1
|
Lucà S, Pagliuca F, Perrotta F, Ronchi A, Mariniello DF, Natale G, Bianco A, Fiorelli A, Accardo M, Franco R. Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist's Key Role. Int J Mol Sci 2024; 25:3618. [PMID: 38612431 PMCID: PMC11011777 DOI: 10.3390/ijms25073618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Idiopathic Interstitial Pneumonias (IIPs) are a heterogeneous group of the broader category of Interstitial Lung Diseases (ILDs), pathologically characterized by the distortion of lung parenchyma by interstitial inflammation and/or fibrosis. The American Thoracic Society (ATS)/European Respiratory Society (ERS) international multidisciplinary consensus classification of the IIPs was published in 2002 and then updated in 2013, with the authors emphasizing the need for a multidisciplinary approach to the diagnosis of IIPs. The histological evaluation of IIPs is challenging, and different types of IIPs are classically associated with specific histopathological patterns. However, morphological overlaps can be observed, and the same histopathological features can be seen in totally different clinical settings. Therefore, the pathologist's aim is to recognize the pathologic-morphologic pattern of disease in this clinical setting, and only after multi-disciplinary evaluation, if there is concordance between clinical and radiological findings, a definitive diagnosis of specific IIP can be established, allowing the optimal clinical-therapeutic management of the patient.
Collapse
Affiliation(s)
- Stefano Lucà
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.L.); (F.P.); (A.R.); (M.A.)
| | - Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.L.); (F.P.); (A.R.); (M.A.)
| | - Fabio Perrotta
- Department of Translational Medical Science, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.P.); (D.F.M.); (A.B.)
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.L.); (F.P.); (A.R.); (M.A.)
| | - Domenica Francesca Mariniello
- Department of Translational Medical Science, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.P.); (D.F.M.); (A.B.)
| | - Giovanni Natale
- Division of Thoracic Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Piazza Miraglia, 2, 80138 Naples, Italy; (G.N.); (A.F.)
| | - Andrea Bianco
- Department of Translational Medical Science, Università degli Studi della Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (F.P.); (D.F.M.); (A.B.)
| | - Alfonso Fiorelli
- Division of Thoracic Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Piazza Miraglia, 2, 80138 Naples, Italy; (G.N.); (A.F.)
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.L.); (F.P.); (A.R.); (M.A.)
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (S.L.); (F.P.); (A.R.); (M.A.)
| |
Collapse
|
2
|
Gaudêncio AS, Azami H, Cardoso JM, Vaz PG, Humeau-Heurtier A. Bidimensional ensemble entropy: Concepts and application to emphysema lung computerized tomography scans. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107855. [PMID: 37852145 DOI: 10.1016/j.cmpb.2023.107855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/01/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND OBJECTIVE Bidimensional entropy algorithms provide meaningful quantitative information on image textures. These algorithms have the advantage of relying on well-known one-dimensional entropy measures dedicated to the analysis of time series. However, uni- and bidimensional algorithms require the adjustment of some parameters that influence the obtained results or even findings. To address this, ensemble entropy techniques have recently emerged as a solution for signal analysis, offering greater stability and reduced bias in data patterns during entropy estimation. However, such algorithms have not yet been extended to their two-dimensional forms. METHODS We therefore propose six bidimensional algorithms, namely ensemble sample entropy, ensemble permutation entropy, ensemble dispersion entropy, ensemble distribution entropy, and two versions of ensemble fuzzy entropy based on different models or parameters initialization of an entropy algorithm. These new measures are first tested on synthetic images and further applied to a biomedical dataset. RESULTS The results suggest that ensemble techniques are able to detect different levels of image dynamics and their degrees of randomness. These methods lead to more stable entropy values (lower coefficients of variations) for the synthetic data. The results also show that these new measures can obtain up to 92.7% accuracy and 88.4% sensitivity when classifying patients with pulmonary emphysema through a k-nearest neighbors algorithm. CONCLUSIONS This is a further step towards the potential clinical deployment of bidimensional ensemble approaches to detect different levels of image dynamics and their successful performance on emphysema lung computerized tomography scans. These bidimensional ensemble entropy algorithms have potential to be used in various imaging applications thanks to their ability to distinguish more stable and less biased image patterns compared to their original counterparts.
