Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome
(1) Background: The presentation of chronic pulmonary aspergillosis (CPA) ranges from single granuloma to fibrosis in the affected lung. CPA can be divided into five categories according to European Respirology Society (ERS) guidance but is usually assessed by clinical physicians. Computer-based qua...
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| Format: | Article |
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MDPI AG
2021-10-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/7/10/842 |
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| author | Shiang-Fen Huang Chia-Chang Huang Kun-Ta Chou Yu-Jiun Chan Ying-Ying Yang Fu-Der Wang |
| author_facet | Shiang-Fen Huang Chia-Chang Huang Kun-Ta Chou Yu-Jiun Chan Ying-Ying Yang Fu-Der Wang |
| author_sort | Shiang-Fen Huang |
| collection | DOAJ |
| description | (1) Background: The presentation of chronic pulmonary aspergillosis (CPA) ranges from single granuloma to fibrosis in the affected lung. CPA can be divided into five categories according to European Respirology Society (ERS) guidance but is usually assessed by clinical physicians. Computer-based quantitative lung parenchyma analysis in CPA and its correlation with clinical manifestations, systemic inflammation, and angiogenesis have never been investigated. (2) Method: Forty-nine patients with CPA and 36 controls were prospectively enrolled. Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in one second (FEV<sub>1</sub>), and FEV<sub>1</sub>/FCV) and biomarkers in the peripheral blood (the chemokines interleukin (IL)-1B, IL-6, IL-10, IL-8, CRP, ESR, MMP1, MMP7, MMP8, TNF-α, calprotectin, SDF-1α, and VEGFA) were measured before antifungal treatment. The disease severity was categorized into mild, moderate, and severe based on chest computed tomography (CT) images. The oxygen demand and overall mortality until the end of the study were recorded. Quantitative parenchyma analysis was performed using the free software 3Dslicer. (3) Results: The results of quantitative parenchyma analysis concorded with the visual severity from the chest CT, oxygen demand, FVC, and FEV<sub>1</sub> in the study subjects. The decrease in kurtosis and skewness of the lung density histograms on CT, increase in high attenuation area (HAA), and reduced lung volume were significantly correlated with increases in the PMN %, CRP, IL-1B, SDF-1α, MMP1, and Calprotectin in peripheral blood in the multivariable regression analysis. TNF-α and IL-1B at study entry and the CPA severity from either a visual method or computer-based evaluation were predictors of long-term mortality. (4) Conclusion: The computer-based parenchyma analysis in CPA agreed with the categorization on a visual basis and was associated with the clinical outcomes, chemokines, and systemic proinflammation profiles. |
| first_indexed | 2024-03-10T06:27:41Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T06:27:41Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
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| spelling | doaj.art-31d4683c82fd4c5bad1791c0a84ca9732023-11-22T18:47:21ZengMDPI AGJournal of Fungi2309-608X2021-10-0171084210.3390/jof7100842Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical OutcomeShiang-Fen Huang0Chia-Chang Huang1Kun-Ta Chou2Yu-Jiun Chan3Ying-Ying Yang4Fu-Der Wang5Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, TaiwanDivision of Endocrinology and Metabolism, Department of Medicine, Veterans General Hospital, Taipei 112201, TaiwanSchool of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, TaiwanDivision of Microbiology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei 112201, TaiwanDivision of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei 112201, TaiwanDivision of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan(1) Background: The presentation of chronic pulmonary aspergillosis (CPA) ranges from single granuloma to fibrosis in the affected lung. CPA can be divided into five categories according to European Respirology Society (ERS) guidance but is usually assessed by clinical physicians. Computer-based quantitative lung parenchyma analysis in CPA and its correlation with clinical manifestations, systemic inflammation, and angiogenesis have never been investigated. (2) Method: Forty-nine patients with CPA and 36 controls were prospectively enrolled. Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in one second (FEV<sub>1</sub>), and FEV<sub>1</sub>/FCV) and biomarkers in the peripheral blood (the chemokines interleukin (IL)-1B, IL-6, IL-10, IL-8, CRP, ESR, MMP1, MMP7, MMP8, TNF-α, calprotectin, SDF-1α, and VEGFA) were measured before antifungal treatment. The disease severity was categorized into mild, moderate, and severe based on chest computed tomography (CT) images. The oxygen demand and overall mortality until the end of the study were recorded. Quantitative parenchyma analysis was performed using the free software 3Dslicer. (3) Results: The results of quantitative parenchyma analysis concorded with the visual severity from the chest CT, oxygen demand, FVC, and FEV<sub>1</sub> in the study subjects. The decrease in kurtosis and skewness of the lung density histograms on CT, increase in high attenuation area (HAA), and reduced lung volume were significantly correlated with increases in the PMN %, CRP, IL-1B, SDF-1α, MMP1, and Calprotectin in peripheral blood in the multivariable regression analysis. TNF-α and IL-1B at study entry and the CPA severity from either a visual method or computer-based evaluation were predictors of long-term mortality. (4) Conclusion: The computer-based parenchyma analysis in CPA agreed with the categorization on a visual basis and was associated with the clinical outcomes, chemokines, and systemic proinflammation profiles.https://www.mdpi.com/2309-608X/7/10/842chronic pulmonary aspergillosisinflammationparenchyma analysis |
| spellingShingle | Shiang-Fen Huang Chia-Chang Huang Kun-Ta Chou Yu-Jiun Chan Ying-Ying Yang Fu-Der Wang Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome Journal of Fungi chronic pulmonary aspergillosis inflammation parenchyma analysis |
| title | Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome |
| title_full | Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome |
| title_fullStr | Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome |
| title_full_unstemmed | Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome |
| title_short | Chronic Pulmonary Aspergillosis: Disease Severity Using Image Analysis and Correlation with Systemic Proinflammation and Predictors of Clinical Outcome |
| title_sort | chronic pulmonary aspergillosis disease severity using image analysis and correlation with systemic proinflammation and predictors of clinical outcome |
| topic | chronic pulmonary aspergillosis inflammation parenchyma analysis |
| url | https://www.mdpi.com/2309-608X/7/10/842 |
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