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Quantitative CT-derived vessel metrics in idiopathic pulmonary fibrosis: A structure function study

Jacob, J; Pienn, M; Payer, C; Urschler, M; Kokosi, M; Devaraj, A; Wells, AW; (2019) Quantitative CT-derived vessel metrics in idiopathic pulmonary fibrosis: A structure function study. Journal of Respirology , 24 (5) , Article 13485. 10.1111/resp.13485. Green open access

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Abstract

BACKGROUND AND OBJECTIVE: To investigate whether quantitative lung vessel morphology determined by a new fully-automated algorithm is associated with functional indices in idiopathic pulmonary fibrosis (IPF). METHODS: 152 IPF patients had vessel volume, density, tortuosity and heterogeneity quantified from CT images by a fully-automated algorithm. Separate quantitation of vessel metrics in pulmonary arteries and veins was performed in 106 patients. Results were evaluated against readouts from lung function tests. RESULTS: Normalized vessel volume expressed as a percentage of total lung volume was moderately correlated with functional indices on univariable linear regression analysis: forced vital capacity (R2=0.27, p<1x10-6); diffusion capacity of carbon monoxide (DLco; R2=0.12, p=3x10-5); total lung capacity (TLC; R2=0.45, p<1x10-6); composite physiologic index (CPI; R2=0.28, p<1x10-6). Normalized vessel volume was correlated with vessel density but not with vessel heterogeneity. Quantitatively-derived vessel metrics (and artery and vein subdivision scores) were not significantly linked with the transfer factor for carbon monoxide (Kco), and only weakly with DLco. On multivariable linear regression analysis, normalized vessel volume and vessel heterogeneity were independently linked with DLco, TLC and CPI indicating that they capture different aspects of lung damage. Artery-vein separation provided no additional information beyond that captured in the whole vasculature. CONCLUSION: Our study confirms previous observations of links between vessel volume and functional measures of disease severity in IPF using a new vessel-quantitation tool. Additionally, the new tool shows independent linkages of normalized vessel volume and vessel heterogeneity with functional indices. Quantitative vessel metrics do not appear to reflect vasculopathic damage in IPF.

Type: Article
Title: Quantitative CT-derived vessel metrics in idiopathic pulmonary fibrosis: A structure function study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/resp.13485
Publisher version: https://doi.org/10.1111/resp.13485
Language: English
Additional information: © 2019 The Authors Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: interstitial lung disease, lungfibrosis, radiology and other imaging, respiratory structure and function
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10065832
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