Role of visual assessment of chronic obstructive pulmonary disease on chest CT: beauty is in the eye of the beholder.
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ABSTRACT:
SUBMITTER: Pompe E
PROVIDER: S-EPMC8743402 | biostudies-literature | 2021 Dec
REPOSITORIES: biostudies-literature
Publications
Role of visual assessment of chronic obstructive pulmonary disease on chest CT: beauty is in the eye of the beholder.
Pompe Esther E Mohamed Hoesein Firdaus A A FAA
Journal of thoracic disease 20211201 12
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Project description:Objectives:Diagnostic guidelines for chronic obstructive pulmonary disease (COPD) are based on spirometry and clinical criteria. However, this does not address the pathophysiological complexity of the disease sufficiently. Until now, inspiratory chest computed tomography (CT) has been considered as the preferred imaging method in these patients. We hypothesized that expiratory CT may be superior to demonstrate pathophysiological changes. The aim of this prospective study was to systematically compare lung function tests with quantified CT parameters in inspiration and expiration. Materials and Methods:Forty-six patients with diagnosed COPD underwent spirometry, body plethysmography, and dose-optimized CT in maximal inspiration and expiration. Four quantified CT parameters were acquired in inspiration, expiration, and their calculated delta values. These parameters were correlated with seven established lung function parameters. Results:For inspiratory scans, a weak-to-moderate correlation with the lung function parameters was found. These correlations significantly improved when adding the expiratory scan (p < 0.05). Moreover, some parameters showed a significant correlation only in expiratory datasets. Calculated delta values showed even stronger correlation with lung function testing. Conclusions:Expiratory quantified CT and calculated delta values significantly improve the correlation with lung function parameters. Thus, an additional expiratory CT may improve image-based phenotyping of patients with COPD.
| S-EPMC5857310 | biostudies-literature
Project description:RationaleAutomated analysis of computed tomographic (CT) lung images for epidemiologic and genetic association studies is increasingly common, but little is known about the utility of visual versus semiautomated emphysema and airway assessments for genetic association studies.ObjectivesAssess the relative utility of visual versus semiautomated emphysema and airway assessments for genetic association studies.MethodsA standardized inspection protocol was used to visually assess chest CT images for 1,540 non-Hispanic white subjects within the COPDGene Study for the presence and severity of radiographic features representing airway wall thickness and emphysema. A genome-wide association study (GWAS) was performed, and two sets of candidate single-nucleotide polymorphisms with a higher prior likelihood of association were specified a priori for separate analysis. For each visual CT examination feature, a corresponding semiautomated CT feature(s) was identified for comparison in the same subjects.Measurements and main resultsGWAS for visual features of chest CT scans identified a genome-wide significant association with visual emphysema at the 15q25 locus (P = 6.3e-9). In the a priori-specified set of 19 previously identified GWAS loci, 7 and 8 loci were associated with airway measures or emphysema measures, respectively. In the a priori-specified candidate gene set, 13 of 196 candidate genes harbored a nearby single-nucleotide polymorphism significantly associated with an emphysema phenotype. Visual CT examination associations were robust to adjustment for semiautomated correlates in many cases.ConclusionsStandardized visual assessments of emphysema and airway disease are significantly associated with genetic loci previously associated with chronic obstructive pulmonary disease susceptibility or semiautomated CT examination phenotypes in GWAS. Visual CT measures of emphysema and airways disease offer independent information for genetic association studies in relation to standard semiautomated measures.
| S-EPMC5291477 | biostudies-literature
Project description:PurposeTo provide a new detailed visual assessment scheme of computed tomography (CT) for chronic obstructive pulmonary disease (COPD) by using standard reference images and to compare this visual assessment method with quantitative CT and several physiologic parameters.Materials and methodsThis research was approved by the institutional review board of each institution. CT images of 200 participants in the COPDGene study were evaluated. Four thoracic radiologists performed independent, lobar analysis of volumetric CT images for type (centrilobular, panlobular, and mixed) and extent (on a six-point scale) of emphysema, the presence of bronchiectasis, airway wall thickening, and tracheal abnormalities. Standard images for each finding, generated by two radiologists, were used for reference. The extent of emphysema, airway wall thickening, and luminal area were quantified at the lobar level by using commercial software. Spearman rank test and simple and multiple regression analyses were performed to compare the results of visual assessment with physiologic and quantitative parameters.ResultsThe type of emphysema, determined by four readers, showed good agreement (κ = 0.63). The extent of the emphysema in each lobe showed good agreement (mean weighted κ = 0.70) and correlated with findings at quantitative CT (r = 0.75), forced expiratory volume in 1 second (FEV(1)) (r = -0.68), FEV(1)/forced vital capacity (FVC) ratio (r = -0.74) (P < .001). Agreement for airway wall thickening was fair (mean κ = 0.41), and the number of lobes with thickened bronchial walls correlated with FEV(1) (r = -0.60) and FEV(1)/FVC ratio (r = -0.60) (P < .001).ConclusionVisual assessment of emphysema and airways disease in individuals with COPD can provide reproducible, physiologically substantial information that may complement that provided by quantitative CT assessment.
| S-EPMC3558873 | biostudies-literature
Project description:ObjectiveTo assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD.Materials and methodsTwenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test.ResultsMost patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups.ConclusionThe ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.
