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Quantitative assessment of change in regional disease patterns on serial HRCT of fibrotic interstitial pneumonia with texture-based automated quantification system

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Abstract

Objectives

To evaluate the usefulness of a texture-based automated quantification system (AQS) for evaluating the extent and interval change of regional disease patterns on initial and follow-up high-resolution computed tomographies (HRCTs) of fibrotic interstitial pneumonia (FIP).

Methods

Eighty-nine patients with clinically and/or biopsy confirmed usual interstitial pneumonia (UIP) (n = 71) and non-specific interstitial pneumonia (NSIP) (n = 18) were included. An AQS to quantify five disease patterns (ground-glass opacity [GGO], reticular opacity [RO], honeycombing [HC], emphysema [EMPH], consolidation [CONS]) and normal lung was developed. The extent and interval changes of each disease pattern, FS (fibrosis score), TA (total abnormal lung fraction) of entire lung on initial and 1-year follow-up HRCTs were quantified. The agreement between the results of AQS and two readers was assessed. Results of AQS were correlated with forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLco).

Results

The Intraclass correlation coefficient (ICC) study revealed acceptable agreement between visual assessment and AQS (r = 0.78, 0.66 for HC; 0.76, 0.61 for FS; 0.64, 0.68 for TA, initial and follow-up HRCTs, respectively). Linear regression analysis revealed the extent of HC, TA on initial CT, interval changes of FS contributed negatively to DLco, and interval changes of FS, TA contributed negatively to FVC.

Conclusions

Our AQS is comparable with visual assessment for evaluating the disease extent and the interval changes of FIP on HRCT.

Key Points

• HRCT is widely used to assess fibrotic interstitial pneumonia

• An automated quantification system matched well with visual assessment of HRCT

• Abnormal lung fraction on HRCT correlated with the decrease in diffusion capacity

• Automated quantification of HRCT images is useful in assessing fibrotic interstitial pneumonia

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Abbreviations

HRCT:

High-resolution computed tomography

DILD:

Diffuse interstitial lung disease

FIP:

Fibrotic interstitial pneumonia

AQS:

Automated quantification system

IPF:

Idiopathic pulmonary fibrosis

NSIP:

Non-specific interstitial pneumonia

UIP:

Usual interstitial pneumonia

PFT:

Pulmonary function test

GGO:

Ground-glass opacity

RO:

Reticular opacity

HC:

Honeycombing

EMPH:

Emphysema

CONS:

Consolidation

NL:

Normal lung

FS:

Fibrosis score

TA:

Total abnormal lung fraction

FVC:

Forced vital capacity

DLco:

Carbon monoxide diffusing capacity

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, South Korea

    Ra Gyoung Yoon, Joon Beom Seo, Namkug Kim, Hyun Joo Lee, Sang Min Lee & Jae Woo Song

  2. Department of Radiology, East-West Neo Medical Center, Kyung Hee University, 149, Sangil-dong, Gangdong-gu, Seoul, 134-727, South Korea

    Young Kyung Lee

  3. Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-Gil, Seoul, 138-736, South Korea

    Jin Woo Song & Dong Soon Kim

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  1. Ra Gyoung Yoon
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Correspondence to Joon Beom Seo.

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Yoon, R.G., Seo, J.B., Kim, N. et al. Quantitative assessment of change in regional disease patterns on serial HRCT of fibrotic interstitial pneumonia with texture-based automated quantification system. Eur Radiol 23, 692–701 (2013). https://doi.org/10.1007/s00330-012-2634-8

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  • DOI: https://doi.org/10.1007/s00330-012-2634-8

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