深度学习评估肺气和纤维化间歇性肺异常的进展
Samuel Y Ash1,2, Bina Choi2,3, Andrea Oh4
1Department of Critical Care, South Shore Hospital, South Weymouth, Massachusetts.
在没有肺部疾病的吸烟者中,即使是肺纤维化中的小变化也是显著的. 肺气和纤维化综合进展会增加死亡风险.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
- 老年学是一门学科.
背景情况:
- 对联合肺气和纤维化间歇性肺异常进展的理解有限.
- 需要在没有间歇性肺病的吸烟者中确定纤维化间歇性肺异常的临床意义上的进展.
- 研究结合性纤维化和肺气进展对死亡率的影响.
研究的目的:
- 在没有间歇性肺病的吸烟者中定义纤维化间歇性肺异常的临床意义上的进展.
- 评估肺气和纤维化进展对死亡率的影响.
主要方法:
- 利用深度学习算法来评估COPDGene研究中的4,450名吸烟者的CT扫描中的肺气和肺纤维化.
- 定义肺气进展的增加至少为一个等级,并确定纤维化 (0.58%) 的最小临床重要差异.
- 采用多变量共享脆弱模型来分析进展和死亡率之间的关系.
主要成果:
- 63%的患者没有进展,19%的患者仅有肺瘤进展,12%的患者仅有纤维化进展,6.2%的患者有两种情况.
- 肺瘤进展本身就增加了死亡风险 (HR 1.42).
- 纤维化进展单独增加了死亡风险 (HR 1.49),而联合进展显著增加了死亡风险 (HR 2.18).
结论:
- 肺纤维化中的小变化在没有已知的间歇性肺病的吸烟者中可能具有临床意义.
- 肺气和纤维化的联合进展与死亡率的增加密切相关.
- 强调在风险人群中监测这两种情况的重要性.
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