Jonathan H Chung1, Ayodeji Adegunsoye2, Justin M Oldham3, Rekha Vij2, Aliya Husain4, Steven M Montner5, Ronald A Karwoski6, Brian J Bartholmai6, Mary E Strek2. 1. Department of Radiology, The University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA. jonherochung@uchicago.edu. 2. Section of Pulmonary/Critical Care, Department of Medicine, The University of Chicago Medical Center, 5841 South Maryland Ave., Chicago, IL, 60637, USA. 3. Section of Pulmonary/Critical Care, Department of Medicine, The University of California at Davis, 2825 J St., Suite 400, Sacramento, CA, 95816, USA. 4. Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Ave., Chicago, IL, 60637, USA. 5. Department of Radiology, The University of Chicago Medical Center, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA. 6. Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Abstract
OBJECTIVES: To determine if a quantitative imaging variable (volume-related structures [VRS]) could identify subjects with a non-IPF diagnosis CT pattern who were highly likely to have UIP histologically. METHODS: Subjects with a multidisciplinary diagnosis of interstitial lung disease including surgical lung biopsy and chest CT within 1 year of each other were included in the study. Non-contrast CT scans were analyzed using the Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) program, which quantifies the amount of various abnormal CT patterns on chest CT. Quantitative data were analyzed relative to pathological diagnosis as well as the qualitative CT pattern. RESULTS: CALIPER-derived volumes of reticulation (p = 0.012), honeycombing (p = 0.017), and VRS (p < 0.001) were associated with a UIP pattern on pathology on univariate analysis but only VRS was associated with a UIP pathology on multivariable analysis (p = 0.013). Using a VRS cut-off of 173 cm3, the sensitivity and specificity for pathological UIP were similar to those for standard qualitative CT assessment (55.9% and 80.4% compared to 60.6% and 80.4%, respectively). VRS differentiated pathological UIP cases in those with a non-IPF diagnosis CT category (p < 0.001) but not in other qualitative CT patterns (typical UIP, probable UIP, and indeterminate for UIP). The rate of pathological UIP in those with VRS greater than 173 cm3 (84.2%) was nearly identical to those who had a qualitative CT pattern of probable UIP (88.9%). CONCLUSIONS: VRS may be an adjunct to CT in predicting pathology in patients with interstitial lung disease. KEY POINTS: • Volume of vessel-related structures (VRS) was associated with usual interstitial pneumonia (UIP) on pathology. • This differentiation arose from those with CT scans with a non-IPF diagnosis imaging pattern. • Higher VRS has similar diagnostic ramifications for UIP as probable UIP, transitively suggesting in patients with high VRS, pathology may be obviated.
OBJECTIVES: To determine if a quantitative imaging variable (volume-related structures [VRS]) could identify subjects with a non-IPF diagnosis CT pattern who were highly likely to have UIP histologically. METHODS: Subjects with a multidisciplinary diagnosis of interstitial lung disease including surgical lung biopsy and chest CT within 1 year of each other were included in the study. Non-contrast CT scans were analyzed using the Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) program, which quantifies the amount of various abnormal CT patterns on chest CT. Quantitative data were analyzed relative to pathological diagnosis as well as the qualitative CT pattern. RESULTS: CALIPER-derived volumes of reticulation (p = 0.012), honeycombing (p = 0.017), and VRS (p < 0.001) were associated with a UIP pattern on pathology on univariate analysis but only VRS was associated with a UIP pathology on multivariable analysis (p = 0.013). Using a VRS cut-off of 173 cm3, the sensitivity and specificity for pathological UIP were similar to those for standard qualitative CT assessment (55.9% and 80.4% compared to 60.6% and 80.4%, respectively). VRS differentiated pathological UIP cases in those with a non-IPF diagnosis CT category (p < 0.001) but not in other qualitative CT patterns (typical UIP, probable UIP, and indeterminate for UIP). The rate of pathological UIP in those with VRS greater than 173 cm3 (84.2%) was nearly identical to those who had a qualitative CT pattern of probable UIP (88.9%). CONCLUSIONS: VRS may be an adjunct to CT in predicting pathology in patients with interstitial lung disease. KEY POINTS: • Volume of vessel-related structures (VRS) was associated with usual interstitial pneumonia (UIP) on pathology. • This differentiation arose from those with CT scans with a non-IPF diagnosis imaging pattern. • Higher VRS has similar diagnostic ramifications for UIP as probable UIP, transitively suggesting in patients with high VRS, pathology may be obviated.
