MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease

ObjectivesQuantitative computed tomography (QCT) offers some promising markers to quantify cystic fibrosis (CF)-lung disease. Air trapping may precede irreversible bronchiectasis; therefore, the temporal interdependencies of functional and structural lung disease need to be further investigated. We...

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Main Authors: Oliver Weinheimer, Philip Konietzke, Willi L. Wagner, Dorothea Weber, Beverly Newman, Craig J. Galbán, Hans-Ulrich Kauczor, Marcus A. Mall, Terry E. Robinson, Mark O. Wielpütz
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-02-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2023.1068103/full
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author Oliver Weinheimer
Oliver Weinheimer
Oliver Weinheimer
Philip Konietzke
Philip Konietzke
Philip Konietzke
Willi L. Wagner
Willi L. Wagner
Willi L. Wagner
Dorothea Weber
Dorothea Weber
Beverly Newman
Craig J. Galbán
Hans-Ulrich Kauczor
Hans-Ulrich Kauczor
Hans-Ulrich Kauczor
Marcus A. Mall
Marcus A. Mall
Marcus A. Mall
Terry E. Robinson
Mark O. Wielpütz
Mark O. Wielpütz
Mark O. Wielpütz
author_facet Oliver Weinheimer
Oliver Weinheimer
Oliver Weinheimer
Philip Konietzke
Philip Konietzke
Philip Konietzke
Willi L. Wagner
Willi L. Wagner
Willi L. Wagner
Dorothea Weber
Dorothea Weber
Beverly Newman
Craig J. Galbán
Hans-Ulrich Kauczor
Hans-Ulrich Kauczor
Hans-Ulrich Kauczor
Marcus A. Mall
Marcus A. Mall
Marcus A. Mall
Terry E. Robinson
Mark O. Wielpütz
Mark O. Wielpütz
Mark O. Wielpütz
author_sort Oliver Weinheimer
collection DOAJ
description ObjectivesQuantitative computed tomography (QCT) offers some promising markers to quantify cystic fibrosis (CF)-lung disease. Air trapping may precede irreversible bronchiectasis; therefore, the temporal interdependencies of functional and structural lung disease need to be further investigated. We aim to quantify airway dimensions and air trapping on chest CT of school-age children with mild CF-lung disease over two years.MethodsFully-automatic software analyzed 144 serial spirometer-controlled chest CT scans of 36 children (median 12.1 (10.2–13.8) years) with mild CF-lung disease (median ppFEV1 98.5 (90.8–103.3) %) at baseline, 3, 12 and 24 months. The airway wall percentage (WP5–10), bronchiectasis index (BEI), as well as severe air trapping (A3) were calculated for the total lung and separately for all lobes. Mixed linear models were calculated, considering the lobar distribution of WP5–10, BEI and A3 cross-sectionally and longitudinally.ResultsWP5–10 remained stable (P = 0.248), and BEI changed from 0.41 (0.28–0.7) to 0.54 (0.36–0.88) (P = 0.156) and A3 from 2.26% to 4.35% (P = 0.086) showing variability over two years. ppFEV1 was also stable (P = 0.276). A robust mixed linear model showed a cross-sectional, regional association between WP5–10 and A3 at each timepoint (P < 0.001). Further, BEI showed no cross-sectional, but another mixed model showed short-term longitudinal interdependencies with air trapping (P = 0.003).ConclusionsRobust linear/beta mixed models can still reveal interdependencies in medical data with high variability that remain hidden with simpler statistical methods. We could demonstrate cross-sectional, regional interdependencies between wall thickening and air trapping. Further, we show short-term regional interdependencies between air trapping and an increase in bronchiectasis. The data indicate that regional air trapping may precede the development of bronchiectasis. Quantitative CT may capture subtle disease progression and identify regional and temporal interdependencies of distinct manifestations of CF-lung disease.
