Evaluation of visual and computer-based CT analysis for the identification of functional patterns of obstruction and restriction in hypersensitivity pneumonitis

Joseph Jacob, Brian Jack Bartholmai, Anne Laure Brun, Ryoko Egashira, Srinivasan Rajagopalan, Ronald Karwoski, Vasileios Kouranos, Maria Kokosi, David M. Hansell, Athol U. Wells

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and objective: To determine whether computer-based quantification (CALIPER software) is superior to visual computed tomography (CT) scoring in the identification of CT patterns indicative of restrictive and obstructive functional indices in hypersensitivity pneumonitis (HP). Methods: A total of 135 consecutive HP patients had CT parenchymal patterns evaluated quantitatively by both visual scoring and CALIPER. Results were evaluated against: forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO) and a composite physiological index (CPI) to identify which CT scoring method better correlated with functional indices. Results: CALIPER-derived scores of total interstitial lung disease extent correlated more strongly than visual scores: FVC (CALIPER R=0.73, visual R=0.51); DLCO (CALIPER R=0.61, visual R=0.48); and CPI (CALIPER R=0·70, visual R=0·55). The CT variable that correlated most strongly with restrictive functional indices was CALIPER pulmonary vessel volume (PVV): FVC R=0.75, DLCO R=0.68 and CPI R=0.76. Ground-glass opacity quantified by CALIPER alone demonstrated strong associations with restrictive functional indices: CALIPER FVC R=0.65; DLCO R=0.59; CPI R=0.64; and visual=not significant. Decreased attenuation lung quantified by CALIPER was a better morphological measure of obstructive lung disease than equivalent visual scores as judged by relationships with TLC (CALIPER R=0.63 and visual R=0.12). All results were maintained on multivariate analysis. Conclusion: CALIPER improved on visual scoring in HP as judged by restrictive and obstructive functional correlations. Decreased attenuation regions of the lung quantified by CALIPER demonstrated better linkages to obstructive lung physiology than visually quantified CT scores. A novel CALIPER variable, the PVV, demonstrated the strongest linkages with restrictive functional indices and could represent a new automated index of disease severity in HP.

Original languageEnglish (US)
JournalRespirology
DOIs
StateAccepted/In press - 2017

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Extrinsic Allergic Alveolitis
Vital Capacity
Tomography
Lung
Total Lung Capacity
Obstructive Lung Diseases
Interstitial Lung Diseases
Carbon Monoxide
Glass
Research Design
Software
Multivariate Analysis

Keywords

  • Air trapping
  • Hypersensitivity pneumonitis
  • Pulmonary vessel volume
  • Quantitative computer analysis
  • Visual computed tomography analysis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Evaluation of visual and computer-based CT analysis for the identification of functional patterns of obstruction and restriction in hypersensitivity pneumonitis. / Jacob, Joseph; Bartholmai, Brian Jack; Brun, Anne Laure; Egashira, Ryoko; Rajagopalan, Srinivasan; Karwoski, Ronald; Kouranos, Vasileios; Kokosi, Maria; Hansell, David M.; Wells, Athol U.

In: Respirology, 2017.

Research output: Contribution to journalArticle

Jacob, Joseph ; Bartholmai, Brian Jack ; Brun, Anne Laure ; Egashira, Ryoko ; Rajagopalan, Srinivasan ; Karwoski, Ronald ; Kouranos, Vasileios ; Kokosi, Maria ; Hansell, David M. ; Wells, Athol U. / Evaluation of visual and computer-based CT analysis for the identification of functional patterns of obstruction and restriction in hypersensitivity pneumonitis. In: Respirology. 2017.
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abstract = "Background and objective: To determine whether computer-based quantification (CALIPER software) is superior to visual computed tomography (CT) scoring in the identification of CT patterns indicative of restrictive and obstructive functional indices in hypersensitivity pneumonitis (HP). Methods: A total of 135 consecutive HP patients had CT parenchymal patterns evaluated quantitatively by both visual scoring and CALIPER. Results were evaluated against: forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO) and a composite physiological index (CPI) to identify which CT scoring method better correlated with functional indices. Results: CALIPER-derived scores of total interstitial lung disease extent correlated more strongly than visual scores: FVC (CALIPER R=0.73, visual R=0.51); DLCO (CALIPER R=0.61, visual R=0.48); and CPI (CALIPER R=0·70, visual R=0·55). The CT variable that correlated most strongly with restrictive functional indices was CALIPER pulmonary vessel volume (PVV): FVC R=0.75, DLCO R=0.68 and CPI R=0.76. Ground-glass opacity quantified by CALIPER alone demonstrated strong associations with restrictive functional indices: CALIPER FVC R=0.65; DLCO R=0.59; CPI R=0.64; and visual=not significant. Decreased attenuation lung quantified by CALIPER was a better morphological measure of obstructive lung disease than equivalent visual scores as judged by relationships with TLC (CALIPER R=0.63 and visual R=0.12). All results were maintained on multivariate analysis. Conclusion: CALIPER improved on visual scoring in HP as judged by restrictive and obstructive functional correlations. Decreased attenuation regions of the lung quantified by CALIPER demonstrated better linkages to obstructive lung physiology than visually quantified CT scores. A novel CALIPER variable, the PVV, demonstrated the strongest linkages with restrictive functional indices and could represent a new automated index of disease severity in HP.",
keywords = "Air trapping, Hypersensitivity pneumonitis, Pulmonary vessel volume, Quantitative computer analysis, Visual computed tomography analysis",
author = "Joseph Jacob and Bartholmai, {Brian Jack} and Brun, {Anne Laure} and Ryoko Egashira and Srinivasan Rajagopalan and Ronald Karwoski and Vasileios Kouranos and Maria Kokosi and Hansell, {David M.} and Wells, {Athol U.}",
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T1 - Evaluation of visual and computer-based CT analysis for the identification of functional patterns of obstruction and restriction in hypersensitivity pneumonitis