| S-EPMC7371623 | biostudies-literature
Project description:Chronic obstructive pulmonary disease (COPD) is a major health problem which had not received the attention commensurate with the magnitude of its global burden. This is finally changing with the help of a vibrant community of health-care professionals, public officials, and academic researchers. Advances in characterization of the disease, treatment options, imaging modalities, and better understanding of the comorbidities promise to revolutionize how the disease is managed. COPD should no longer augur despair among physicians and patients.
| S-EPMC5772102 | biostudies-literature
Project description:BackgroundChronic obstructive pulmonary disease (COPD) has variable subtypes involving mixture of large airway inflammation, small airway disease, and emphysema. This study evaluated the relationship between visually assessed computed tomography (CT) subtypes and clinical/imaging characteristics.MethodsIn total, 452 participants were enrolled in this study between 2012 and 2017. Seven subtypes were defined by visual evaluation of CT images using Fleischner Society classification: normal, paraseptal emphysema (PSE), bronchial disease, and centrilobular emphysema (trace, mild, moderate and confluent/advanced destructive). The differences in several variables, including clinical, laboratory, spirometric, and quantitative CT features among CT-based visual subtypes, were compared using the chi-square tests and one-way analysis of variance.ResultsSubjects who had PSE had better forced expiratory volume in 1 second (FEV1) (P=0.03) percentage and higher lung density (P<0.05) than those with moderate to confluent/advanced destructive centrilobular emphysema. As the visual grade of centrilobular emphysema worsened, pulmonary function declined and modified Medical Research Council, COPD assessment test (CAT) score, and quantitative assessment (emphysema index and air trapping) increased. The bronchial subtype was associated with higher body mass index (BMI), better lung function and higher lung density. Participants with trace emphysema showed a rapid increase in functional small airway disease.ConclusionsClassifying subtypes using visual CT imaging features can reflect heterogeneity and pathological processes of COPD.
| S-EPMC8024830 | biostudies-literature
Project description:Diaphragm muscles in Chronic Obstructive Pulmonary Disease (COPD) patients undergo an adaptive fast to slow transformation that includes cellular adaptations. This project studies the signaling mechanisms responsible for this transformation. Keywords: other
2003-07-16 | GSE475 | GEO
Project description:BackgroundChronic obstructive pulmonary disease (COPD) is a well-known risk factor for postoperative pulmonary complications (PPCs), necessitating careful preoperative evaluation in patients undergoing lung resection surgery. The risk of PPCs in patients with COPD may vary with severity of symptoms, and the COPD Assessment Test (CAT) score is commonly used to assess patient quality of life and predict acute exacerbations. However, few studies have explored the correlation between CAT score and PPC incidence in COPD. This study aimed to assess the predictive value of CAT scores for PPCs and compare them with other established PPC predictors in mild to moderate COPD.MethodsWe retrospectively reviewed 83 patients with COPD who underwent preoperative evaluation before lung cancer surgery, including cardiopulmonary exercise tests (CPETs), between January 2020 and June 2022. We compared the predictive value of the following factors for the incidence of PPCs: spirometry, CPETs, 6-min walk tests, symptom-based scores (including CAT scores), the COPD composite severity index, surgery type, comorbidity index, and PPC prediction models.ResultsAmong the 83 patients, 16 (19.2%) developed PPCs, with persistent air leakage being the most common complication. CAT scores significantly differed between PPC and non-PPC groups (mean value 9.4 vs. 6.7, P=0.002). In multivariable logistic regression analysis, a CAT score of ≥7 was an independent risk factor for the incidence of PPCs (odds ratio =9.88; 95% confidence interval: 1.95-50.04; P=0.005), whereas other factors demonstrated no significant predictive value.ConclusionsCAT scores are valuable for evaluating patients with mild to moderate COPD before lung resection surgery, reliably predicting PPCs.
| S-EPMC11565318 | biostudies-literature
Project description:Assessment of patients with chronic obstructive pulmonary disease (COPD) is important to establish an accurate diagnosis, assist in making therapeutic decisions, measuring outcomes for clinical and research purposes, and determining prognosis. Chest computed tomography (CT) scans are useful in patients who present with airflow limitation and clinical features suggestive of COPD but in whom other diagnoses are being considered. In such cases, a chest CT may indicate another diagnosis. The amount and distribution of emphysema can identify outcomes from lung volume reduction surgery, and chest CT scans are mandatory in assessment of patients for this surgery. Quantitative parameters from chest CT scans have been used to define longitudinal progression of disease. Assessment of patients with COPD for both clinical and research purposes should incorporate a variety of different outcomes. There are outcome measures that have been successfully incorporated in large clinical trials, and the design and outcomes of these trials can be used to plan future clinical investigations in COPD.
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Project description:Sexual ornaments are often assumed to be indicators of mate quality. Yet it remains poorly known how certain ornaments are chosen before any coevolutionary race makes them indicative. Perceptual biases have been proposed to play this role, but known biases are mostly restricted to a specific taxon, which precludes evaluating their general importance in sexual selection. Here we identify a potentially universal perceptual bias in mate choice. We used an algorithm that models the sparseness of the activity of simple cells in the primary visual cortex (or V1) of humans when coding images of female faces. Sparseness was found positively correlated with attractiveness as rated by men and explained up to 17% of variance in attractiveness. Because V1 is adapted to process signals from natural scenes, in general, not faces specifically, our results indicate that attractiveness for female faces is influenced by a visual bias. Sparseness and more generally efficient neural coding are ubiquitous, occurring in various animals and sensory modalities, suggesting that the influence of efficient coding on mate choice can be widespread in animals.
| S-EPMC4821279 | biostudies-other