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spelling doaj.art-449af3d86b7140669ed3c77f9323ce8f2023-02-02T08:50:30ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-02-011110.3389/fped.2023.10681031068103MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung diseaseOliver Weinheimer0Oliver Weinheimer1Oliver Weinheimer2Philip Konietzke3Philip Konietzke4Philip Konietzke5Willi L. Wagner6Willi L. Wagner7Willi L. Wagner8Dorothea Weber9Dorothea Weber10Beverly Newman11Craig J. Galbán12Hans-Ulrich Kauczor13Hans-Ulrich Kauczor14Hans-Ulrich Kauczor15Marcus A. Mall16Marcus A. Mall17Marcus A. Mall18Terry E. Robinson19Mark O. Wielpütz20Mark O. Wielpütz21Mark O. Wielpütz22Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, GermanyInstitute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, GermanyDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Radiology, University of Michigan, Ann Arbor, United StatesDepartment of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, GermanyDepartment of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, GermanyBerlin Institute of Health @ Charité-Universitätsmedizin Berlin, Berlin, GermanyGerman Center for Lung Research (DZL), Associated Partner Site, Berlin, Germany0Department of Pediatrics, Center of Excellence in Pulmonary Biology, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, GermanyTranslational Lung Research Center (TLRC), German Lung Research Center (DZL), University of Heidelberg, Heidelberg, GermanyDepartment of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, GermanyObjectivesQuantitative computed tomography (QCT) offers some promising markers to quantify cystic fibrosis (CF)-lung disease. Air trapping may precede irreversible bronchiectasis; therefore, the temporal interdependencies of functional and structural lung disease need to be further investigated. We aim to quantify airway dimensions and air trapping on chest CT of school-age children with mild CF-lung disease over two years.MethodsFully-automatic software analyzed 144 serial spirometer-controlled chest CT scans of 36 children (median 12.1 (10.2–13.8) years) with mild CF-lung disease (median ppFEV1 98.5 (90.8–103.3) %) at baseline, 3, 12 and 24 months. The airway wall percentage (WP5–10), bronchiectasis index (BEI), as well as severe air trapping (A3) were calculated for the total lung and separately for all lobes. Mixed linear models were calculated, considering the lobar distribution of WP5–10, BEI and A3 cross-sectionally and longitudinally.ResultsWP5–10 remained stable (P = 0.248), and BEI changed from 0.41 (0.28–0.7) to 0.54 (0.36–0.88) (P = 0.156) and A3 from 2.26% to 4.35% (P = 0.086) showing variability over two years. ppFEV1 was also stable (P = 0.276). A robust mixed linear model showed a cross-sectional, regional association between WP5–10 and A3 at each timepoint (P < 0.001). Further, BEI showed no cross-sectional, but another mixed model showed short-term longitudinal interdependencies with air trapping (P = 0.003).ConclusionsRobust linear/beta mixed models can still reveal interdependencies in medical data with high variability that remain hidden with simpler statistical methods. We could demonstrate cross-sectional, regional interdependencies between wall thickening and air trapping. Further, we show short-term regional interdependencies between air trapping and an increase in bronchiectasis. The data indicate that regional air trapping may precede the development of bronchiectasis. Quantitative CT may capture subtle disease progression and identify regional and temporal interdependencies of distinct manifestations of CF-lung disease.https://www.frontiersin.org/articles/10.3389/fped.2023.1068103/fullQuantitative computer tomographyBronchiectasisAir trappingCystic FibrosisAutomated analysis
spellingShingle Oliver Weinheimer
Oliver Weinheimer
Oliver Weinheimer
Philip Konietzke
Philip Konietzke
Philip Konietzke
Willi L. Wagner
Willi L. Wagner
Willi L. Wagner
Dorothea Weber
Dorothea Weber
Beverly Newman
Craig J. Galbán
Hans-Ulrich Kauczor
Hans-Ulrich Kauczor
Hans-Ulrich Kauczor
Marcus A. Mall
Marcus A. Mall
Marcus A. Mall
Terry E. Robinson
Mark O. Wielpütz
Mark O. Wielpütz
Mark O. Wielpütz
MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease
Frontiers in Pediatrics
Quantitative computer tomography
Bronchiectasis
Air trapping
Cystic Fibrosis
Automated analysis
title MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease
title_full MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease
title_fullStr MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease
title_full_unstemmed MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease
title_short MDCT-based longitudinal automated airway and air trapping analysis in school-age children with mild cystic fibrosis lung disease
title_sort mdct based longitudinal automated airway and air trapping analysis in school age children with mild cystic fibrosis lung disease
topic Quantitative computer tomography
Bronchiectasis
Air trapping
Cystic Fibrosis
Automated analysis
url https://www.frontiersin.org/articles/10.3389/fped.2023.1068103/full
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