Collapse
Affiliation(s)
- Andreia S Gaudêncio
- LIBPhys, Department of Physics, University of Coimbra, Coimbra, P-3004 516, Portugal; Univ Angers, LARIS, SFR MATHSTIC, F-49000 Angers, France.
| | - Hamed Azami
- Centre for Addiction and Mental Health, Toronto Dementia Research Alliance, Univ Toronto, Toronto, ON, Canada
| | - João M Cardoso
- LIBPhys, Department of Physics, University of Coimbra, Coimbra, P-3004 516, Portugal
| | - Pedro G Vaz
- LIBPhys, Department of Physics, University of Coimbra, Coimbra, P-3004 516, Portugal
| | | |
Collapse
|
3
|
Mento F, Perini M, Malacarne C, Demi L. Ultrasound multifrequency strategy to estimate the lung surface roughness, in silico and in vitro results. ULTRASONICS 2023; 135:107143. [PMID: 37647701 DOI: 10.1016/j.ultras.2023.107143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
Lung ultrasound (LUS) is an important imaging modality to assess the state of the lung surface. Nevertheless, LUS is limited to the visual evaluation of imaging artifacts, especially the vertical ones. These artifacts are observed in pathologies characterized by a reduction of dimensions of air-spaces (alveoli). In contrast, there exist pathologies, such as chronic obstructive pulmonary disease (COPD), in which an enlargement of air-spaces can occur, which causes the lung surface to behave essentially as a perfect reflector, thus not allowing ultrasound penetration. This characteristic high reflectivity could be exploited to characterize the lung surface. Specifically, air-spaces of different sizes could cause the lung surface to have a different roughness, whose estimation could provide a way to assess the state of the lung surface. In this study, we present a quantitative multifrequency approach aiming at estimating the lung surface's roughness by measuring image intensity variations along the lung surface as a function of frequency. This approach was tested both in silico and in vitro, and it showed promising results. For the in vitro experiments, radiofrequency (RF) data were acquired from a novel experimental model. The results showed consistency between in silico and in vitro experiments.
Collapse
Affiliation(s)
- Federico Mento
- Department of Information Engineering and Computer Science, University of Trento, Via Sommarive 9, 38123 Trento, Italy
| | - Matteo Perini
- Polo Meccatronica (ProM), Via Fortunato Zeni 8, 38068 Rovereto, Italy
| | - Ciro Malacarne
- Polo Meccatronica (ProM), Via Fortunato Zeni 8, 38068 Rovereto, Italy
| | - Libertario Demi
- Department of Information Engineering and Computer Science, University of Trento, Via Sommarive 9, 38123 Trento, Italy.
| |
Collapse
|
4
|
Konietzke P, Brunner C, Konietzke M, Wagner WL, Weinheimer O, Heußel CP, Herth FJF, Trudzinski F, Kauczor HU, Wielpütz MO. GOLD stage-specific phenotyping of emphysema and airway disease using quantitative computed tomography. Front Med (Lausanne) 2023; 10:1184784. [PMID: 37534319 PMCID: PMC10393128 DOI: 10.3389/fmed.2023.1184784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/22/2023] [Indexed: 08/04/2023] Open
Abstract
Background In chronic obstructive pulmonary disease (COPD) abnormal lung function is related to emphysema and airway obstruction, but their relative contribution in each GOLD-stage is not fully understood. In this study, we used quantitative computed tomography (QCT) parameters for phenotyping of emphysema and airway abnormalities, and to investigate the relative contribution of QCT emphysema and airway parameters to airflow limitation specifically in each GOLD stage. Methods Non-contrast computed tomography (CT) of 492 patients with COPD former GOLD 0 COPD and COPD stages GOLD 1-4 were evaluated using fully automated software for quantitative CT. Total lung volume (TLV), emphysema index (EI), mean lung density (MLD), and airway wall thickness (WT), total diameter (TD), lumen area (LA), and wall percentage (WP) were calculated for the entire lung, as well as for all lung lobes separately. Results from the 3rd-8th airway generation were aggregated (WT3-8, TD3-8, LA3-8, WP3-8). All subjects underwent whole-body plethysmography (FEV1%pred, VC, RV, TLC). Results EI was higher with increasing GOLD stages with 1.0 ± 1.8% in GOLD 0, 4.5 ± 9.9% in GOLD 1, 19.4 ± 15.8% in GOLD 2, 32.7 ± 13.4% in GOLD 3 and 41.4 ± 10.0% in GOLD 4 subjects (p < 0.001). WP3-8 showed no essential