Abstract
ObjectivesTo quantify airway and artery (AA)-dimensions in cystic fibrosis (CF) and control patients for objective CT diagnosis of bronchiectasis and airway wall thickness (AWT).MethodsSpirometer-guided inspiratory and expiratory CTs of 11 CF and 12 control patients were collected retrospectively. Airway pathways were annotated semi-automatically to reconstruct three-dimensional bronchial trees. All visible AA-pairs were measured perpendicular to the airway axis. Inner, outer and AWT (outer−inner) diameter were divided by the adjacent artery diameter to compute AinA-, AoutA- and AWTA-ratios. AA-ratios were predicted using mixed-effects models including disease status, lung volume, gender, height and age as covariates.ResultsDemographics did not differ significantly between cohorts. Mean AA-pairs CF: 299 inspiratory; 82 expiratory. Controls: 131 inspiratory; 58 expiratory. All ratios were significantly larger in inspiratory compared to expiratory CTs for both groups (p<0.001). AoutA- and AWTA-ratios were larger in CF than in controls, independent of lung volume (p<0.01). Difference of AoutA- and AWTA-ratios between patients with CF and controls increased significantly for every following airway generation (p<0.001).ConclusionDiagnosis of bronchiectasis is highly dependent on lung volume and more reliably diagnosed using outer airway diameter. Difference in bronchiectasis and AWT severity between the two cohorts increased with each airway generation.Key points• More peripheral airways are visible in CF patients compared to controls.• Structural lung changes in CF patients are greater with each airway generation.• Number of airways visualized on CT could quantify CF lung disease.• For objective airway disease quantification on CT, lung volume standardization is required.
Highlights
In cystic fibrosis (CF) lung disease is characterized by progressive bronchiectasis (BE) and airway wall thickening (AWT) [1,2,3]
One subject in the CF group was excluded after image analysis since the patient appeared to be mislabeled and diagnosed with common variable immunodeficiency
All but one control patient had spirometry performed on the same day or maximally 1 month apart from the computed tomography (CT) scan
Summary
In cystic fibrosis (CF) lung disease is characterized by progressive bronchiectasis (BE) and airway wall thickening (AWT) [1,2,3]. The inner airway dimensions are mostly used for comparison with the artery [7,8,9]. No clear consensus, based on objective quantitative measures, exists on whether inner or outer airway diameter should be compared with the artery for the diagnosis of BE [10]. The approximate ratio of 1 was based on the outer airway diameter [11]. It is not clear whether identical AA-ratio cutoffs can be used to define BE in children, where a smaller AA-ratio has been suggested [5]. The AA-ratio is thought to increase with age in healthy subjects [12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
