在CT中使用同时体积,噪声和偏差肺密度校正来量化肺的进展
Gonzalo Vegas Sánchez-Ferrero1, Alejandro A Díaz1, Samuel Y Ash1
1From the Applied Chest Imaging Laboratory, Department of Radiology (G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and Channing Division of Network Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.), National Jewish Health, Denver, Colo.
一种新的CT扫描分析方法通过纠正肺体积,噪声和扫描器差异来准确测量肺气的进展. 这种改进的方法可靠地识别疾病的进展,并将其与肺功能下降联系起来.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
- 医学成像分析 医学成像分析
背景情况:
- 计算机断层扫描 (CT) 衰减受肺体积,辐射剂量和扫描器变化的影响,从而损害了多中心研究中肺瘤进展的准确评估.
- 由于这些混因素,测量肺密度变化在肺气进展中的现有方法缺乏稳定性.
研究的目的:
- 开发和验证一种基于CT的肺瘤进展分析的新方法,同时纠正肺体积,噪声和间扫描器偏差.
- 提高纵向多中心肺研究中肺密度变化估计的准确性和可靠性.
主要方法:
- 对COPDGene研究队列 (n=4954) 进行了二次分析,将体积调整的肺密度 (VALD) 与新的联合体积-噪声偏差调整的肺密度 (VNB-ALD) 方法进行了比较.
- 在不同的辐射剂量和扫描仪模型下评估了可重复性. 视觉评分的肺气进展被用于验证.
- 基于这两种方法,分层临床分析检查了进展者和非进展者之间的差异.
主要成果:
- 与VALD (30 g/L ± 0.46) 相比,VNB-ALD方法显示出更好的重复性 (14 g/L ± 0.34).
- 与VALD不同的是,VNB-ALD与视觉肺瘤进展得分表现出强烈一致.
- 与非进展者相比,VNB-ALD确定了在1秒内强制呼气体积 (FEV1) 显著下降的进展者.
结论:
- 在CT肺密度分析中同时对体积,噪声和间扫描器偏差进行校正,可提高肺瘤进展评估的重复性和准确性.
- VNB-ALD方法有效地区分肺瘤进展者和非进展者,并与临床显著的肺功能下降相关联.
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