differences between GOLD 0 and GOLD 1, tended to be higher in GOLD 2 with 52.4 ± 7.2%, and was lower in GOLD 4 with 50.6 ± 5.9% (p = 0.010 - p = 0.960). In the upper lobes WP3-8 showed no significant differences between the GOLD stages (p = 0.824), while in the lower lobes the lowest WP3-8 was found in GOLD 0/1 with 49.9 ± 6.5%, while higher values were detected in GOLD 2 with 51.9 ± 6.4% and in GOLD 3/4 with 51.0 ± 6.0% (p < 0.05). In a multilinear regression analysis, the dependent variable FEV1%pred can be predicted by a combination of both the independent variables EI (p < 0.001) and WP3-8 (p < 0.001). Conclusion QCT parameters showed a significant increase of emphysema from GOLD 0-4 COPD. Airway changes showed a different spatial pattern with higher values of relative wall thickness in the lower lobes until GOLD 2 and subsequent lower values in GOLD3/4, whereas there were no significant differences in the upper lobes. Both, EI and WP5-8 are independently correlated with lung function decline.
Collapse
Affiliation(s)
- Philip Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Christian Brunner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Marilisa Konietzke
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Willi Linus Wagner
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Oliver Weinheimer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Claus Peter Heußel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Felix J. F. Herth
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Pulmonology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Franziska Trudzinski
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Pulmonology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Mark Oliver Wielpütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
5
|
Wu Y, Du R, Feng J, Qi S, Pang H, Xia S, Qian W. Deep CNN for COPD identification by Multi-View snapshot integration of 3D airway tree and lung field. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
6
|
Effective Component Compatibility of Bufei Yishen Formula III Which Regulates the Mucus Hypersecretion of COPD Rats via the miR-146a-5p/EGFR/MEK/ERK Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9423435. [PMID: 36619199 PMCID: PMC9812609 DOI: 10.1155/2022/9423435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Abstract
Background The effective-component compatibility of Bufei Yishen formula III (ECC-BYF III) with 5 ingredients (ginsenoside Rh1, astragaloside, icariin, nobiletin, and paeonol) has been shown to protect against chronic obstructive pulmonary disease (COPD). The present study aimed to observe the effects of ECC-BYF III in a COPD rat model and dissect its potential mechanisms in regulating mucus hypersecretion via the miR-146a-5p/epidermal growth factor receptor (EGFR)/MEK/ERK pathway. Methods COPD model rats were treated with normal saline, ECC-BYF III, or N-acetylcysteine (NAC). Pulmonary function, lung tissue histology with H & E and AB-PAS staining, expression levels of interleukin (IL)-4, IL-6, IL-1β, MUC5AC, MUC5B, and FOXA2 in lung tissues and the mRNA and proteins involved in the miR-146a-5p/EGFR/MEK/ERK pathway were evaluated. Results The COPD rats showed a significant decrease in the pulmonary function and serious pathological damage to the lung tissue. ECC-BYF III and NAC significantly improved the ventilation function and small airway pathological damage in the COPD rats. The goblet cells and the expression levels of IL-1β, IL-6, MUC5AC, and MUC5B were increased in the COPD rats and were significantly decreased after ECC-BYF III or NAC intervention. The expression levels of IL-4 and FOXA2 in the COPD rats were markedly decreased and were improved in the ECC-BYF III and NAC groups. ECC-BYF III appeared to have a potent effect in restoring the reduced expression of miR-146a-5p. The increased phosphorylation levels of EGFR, MEK, and ERK1/2 and the protein expression levels of SPDEF in the lungs of COPD rats could be significantly reduced by ECC-BYF III. Conclusions ECC-BYF III has a significant effect in improving the airway mucus hypersecretion in COPD model rats, as well as a protective effect against limited pulmonary function and injured lung histopathology. The protective effect of ECC-BYF III in reducing airway mucus hypersecretion in COPD may involve the miR-146a-5p/EGFR/MEK/ERK pathway.
