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Published in: European Radiology 12/2018

01-12-2018 | Chest

An automated computed tomography score for the cystic fibrosis lung

Authors: Guillaume Chassagnon, Clémence Martin, Pierre-Régis Burgel, Dominique Hubert, Isabelle Fajac, Nikos Paragios, Evangelia I. Zacharaki, Paul Legmann, Joel Coste, Marie-Pierre Revel

Published in: European Radiology | Issue 12/2018

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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
Appendix
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Metadata
Title
An automated computed tomography score for the cystic fibrosis lung
Authors
Guillaume Chassagnon
Clémence Martin
Pierre-Régis Burgel
Dominique Hubert
Isabelle Fajac
Nikos Paragios
Evangelia I. Zacharaki
Paul Legmann
Joel Coste
Marie-Pierre Revel
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5516-x

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