Abstract
Background: To date, radiographic sign clusters of multidrug-resistant pulmonary tuberculosis (MDR-TB) patients have not been reported. We conducted a study to investigate the classification and prognosis of sign clusters in pulmonary Computed Tomography (CT) images from patients with MDR-TB for the first time by using principal component analysis (PCA).Methods: The clinical data and pulmonary CT findings of 108 patients with MDR-TB in the Liupanshui Third Hospital were collected (from January 2018 to December 2020). PCA was used to analyze the sign clusters on pulmonary CT, and receiver operating characteristic (ROC) analysis was used to analyze the predictive value of the treatment outcome of MDR-TB patients.Results: Six cluster signs of MDR-TB were determined by PCA: nodules, infiltration, consolidation, cavities, destroyed lung and non-active lesions. Nine months after treatment, the area under the ROC curve (AUC) of MDR-TB patients with a cavity sign cluster was 0.818 (95% CI: 0.733–0.886), and the positive predictive value (PPV) and negative predictive value (NPV) of the treatment outcome were 79.6% (95% CI: 65.7–89.8%) and 72.9% (95% CI: 59.7–83.6%), respectively.Conclusion: PCA plays an important role in the classification of sign groups on pulmonary CT images of MDR-TB patients, and the sign clusters obtained from PCA are of great significance in predicting the treatment outcome.
Highlights
Due to its high incidence rate, high recurrence rate, high mortality rate, long course of treatment and high cost, multidrug-resistant pulmonary tuberculosis (MDR-TB, defined as TB strains resistant to at least isoniazid and rifampin) is still one of the main public health problems in tuberculosis prevention and control (Pontali et al, 2019; Harding, 2020; Migliori et al, 2020; Singh et al, 2020)
The Ethics Committee of Liupanshui Third Hospital approved the study, and individual consent for this retrospective analysis was waived because only imaging findings and demographic data were retrieved from the picture archiving and communication system (PACS) server and medical records
The results showed that the incidence and score of pure consolidation in drug-sensitive TB (DS-TB) patients were higher than those in the MDR-TB group (P < 0.05); in contrast, the incidence and score of fibrous lesions and bronchiectasis in the MDR-TB group were higher (P < 0.05)
Summary
Due to its high incidence rate, high recurrence rate, high mortality rate, long course of treatment and high cost, multidrug-resistant pulmonary tuberculosis (MDR-TB, defined as TB strains resistant to at least isoniazid and rifampin) is still one of the main public health problems in tuberculosis prevention and control (Pontali et al, 2019; Harding, 2020; Migliori et al, 2020; Singh et al, 2020). Imaging is of great reference value for the early diagnosis and evaluation of the treatment outcome of MDR-TB patients. There are many studies describing the signs of CT imaging in patients with MDR-TB (Zahirifard et al, 2003; Song et al, 2016; Wang et al, 2018; Mehrian et al, 2020). During clinical practice, there is nearly no possibility that only a single sign exists in a CT image of patients with MDR-TB. Radiographic sign clusters of multidrug-resistant pulmonary tuberculosis (MDR-TB) patients have not been reported. We conducted a study to investigate the classification and prognosis of sign clusters in pulmonary Computed Tomography (CT) images from patients with MDR-TB for the first time by using principal component analysis (PCA)
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