Collapse
|
7
|
Draelos RL, Carin L. Explainable multiple abnormality classification of chest CT volumes. Artif Intell Med 2022; 132:102372. [DOI: 10.1016/j.artmed.2022.102372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/09/2022] [Accepted: 07/28/2022] [Indexed: 12/20/2022]
|
8
|
Trușculescu AA, Manolescu DL, Broască L, Ancușa VM, Ciocârlie H, Pescaru CC, Vaștag E, Oancea CI. Enhancing Imagistic Interstitial Lung Disease Diagnosis by Using Complex Networks. Medicina (B Aires) 2022; 58:medicina58091288. [PMID: 36143965 PMCID: PMC9504499 DOI: 10.3390/medicina58091288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/28/2022] [Accepted: 09/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives: Diffuse interstitial lung diseases (DILD) are a heterogeneous group of over 200 entities, some with dramatical evolution and poor prognostic. Because of their overlapping clinical, physiopathological and imagistic nature, successful management requires early detection and proper progression evaluation. This paper tests a complex networks (CN) algorithm for imagistic aided diagnosis fitness for the possibility of achieving relevant and novel DILD management data. Materials and Methods: 65 DILD and 31 normal high resolution computer tomography (HRCT) scans were selected and analyzed with the CN model. Results: The algorithm is showcased in two case reports and then statistical analysis on the entire lot shows that a CN algorithm quantifies progression evaluation with a very fine accuracy, surpassing functional parameters’ variations. The CN algorithm can also be successfully used for early detection, mainly on the ground glass opacity Hounsfield Units band of the scan. Conclusions: A CN based computer aided diagnosis could provide the much-required data needed to successfully manage DILDs.
Collapse
Affiliation(s)
- Ana Adriana Trușculescu
- Pulmonology Department, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timișoara, Romania
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Diana Luminița Manolescu
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
- Correspondence:
| | - Laura Broască
- Department of Computer and Information Technology, Automation and Computers Faculty, “Politehnica” University of Timișoara, Vasile Pârvan Blvd. No. 2, 300223 Timișoara, Romania
| | - Versavia Maria Ancușa
- Department of Computer and Information Technology, Automation and Computers Faculty, “Politehnica” University of Timișoara, Vasile Pârvan Blvd. No. 2, 300223 Timișoara, Romania
| | - Horia Ciocârlie
- Department of Computer and Information Technology, Automation and Computers Faculty, “Politehnica” University of Timișoara, Vasile Pârvan Blvd. No. 2, 300223 Timișoara, Romania
| | - Camelia Corina Pescaru
- Pulmonology Department, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timișoara, Romania
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Emanuela Vaștag
- Pulmonology Department, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timișoara, Romania
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Cristian Iulian Oancea
- Pulmonology Department, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timișoara, Romania
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
| |
Collapse
|
9
|
Park J, Kim EK, Lee SH, Kim MA, Kim JH, Lee SM, Lee JS, Oh YM, Lee SD, Lee JH. Phenotyping COPD Patients with Emphysema Distribution Using Quantitative CT Measurement; More Severe Airway Involvement in Lower Dominant Emphysema. Int J Chron Obstruct Pulmon Dis 2022; 17:2013-2025. [PMID: 36072609 PMCID: PMC9441583 DOI: 10.2147/copd.s362906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jisoo Park
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Eun-Kyung Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Se Hee Lee
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Mi-Ae Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jung-Hyun Kim
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Sang Min Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Seung Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Do Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji-Hyun Lee
- Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea
- Correspondence: Ji-Hyun Lee, Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea, Tel +82-31-780-5205, Fax +82-31-780-2992, Email
| | | |
Collapse
|
10
|
Ferri F, Bouzerar R, Auquier M, Vial J, Renard C. Pulmonary emphysema quantification at low dose chest CT using Deep Learning image reconstruction. Eur J Radiol 2022; 152:110338. [DOI: 10.1016/j.ejrad.2022.110338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/06/2022] [Accepted: 05/01/2022] [Indexed: 11/29/2022]
|
11
|
Donaldson K, Wallace WA, MacNee W, Henry C, Seaton A. The recognition of lung disease in coal workers: The role of Gough–Wentworth whole lung sections. J R Coll Physicians Edinb 2022; 52:65-72. [DOI: 10.1177/14782715221088982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
From the identification of a specific lung disease caused by coal dust exposure in miners in 1831 until the demonstration of the association of that exposure to risk of emphysema in 1984, there was continuous argument about the harmfulness of coal dust. Ill health in miners was attributed variously to tuberculosis, quartz exposure or cigarette smoking. An acceptance that coal dust was harmful only started with investigative radiology and pathology in the 1920s, and physiology in the 1950s. Most of the early investigations were in South Wales, the centre of the most important coal field in Great Britain. Among the investigators was Professor Jethro Gough who, with his technician James Wentworth, introduced a technique for making thick sections of whole, inflated lungs on paper backing. Here, we describe this method and its central role in understanding the relationships between coal dust exposure, pneumoconiosis, emphysema and lung dysfunction in miners.
