35 children with CF and compared with scans from 12 disease control subjects. Automated image analysis software was developed to count visible airways on inspiratory images and to measure a low attenuation density (LAD) index on expiratory images. Among the children with CF, relationships among automated measures, Brody HRCT scanning scores, lung function, and sputum markers of inflammation were assessed.

RESULTS

The number of total, central, and peripheral airways on inspiratory images and LAD (%) on expiratory images were significantly higher in children with CF compared with control subjects. Among subjects with CF, peripheral airway counts correlated strongly with Brody bronchiectasis scores by two raters (r=0.86, P<.0001; r=0.91, P<.0001), correlated negatively with lung function, and were positively associated with sputum free neutrophil elastase activity. LAD (%) correlated with Brody air trapping scores (r=0.83, P<.0001; r=0.69, P<.0001) but did not correlate with lung function or sputum inflammatory markers.

CONCLUSIONS

Quantitative airway counts and LAD (%) on HRCT scans appear to be useful surrogates for bronchiectasis and air trapping in children with CF. Our automated methodology provides objective quantitative measures of bronchiectasis and air trapping that may serve as end points in CF clinical trials.

Authors+Show Affiliations

Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO. Electronic address: emily.deboer@childrenscolorado.org.Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.Department of Pediatrics, Seattle Children's and University of Washington School of Medicine, Seattle, WA.Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.Department of Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24114359

Citation

DeBoer, Emily M., et al. "Automated CT Scan Scores of Bronchiectasis and Air Trapping in Cystic Fibrosis." Chest, vol. 145, no. 3, 2014, pp. 593-603.
DeBoer EM, Swiercz W, Heltshe SL, et al. Automated CT scan scores of bronchiectasis and air trapping in cystic fibrosis. Chest. 2014;145(3):593-603.
DeBoer, E. M., Swiercz, W., Heltshe, S. L., Anthony, M. M., Szefler, P., Klein, R., ... Sagel, S. D. (2014). Automated CT scan scores of bronchiectasis and air trapping in cystic fibrosis. Chest, 145(3), pp. 593-603. doi:10.1378/chest.13-0588.
DeBoer EM, et al. Automated CT Scan Scores of Bronchiectasis and Air Trapping in Cystic Fibrosis. Chest. 2014 Mar 1;145(3):593-603. PubMed PMID: 24114359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Automated CT scan scores of bronchiectasis and air trapping in cystic fibrosis. AU - DeBoer,Emily M, AU - Swiercz,Waldemar, AU - Heltshe,Sonya L, AU - Anthony,Margaret M, AU - Szefler,Paul, AU - Klein,Rebecca, AU - Strain,John, AU - Brody,Alan S, AU - Sagel,Scott D, PY - 2013/10/12/entrez PY - 2013/10/12/pubmed PY - 2014/4/24/medline SP - 593 EP - 603 JF - Chest JO - Chest VL - 145 IS - 3 N2 - BACKGROUND: Computer analysis of high-resolution CT (HRCT) scans may improve the assessment of structural lung injury in children with cystic fibrosis (CF). The goal of this cross-sectional pilot study was to validate automated, observer-independent image analysis software to establish objective, simple criteria for bronchiectasis and air trapping. METHODS: HRCT scans of the chest were performed in 35 children with CF and compared with scans from 12 disease control subjects. Automated image analysis software was developed to count visible airways on inspiratory images and to measure a low attenuation density (LAD) index on expiratory images. Among the children with CF, relationships among automated measures, Brody HRCT scanning scores, lung function, and sputum markers of inflammation were assessed. RESULTS: The number of total, central, and peripheral airways on inspiratory images and LAD (%) on expiratory images were significantly higher in children with CF compared with control subjects. Among subjects with CF, peripheral airway counts correlated strongly with Brody bronchiectasis scores by two raters (r=0.86, P<.0001; r=0.91, P<.0001), correlated negatively with lung function, and were positively associated with sputum free neutrophil elastase activity. LAD (%) correlated with Brody air trapping scores (r=0.83, P<.0001; r=0.69, P<.0001) but did not correlate with lung function or sputum inflammatory markers. CONCLUSIONS: Quantitative airway counts and LAD (%) on HRCT scans appear to be useful surrogates for bronchiectasis and air trapping in children with CF. Our automated methodology provides objective quantitative measures of bronchiectasis and air trapping that may serve as end points in CF clinical trials. SN - 1931-3543 UR - https://www.unboundmedicine.com/medline/citation/24114359/Automated_CT_scan_scores_of_bronchiectasis_and_air_trapping_in_cystic_fibrosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(15)34373-7 DB - PRIME DP - Unbound Medicine ER -