Abstract

Background: Our study assesses the diagnostic value of different features extracted from high resolution computed tomography (HRCT) images of patients with idiopathic pulmonary fibrosis. These features are investigated over a range of HRCT lung volume measurements (in Hounsfield Units) for which no prior study has yet been published. In particular, we provide a comparison of their diagnostic value at different Hounsfield Unit (HU) thresholds, including corresponding pulmonary functional tests. Methods: We consider thirty-two patients retrospectively for whom both HRCT examinations and spirometry tests were available. First, we analyse the HRCT histogram to extract quantitative lung fibrosis features. Next, we evaluate the relationship between pulmonary function and the HRCT features at selected HU thresholds, namely −200 HU, 0 HU, and +200 HU. We model the relationship using a Poisson approximation to identify the measure with the highest log-likelihood. Results: Our Poisson models reveal no difference at the −200 and 0 HU thresholds. However, inferential conclusions change at the +200 HU threshold. Among the HRCT features considered, the percentage of normally attenuated lung at −200 HU shows the most significant diagnostic utility. Conclusions: The percentage of normally attenuated lung can be used together with qualitative HRCT assessment and pulmonary function tests to enhance the idiopathic pulmonary fibrosis (IPF) diagnostic process.

Highlights

  • Idiopathic pulmonary fibrosis (IPF) is a chronic disease characterized by an irreversible decline in lung function [1,2,3]

  • Histograms of distribution, pulmonary function tests, and some high resolution computed tomography (HRCT) parameters are reported for each subject considering Hounsfield Unit (HU) < 200

  • Using the GAP index as the response variable and the HRCT measures at the three different thresholds as explanatory variables, we discovered that the best diagnostic performance is achieved for the −200 HU threshold, with the most significant variables being Kurtosis and NL (p = 0.049 and p = 0.009, respectively)

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Summary

Introduction

Idiopathic pulmonary fibrosis (IPF) is a chronic disease characterized by an irreversible decline in lung function [1,2,3]. IPF produces rather distinctive features in high resolution computed tomography imaging (HRCT). Our study assesses the diagnostic value of different features extracted from high resolution computed tomography (HRCT) images of patients with idiopathic pulmonary fibrosis. These features are investigated over a range of HRCT lung volume measurements We provide a comparison of their diagnostic value at different Hounsfield Unit (HU) thresholds, including corresponding pulmonary functional tests. We evaluate the relationship between pulmonary function and the HRCT features at selected HU thresholds, namely −200 HU, 0 HU, and +200 HU

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