Collapse
Affiliation(s)
- Ken Donaldson
- Surgeons’ Hall Museums, Royal College of Surgeons of Edinburgh, Edinburgh, UK
| | - William A Wallace
- Royal Infirmary of Edinburgh and Division of Pathology, University of Edinburgh, Edinburgh, UK
| | | | - Christopher Henry
- Surgeons Hall Museums, Royal College of Surgeons of Edinburgh, Edinburgh, UK
| | | |
Collapse
|
12
|
Koster TD, Dijk MV, Slebos DJ. Bronchoscopic Lung Volume Reduction for Emphysema: Review and Update. Semin Respir Crit Care Med 2022; 43:541-551. [PMID: 35562097 DOI: 10.1055/s-0042-1747938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In carefully selected patients with severe chronic obstructive pulmonary disease, characterized by emphysema and hyperinflation, lung volume reduction is an option to reduce lung hyperinflation, improve lung function, quality of life, and exercise capacity. Currently, there are several bronchoscopic and surgical treatment options to achieve lung volume reduction. It is important to carefully phenotype these patients, to select the optimal treatment option, with consideration of possible adverse events or contraindications, and it is highly recommended to discuss these treatment strategies in a multidisciplinary team. The treatment with one-way endobronchial valves has been investigated most extensively and more data are available regarding the treatment of more "marginal cases," or subsequent lung volume reduction surgery. Other bronchoscopic lung volume reduction options include treatment with coils, thermal vapor ablation, and sclerosant agents. In this review, we aim to summarize the current clinical evidence on the bronchoscopic lung volume reduction therapies and important aspects regarding optimal patient selection.
Collapse
Affiliation(s)
- T David Koster
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marlies Van Dijk
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Dirk-Jan Slebos
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
13
|
SARI A, ÖNDER Ö, ARMAĞAN B, BÖLEK EÇ, FARİSOĞULLARI B, BİLGİN E, YARDIMCI GK, ARIYÜREK M, AKDOĞAN A. Pleuroparenchymal fibroelastosis in systemic sclerosis-associated interstitial lung disease. Turk J Med Sci 2022; 52:83-88. [PMID: 36161593 PMCID: PMC10734826 DOI: 10.3906/sag-2107-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/22/2022] [Accepted: 01/01/2022] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND To explore the frequency and clinical associations of radiologic pleuroparenchymal fibroelastosis (PPFE) in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD). METHODS In this single-center retrospective study, high resolution computed tomography (HRCT) images of 105 patients with SSc-ILD were examined for the presence of PPFE. Demographic, clinical, laboratory, and pulmonary function test (PFT) data of patients with and without PPFE were compared. RESULTS PPFE was detected in 19 (18.1%) patients ('definite PPFE' in 13 and 'consistent with PPFE' in 6 patients). Patients with PPFE had higher age and longer disease duration than PPFE (-) patients (p < 0.05 for both). Radiologic usual interstitial pneumoniae (UIP) pattern was more frequent (26.3% vs. 4.7%, p = 0.01) and median force vital capacity (FVC) was lower in patients with PPFE (64% vs. 82%, p = 0.005). Spontaneous pneumothorax developed in one patient with PPFE. More deaths occured in PPFE (+) group during follow-up (31% vs. 11%, p = 0.04).
