Christopher Kloth1, Anya C Blum2, Wolfgang M Thaiss2, Heike Preibsch2, Hendrik Ditt3, Rainer Grimmer3, Jan Fritz4, Konstantin Nikolaou2, Hans Bösmüller5, Marius Horger2. 1. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076 Tuebingen, Germany. Electronic address: christopher.kloth@med.uni-tuebingen.de. 2. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076 Tuebingen, Germany. 3. Siemens Healthcare GmbH, Diagnostic Imaging, Forchheim, Germany. 4. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland. 5. Institute of Pathology, Eberhard-Kales-University Tuebingen, Tuebingen, Germany.
Abstract
RATIONALE AND OBJECTIVES: This study aimed to determine the diagnostic aid of computed tomography (CT) features for the differentiation of active alveolitis and fibrosis using a CT texture analysis (CTTA) prototype and CT densitometry in patients with systemic sclerosis (SSc) using ancillary high-resolution computed tomography (HRCT) features and their longitudinal course as standard of reference. MATERIALS AND METHODS: We retrospectively analyzed thin-slice noncontrast chest CT image data of 43 patients with SSc (18 men, mean age 51.55 ± 15.52 years; range 23-71 years). All of them had repeated noncontrast enhanced HRCT of the lung. Classification into active alveolitis or fibrosis was done on HRCT based on classical HRCT findings (active alveolitis [19; 44.2%] and fibrosis [24; 55.8%]) and their course at midterm. Results were compared to pulmonary functional tests and were followed up by CT. Ground glass opacity was considered suggestive of alveolitis, whereas coarse reticulation with parenchymal distortion, traction bronchiectasis, and honeycombing were assigned to fibrosis. RESULTS: Statistically significant differences in CTTA were found for first-order textural features (mean intensity, average, deviation, skewness) and second-order statistics (entropy of co-occurrence matrix, mean number of nonuniformity (NGLDM), entropy of NGLDM, entropy of heterogeneity, intensity, and average). Cut-off value for the prediction of fibrosis at baseline was significant for entropy of intensity (P value < .001) and for mean deviation (P value < .001), and for prediction of alveolitis was significant for uniformity of intensity (P value < .001) and for NGLDM (P value < .001). At pulmonary functional tests, forced expiratory volume in 1 second and single-breath diffusion capacity for carbon monoxide were significantly lower in fibrosis than in alveolitis 2.03 ± 0.78 vs. 2.61 ± 0.83, P < .016 and 4.51 ± 1.61 vs. 6.04 ± 1.75, P < .009, respectively. Differences in CT densitometry between alveolitis and fibrosis were not significant. CONCLUSIONS: CTTA parameters are significantly different in active alveolitis vs. fibrosis in patients with SSc and may be helpful for differentiation of these two entities.
RATIONALE AND OBJECTIVES: This study aimed to determine the diagnostic aid of computed tomography (CT) features for the differentiation of active alveolitis and fibrosis using a CT texture analysis (CTTA) prototype and CT densitometry in patients with systemic sclerosis (SSc) using ancillary high-resolution computed tomography (HRCT) features and their longitudinal course as standard of reference. MATERIALS AND METHODS: We retrospectively analyzed thin-slice noncontrast chest CT image data of 43 patients with SSc (18 men, mean age 51.55 ± 15.52 years; range 23-71 years). All of them had repeated noncontrast enhanced HRCT of the lung. Classification into active alveolitis or fibrosis was done on HRCT based on classical HRCT findings (active alveolitis [19; 44.2%] and fibrosis [24; 55.8%]) and their course at midterm. Results were compared to pulmonary functional tests and were followed up by CT. Ground glass opacity was considered suggestive of alveolitis, whereas coarse reticulation with parenchymal distortion, traction bronchiectasis, and honeycombing were assigned to fibrosis. RESULTS: Statistically significant differences in CTTA were found for first-order textural features (mean intensity, average, deviation, skewness) and second-order statistics (entropy of co-occurrence matrix, mean number of nonuniformity (NGLDM), entropy of NGLDM, entropy of heterogeneity, intensity, and average). Cut-off value for the prediction of fibrosis at baseline was significant for entropy of intensity (P value < .001) and for mean deviation (P value < .001), and for prediction of alveolitis was significant for uniformity of intensity (P value < .001) and for NGLDM (P value < .001). At pulmonary functional tests, forced expiratory volume in 1 second and single-breath diffusion capacity for carbon monoxide were significantly lower in fibrosis than in alveolitis 2.03 ± 0.78 vs. 2.61 ± 0.83, P < .016 and 4.51 ± 1.61 vs. 6.04 ± 1.75, P < .009, respectively. Differences in CT densitometry between alveolitis and fibrosis were not significant. CONCLUSIONS:CTTA parameters are significantly different in active alveolitis vs. fibrosis in patients with SSc and may be helpful for differentiation of these two entities.
Authors: Michael Esser; Cristopher Kloth; Wolfgang M Thaiss; Christian P Reinert; Mareen S Kraus; Gabriel Cc Gast; Marius Horger Journal: Br J Radiol Date: 2019-09-19 Impact factor: 3.039
Authors: K Martini; B Baessler; M Bogowicz; C Blüthgen; M Mannil; S Tanadini-Lang; J Schniering; B Maurer; T Frauenfelder Journal: Eur Radiol Date: 2020-10-06 Impact factor: 5.315