Guillaume Chassagnon1,2, Clémence Martin3, Pierre-Régis Burgel3, Dominique Hubert3, Isabelle Fajac4, Nikos Paragios5, Evangelia I Zacharaki5, Paul Legmann6, Joel Coste7, Marie-Pierre Revel6. 1. Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. gchassagnon@gmail.com. 2. Centre for Visual Computing, Ecole Centrale Paris, Grande Voie des Vignes, 92290, Chatenay Malabry, France. gchassagnon@gmail.com. 3. Pulmonary Department and Adult CF Centre, Groupe Hospitalier Cochin-Hotel Dieu, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. 4. Physiology Department, Groupe Hospitalier Cochin-Hotel Dieu, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. 5. Centre for Visual Computing, Ecole Centrale Paris, Grande Voie des Vignes, 92290, Chatenay Malabry, France. 6. Radiology Department, Groupe Hospitalier Cochin-Hotel Dieu, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. 7. Biostatistics and Epidemiology Department, Groupe Hospitalier Cochin-Hotel Dieu, Université Paris Descartes, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
Abstract
OBJECTIVES: To develop an automated density-based computed tomography (CT) score evaluating high-attenuating lung structural abnormalities in patients with cystic fibrosis (CF). METHODS: Seventy adult CF patients were evaluated. The development cohort comprised 17 patients treated with ivacaftor, with 45 pre-therapeutic and follow-up chest CT scans. Another cohort of 53 patients not treated with ivacaftor was used for validation. CT-density scores were calculated using fixed and adapted thresholds based on histogram characteristics, such as the mode and standard deviation. Visual CF-CT score was also calculated. Correlations between the CT scores and forced expiratory volume in 1 s (FEV1% pred), and between their changes over time were assessed. RESULTS: On cross-sectional evaluation, the correlation coefficients between FEV1%pred and the automated scores were slightly lower to that of the visual score in the development and validation cohorts (R = up to -0.68 and -0.61, versus R = -0.72 and R = -0.64, respectively). Conversely, the correlation to FEV1%pred tended to be higher for automated scores (R = up to -0.61) than for visual score (R = -0.49) on longitudinal follow-up. Automated scores based on Mode + 3 SD and Mode +300 HU showed the highest cross-sectional (R = -0.59 to -0.68) and longitudinal (R = -0.51 to -0.61) correlation coefficients to FEV1%pred. CONCLUSIONS: The developed CT-density score reliably quantifies high-attenuating lung structural abnormalities in CF. KEY POINTS: • Automated CT score shows moderate to good cross-sectional correlations with FEV 1 %pred . • CT score has potential to be integrated into the standard reporting workflow.
OBJECTIVES: To develop an automated density-based computed tomography (CT) score evaluating high-attenuating lung structural abnormalities in patients with cystic fibrosis (CF). METHODS: Seventy adult CF patients were evaluated. The development cohort comprised 17 patients treated with ivacaftor, with 45 pre-therapeutic and follow-up chest CT scans. Another cohort of 53 patients not treated with ivacaftor was used for validation. CT-density scores were calculated using fixed and adapted thresholds based on histogram characteristics, such as the mode and standard deviation. Visual CF-CT score was also calculated. Correlations between the CT scores and forced expiratory volume in 1 s (FEV1% pred), and between their changes over time were assessed. RESULTS: On cross-sectional evaluation, the correlation coefficients between FEV1%pred and the automated scores were slightly lower to that of the visual score in the development and validation cohorts (R = up to -0.68 and -0.61, versus R = -0.72 and R = -0.64, respectively). Conversely, the correlation to FEV1%pred tended to be higher for automated scores (R = up to -0.61) than for visual score (R = -0.49) on longitudinal follow-up. Automated scores based on Mode + 3 SD and Mode +300 HU showed the highest cross-sectional (R = -0.59 to -0.68) and longitudinal (R = -0.51 to -0.61) correlation coefficients to FEV1%pred. CONCLUSIONS: The developed CT-density score reliably quantifies high-attenuating lung structural abnormalities in CF. KEY POINTS: • Automated CT score shows moderate to good cross-sectional correlations with FEV 1 %pred . • CT score has potential to be integrated into the standard reporting workflow.
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