Collapse
Affiliation(s)
- Alper SARI
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Ömer ÖNDER
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Berkan ARMAĞAN
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Ertuğrul Çağrı BÖLEK
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Bayram FARİSOĞULLARI
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Emre BİLGİN
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Gözde Kübra YARDIMCI
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Macit ARIYÜREK
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Ali AKDOĞAN
- Department of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| |
Collapse
|
14
|
Hochhegger1,2,3 B, Marchiori4 E, Rodrigues5 R, Mançano6 A, Jasinowodolinski4 D, Caruso Chate7 R, Soares Souza Jr8 A, Marchini Silva9 A, Sawamura10 M, Furnari6 M, Araujo-Neto11 C, Escuissato12 D, Pinetti13 R, Felipe Nobre14 L, Warszawiak15 D, Szarf16 G, Borges da Silva Telles7 G, Meirelles17 G, Rydz Santana18 P, Antunes13 V, Capobianco19 J, Missrie19 I, Volpon Soares Souza8 L, Koenigkam Santos20 M, Irion21 K, Duarte22 I, Santos23 R, Pinto23 E, Penha23 D. ERRATUM. J Bras Pneumol 2022; 47:e20200595errata. [PMID: 35019060 DOI: 10.36416/1806-3713/e20200595errata] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
[This corrects the article doi: 10.36416/1806-3756/e20200595].
Collapse
Affiliation(s)
- Bruno Hochhegger1,2,3
- 1. Pontifícia Universidade Católica do Rio Grande do Sul – PUCRS – Porto Alegre (RS) Brasil. 2. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil. 3. Thoracic Imaging Division, College of Medicine, University of Florida, Gainesville (FL) USA
| | - Edson Marchiori4
- 4. Universidade Federal do Rio de Janeiro – UFRJ – Rio de Janeiro (RJ) Brasil
| | - Rosana Rodrigues5
- 5. Universidade Federal do Rio Grande do Sul – UFRGS – Porto Alegre (RS) Brasil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Gilberto Szarf16
- 16. Universidade Federal de São Paulo – Unifesp – São Paulo (SP) Brasil
| | | | | | | | | | | | | | | | - Marcel Koenigkam Santos20
- 20. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo – USP – Ribeirão Preto (SP) Brasil
| | - Klaus Irion21
- 21. Manchester National Health Service, Manchester, United Kingdom
| | - Isabel Duarte22
- 22. Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | | | | | - Diana Penha23
- 23. Universidade da Beira Interior, Covilhã, Portugal
| |
Collapse
|
15
|
Wilgus ML, Abtin F, Markovic D, Tashkin DP, Phillips JE, Buhr RG, Flynn MJ, Dembek M, Cooper CB, Barjaktarevic I. Panlobular emphysema is associated with COPD disease severity: A study of emphysema subtype by computed tomography. Respir Med 2021; 192:106717. [PMID: 35026616 DOI: 10.1016/j.rmed.2021.106717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/30/2021] [Accepted: 12/12/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Computed tomography has the potential to inform COPD prognosis. We sought to determine associations of emphysema phenotype with clinical parameters including lung function, inflammatory markers, and quality of life. METHODS Participants of this single-center observational cohort (n = 83) were 40-80 years old, had ≥10 pack-year smoking, and a diagnosis of COPD confirmed by spirometry. All participants had available historic chest CT scans which were systematically reviewed by a single expert radiologist and scored for emphysema subtype, extent, and distribution. Associations between radiographic findings and clinical parameters were determined. RESULTS Median age of participants was 72 years, median smoking 40 pack-years, and median FEV1 59% predicted. 84% of the participants had radiographic emphysema. Of those, 26% had panlobular emphysema (PLE), 68% centrilobular emphysema (CLE), and 6% paraseptal emphysema (PSE). As compared to the participants with no radiographic emphysema, the presence of PLE-dominant emphysema was associated with a lower BMI (P = 0.012) and greater extent of emphysema (P = 0.014). After adjusting for age, sex, and pack-years smoking history, PLE was associated with greater airflow obstruction by FEV1% (48% vs 71%, P = 0.005), greater symptom burden by CAT score (18 vs 9, P = 0.015), worse quality of life by SGRQ score (43 vs 22, P = 0.025), and more systemic inflammation by erythrocyte sedimentation rate (P = 0.001). CLE- or PSE-dominant emphysema were not similarly associated with clinical features or symptom burden. CONCLUSIONS The presence of PLE-dominant emphysema was associated with greater extent of emphysema, greater airflow obstruction, increased respiratory symptoms, worse quality of life, and systemic inflammation. Further investigation is indicated to explore the pathogenesis of the PLE phenotype and the prognostic and treatment implications of PLE.
