Computer-assisted staging of chronic rhinosinusitis correlates with symptoms

Area of Science:

• Medical imaging analysis
• Rhinology
• Chronic rhinosinusitis (CRS) research

Background:

• The current Lund-Mackay (LM) staging system for CRS has limitations in correlating with clinical parameters due to its coarse scale.
• A novel "Modified Lund Mackay" (MLM) system was developed using a 3D computerized method to quantify sinonasal mucosal inflammation volume.

Purpose of the Study:

• To determine if the MLM system correlates with patient symptoms and disease-specific quality of life.
• To compare the MLM system with the traditional LM staging system.

Main Methods:

• Collected Total Nasal Symptom Score (TNSS) and 22-item Sino-Nasal Outcome Test (SNOT-22) data from 55 adult subjects.
• Quantified sinonasal mucosal inflammation volume using MATLAB algorithms and custom image analysis software.
• Employed linear regression and Spearman's rank correlation to analyze relationships between scoring systems and clinical data.

Main Results:

• A higher symptom burden was significantly associated with increased sinonasal inflammation measured by the MLM (β = 0.453, p < 0.013), after adjusting for covariates.
• Significant differences were observed between the LM and MLM scores (p < 0.011), reflecting distinct scales.
• No significant association was found between the MLM and SNOT-22 scores.

Conclusions:

• The MLM system represents an advancement as an imaging-based scoring system that correlates with sinonasal symptoms.
• Further development, including automation and validation in larger cohorts, could establish the MLM as a valuable biomarker for CRS treatment and clinical trials.