Authors: Joseph Jacob; Brian J Bartholmai; Anne Laure Brun; Ryoko Egashira; Srinivasan Rajagopalan; Ronald Karwoski; Vasileios Kouranos; Maria Kokosi; David M Hansell; Athol U Wells Journal: Respirology Date: 2017-07-11 Impact factor: 6.424
Authors: Joseph Jacob; Brian J Bartholmai; Srinivasan Rajagopalan; Ryoko Egashira; Anne Laure Brun; Maria Kokosi; Arjun Nair; Simon L F Walsh; Ronald Karwoski; Andrew G Nicholson; David M Hansell; Athol U Wells Journal: Respir Med Date: 2017-07-14 Impact factor: 3.415
Authors: Joseph Jacob; Brian J Bartholmai; Srinivasan Rajagopalan; Maria Kokosi; Ryoko Egashira; Anne Laure Brun; Arjun Nair; Simon L F Walsh; Ronald Karwoski; Athol U Wells Journal: Eur Radiol Date: 2017-09-29 Impact factor: 5.315
Authors: Jonathan H Chung; Steven M Montner; Ayodeji Adegunsoye; Justin M Oldham; Aliya N Husain; Rekha Vij; Imre Noth; Mary E Strek Journal: Eur Radiol Date: 2017-07-07 Impact factor: 5.315
Authors: Simon L F Walsh; Athol U Wells; Sujal R Desai; Venerino Poletti; Sara Piciucchi; Alessandra Dubini; Hilario Nunes; Dominique Valeyre; Pierre Y Brillet; Marianne Kambouchner; António Morais; José M Pereira; Conceição Souto Moura; Jan C Grutters; Daniel A van den Heuvel; Hendrik W van Es; Matthijs F van Oosterhout; Cornelis A Seldenrijk; Elisabeth Bendstrup; Finn Rasmussen; Line B Madsen; Bibek Gooptu; Sabine Pomplun; Hiroyuki Taniguchi; Junya Fukuoka; Takeshi Johkoh; Andrew G Nicholson; Charlie Sayer; Lilian Edmunds; Joseph Jacob; Maria A Kokosi; Jeffrey L Myers; Kevin R Flaherty; David M Hansell Journal: Lancet Respir Med Date: 2016-05-11 Impact factor: 30.700
Authors: Joseph Jacob; Brian J Bartholmai; Srinivasan Rajagopalan; Maria Kokosi; Arjun Nair; Ronald Karwoski; Sushravya M Raghunath; Simon L F Walsh; Athol U Wells; David M Hansell Journal: J Thorac Imaging Date: 2016-09 Impact factor: 3.000
Authors: Joshua J Solomon; Jonathan H Chung; Gregory P Cosgrove; M Kristen Demoruelle; Evans R Fernandez-Perez; Aryeh Fischer; Stephen K Frankel; Stephen B Hobbs; Tristan J Huie; Jill Ketzer; Amar Mannina; Amy L Olson; Gloria Russell; Yutaka Tsuchiya; Zulma X Yunt; Pearlanne T Zelarney; Kevin K Brown; Jeffrey J Swigris Journal: Eur Respir J Date: 2015-11-19 Impact factor: 16.671
Authors: Joseph Jacob; Brian J Bartholmai; Srinivasan Rajagopalan; Coline H M van Moorsel; Hendrik W van Es; Frouke T van Beek; Marjolijn H L Struik; Maria Kokosi; Ryoko Egashira; Anne Laure Brun; Arjun Nair; Simon L F Walsh; Gary Cross; Joseph Barnett; Angelo de Lauretis; Eoin P Judge; Sujal Desai; Ronald Karwoski; Sebastien Ourselin; Elisabetta Renzoni; Toby M Maher; Andre Altmann; Athol U Wells Journal: Am J Respir Crit Care Med Date: 2018-09-15 Impact factor: 30.528
Authors: Joseph Jacob; Brian J Bartholmai; Srinivasan Rajagopalan; Anne Laure Brun; Ryoko Egashira; Ronald Karwoski; Maria Kokosi; Athol U Wells; David M Hansell Journal: BMC Med Date: 2016-11-23 Impact factor: 8.775
Authors: Joseph Jacob; Brian J Bartholmai; Ryoko Egashira; Anne Laure Brun; Srinivasan Rajagopalan; Ronald Karwoski; Maria Kokosi; David M Hansell; Athol U Wells Journal: BMC Pulm Med Date: 2017-05-04 Impact factor: 3.317