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Automatic Quantification of Interstitial Lung Disease From Chest Computed Tomography in Systemic Sclerosis

2020-09-25Journal article Open access
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dc.contributor.authorCarvalho, Alysson Roncally S.
dc.contributor.authorGuimarães, Alan R.
dc.contributor.authorSztajnbok, Flávio R.
dc.contributor.authorRodrigues, Rosana Souza
dc.contributor.authorSilva, Bruno Rangel Antunes
dc.contributor.authorLopes, Agnaldo José
dc.contributor.authorZin, Walter Araujo
dc.contributor.authorAlmeida, Isabel
dc.contributor.authorFrança, Manuela
dc.date.accessioned2021-11-23T15:21:31Z
dc.date.available2021-11-23T15:21:31Z
dc.date.issued2020-09-25
dc.description.abstractBackground: Interstitial lung disease (ILD) is a common complication in patients with systemic sclerosis (SSc), and its diagnosis contributes to early treatment decisions. Purposes: To quantify ILD associated with SSc (SSc-ILD) from chest CT images using an automatic quantification method based on the computation of the weight of interstitial lung opacities. Methods: Ninety-four patients with SSc underwent CT, forced vital capacity (FVC), and carbon monoxide diffusion capacity (DLCO) tests. Seventy-three healthy individuals without radiological evidence of lung disease served as controls. After lung and airway segmentation, the ratio between the weight of interstitial opacities [densities between -500 and +50 Hounsfield units (HU)] and the total lung weight (densities between -1,000 and +50 HU) was used as an ILD indicator (ILD[%] = 100 × [LW(-500 to +50HU)/LW(-1, 000 to +50HU)]). The cutoff of normality between controls and SSc was determined with a receiver operator characteristic curve. The severity of pulmonary involvement in SSc patients was also assessed by calculating Z scores of ILD relative to the average interstitial opacities in controls. Accordingly, SSc-ILD was classified as SSc Limited-ILD (Z score < 3) and SSc Extensive-ILD (Z score ≥ 3 or FVC < 70%). Results: Seventy-eight (83%) SSc patients were classified as presenting SSc-ILD (optimal ILD threshold of 23.4%, 0.83 sensitivity, 0.92 specificity, and 0.94 area under the receiver operator characteristic curve, 95% CI from 0.89 to 0.96, 0.93 positive predictive value, and 0.81 negative predictive value, p < 0.001) and exhibited radiological attenuations compatible with interstitial pneumonia dispersed in the lung parenchyma. Thirty-six (38%) patients were classified as SSc Extensive-ILD (ILD threshold ≥ 29.6% equivalent to a Z score ≥ 3) and 42 (45%) as SSc Limited-ILD. Eighteen (50%) patients with SSc Extensive-ILD presented FVC < 70%, being only five patients classified exclusively based on FVC. SSc Extensive-ILD also presented lower DLCO (57.9 ± 17.9% vs. 73.7 ± 19.8%; p < 0.001) and total lung volume (2,916 ± 674 vs. 4,286 ± 1,136, p < 0.001) compared with SSc Limited-ILD. Conclusion: The proposed method seems to provide an alternative to identify and quantify the extension of ILD in patients with SSc, mitigating the subjectivity of semiquantitative analyzes based on visual scores.pt_PT
dc.description.sponsorshipThis research was supported by the Brazilian Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico-CNPq) and the Rio de Janeiro State Research Supporting Foundation (Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro-FAPERJ)pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCarvalho ARS, Guimarães AR, Sztajnbok FR, et al. Automatic Quantification of Interstitial Lung Disease From Chest Computed Tomography in Systemic Sclerosis. Front Med (Lausanne). 2020;7:577739. doi:10.3389/fmed.2020.577739pt_PT
dc.identifier.doi10.3389/fmed.2020.577739pt_PT
dc.identifier.issn2296-858X
dc.identifier.urihttp://hdl.handle.net/10400.16/2629
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontiers Mediapt_PT
dc.relation.publisherversionhttps://www.frontiersin.org/articles/10.3389/fmed.2020.577739/fullpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectchest computed tomographypt_PT
dc.subjectdensitometrypt_PT
dc.subjectinterstitial lung diseasept_PT
dc.subjectquantitative chest CT-analysispt_PT
dc.subjectsystemic sclerosispt_PT
dc.titleAutomatic Quantification of Interstitial Lung Disease From Chest Computed Tomography in Systemic Sclerosispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceSwitzerlandpt_PT
oaire.citation.startPage577739pt_PT
oaire.citation.titleFrontiers in Medicinept_PT
oaire.citation.volume7pt_PT
person.familyNameFrança
person.givenNameManuela
person.identifier.ciencia-idEA1B-D7C4-C8CE
person.identifier.orcid0000-0003-1068-8577
person.identifier.scopus-author-id24466466300
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationd731cc71-98f2-45c3-82f4-030b27c145b6
relation.isAuthorOfPublication.latestForDiscoveryd731cc71-98f2-45c3-82f4-030b27c145b6

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