AU - Jacob, Joseph

AU - Bartholmai, Brian Jack

AU - Brun, Anne Laure

AU - Egashira, Ryoko

AU - Rajagopalan, Srinivasan

AU - Karwoski, Ronald

AU - Kouranos, Vasileios

AU - Kokosi, Maria

AU - Hansell, David M.

AU - Wells, Athol U.

PY - 2017

Y1 - 2017

N2 - Background and objective: To determine whether computer-based quantification (CALIPER software) is superior to visual computed tomography (CT) scoring in the identification of CT patterns indicative of restrictive and obstructive functional indices in hypersensitivity pneumonitis (HP). Methods: A total of 135 consecutive HP patients had CT parenchymal patterns evaluated quantitatively by both visual scoring and CALIPER. Results were evaluated against: forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO) and a composite physiological index (CPI) to identify which CT scoring method better correlated with functional indices. Results: CALIPER-derived scores of total interstitial lung disease extent correlated more strongly than visual scores: FVC (CALIPER R=0.73, visual R=0.51); DLCO (CALIPER R=0.61, visual R=0.48); and CPI (CALIPER R=0·70, visual R=0·55). The CT variable that correlated most strongly with restrictive functional indices was CALIPER pulmonary vessel volume (PVV): FVC R=0.75, DLCO R=0.68 and CPI R=0.76. Ground-glass opacity quantified by CALIPER alone demonstrated strong associations with restrictive functional indices: CALIPER FVC R=0.65; DLCO R=0.59; CPI R=0.64; and visual=not significant. Decreased attenuation lung quantified by CALIPER was a better morphological measure of obstructive lung disease than equivalent visual scores as judged by relationships with TLC (CALIPER R=0.63 and visual R=0.12). All results were maintained on multivariate analysis. Conclusion: CALIPER improved on visual scoring in HP as judged by restrictive and obstructive functional correlations. Decreased attenuation regions of the lung quantified by CALIPER demonstrated better linkages to obstructive lung physiology than visually quantified CT scores. A novel CALIPER variable, the PVV, demonstrated the strongest linkages with restrictive functional indices and could represent a new automated index of disease severity in HP.

AB - Background and objective: To determine whether computer-based quantification (CALIPER software) is superior to visual computed tomography (CT) scoring in the identification of CT patterns indicative of restrictive and obstructive functional indices in hypersensitivity pneumonitis (HP). Methods: A total of 135 consecutive HP patients had CT parenchymal patterns evaluated quantitatively by both visual scoring and CALIPER. Results were evaluated against: forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity for carbon monoxide (DLCO) and a composite physiological index (CPI) to identify which CT scoring method better correlated with functional indices. Results: CALIPER-derived scores of total interstitial lung disease extent correlated more strongly than visual scores: FVC (CALIPER R=0.73, visual R=0.51); DLCO (CALIPER R=0.61, visual R=0.48); and CPI (CALIPER R=0·70, visual R=0·55). The CT variable that correlated most strongly with restrictive functional indices was CALIPER pulmonary vessel volume (PVV): FVC R=0.75, DLCO R=0.68 and CPI R=0.76. Ground-glass opacity quantified by CALIPER alone demonstrated strong associations with restrictive functional indices: CALIPER FVC R=0.65; DLCO R=0.59; CPI R=0.64; and visual=not significant. Decreased attenuation lung quantified by CALIPER was a better morphological measure of obstructive lung disease than equivalent visual scores as judged by relationships with TLC (CALIPER R=0.63 and visual R=0.12). All results were maintained on multivariate analysis. Conclusion: CALIPER improved on visual scoring in HP as judged by restrictive and obstructive functional correlations. Decreased attenuation regions of the lung quantified by CALIPER demonstrated better linkages to obstructive lung physiology than visually quantified CT scores. A novel CALIPER variable, the PVV, demonstrated the strongest linkages with restrictive functional indices and could represent a new automated index of disease severity in HP.

KW - Air trapping

KW - Hypersensitivity pneumonitis

KW - Pulmonary vessel volume

KW - Quantitative computer analysis

KW - Visual computed tomography analysis

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