Collapse
Affiliation(s)
- M L Wilgus
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - F Abtin
- Division of Thoracic Radiology, Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - D Markovic
- Department of Medicine Statistics Core, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - D P Tashkin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - J E Phillips
- Inflammation Discovery Research, Amgen, Thousand Oaks, CA, USA
| | - R G Buhr
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA; Department of Medicine, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - M J Flynn
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA; Division of Pulmonology, Kaiser Permanente Sunnyside Medical Center, Clackamas, OR, USA
| | - M Dembek
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA; Department of Physician Assistant Studies, Bay Path University, Longmeadow, MA, USA
| | - C B Cooper
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA; Department of Physiology, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - I Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
| |
Collapse
|
16
|
Hochhegger B, Marchiori E, Rodrigues R, Mançano A, Jasinowodolinski D, Chate RC, Souza AS, Silva AM, Sawamura M, Furnari M, Araujo-Neto C, Escuissato D, Pinetti R, Nobre LF, Warszawiak D, Szarf G, Telles GBDS, Meirelles G, Santana PR, Antunes V, Capobianco J, Missrie I, Souza LVS, Santos MK, Irion K, Duarte I, Santos R, Pinto E, Penha D. Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2021; 47:e20200595. [PMID: 34669832 PMCID: PMC9013533 DOI: 10.36416/1806-3756/e20200595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/27/2021] [Indexed: 11/17/2022]
Abstract
Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.
Collapse
Affiliation(s)
- Bruno Hochhegger
- . Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.,. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil.,. Thoracic Imaging Division, College of Medicine, University of Florida, Gainesville (FL) USA
| | - Edson Marchiori
- . Universidade Federal do Rio de Janeiro - UFRJ - Rio de Janeiro (RJ) Brasil
| | - Rosana Rodrigues
- . Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | | | | | | | - Arthur Soares Souza
- . Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto (SP) Brasil
| | | | | | | | | | | | | | | | | | - Gilberto Szarf
- . Universidade Federal de São Paulo - Unifesp - São Paulo (SP) Brasil
| | | | | | | | | | | | | | | | - Marcel Koeningan Santos
- . Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - USP - Ribeirão Preto (SP) Brasil
| | - Klaus Irion
- . Manchester National Health Service, Manchester, United Kingdom
| | - Isabel Duarte
- . Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | | | - Erique Pinto
- . Universidade da Beira Interior, Covilhã, Portugal
| | - Diana Penha
- . Universidade da Beira Interior, Covilhã, Portugal
| |
Collapse
|
17
|
Tung NT, Ho SC, Lu YH, Chen TT, Lee KY, Chen KY, Wu CD, Chung KF, Kuo HP, Thao HNX, Dung HB, Thuy TPC, Wu SM, Kou HY, Lee YL, Chuang HC. Association Between Air Pollution and Lung Lobar Emphysema in COPD. Front Med (Lausanne) 2021; 8:705792. [PMID: 34621758 PMCID: PMC8490678 DOI: 10.3389/fmed.2021.705792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The development of emphysema has been linked to air pollution; however, the association of air pollution with the extent of lobar emphysema remains unclear. This study examined the association of particulate matter <2.5 μm in aerodynamic diameters (PM2.5) (≤2.5 μm), nitrogen dioxide (NO2), and ozone (O3) level of exposure with the presence of emphysema in 86 patients with chronic obstructive pulmonary disease (COPD). Exposure to the air pollution estimated using the land-use regression model was associated with lung function, BODE (a body mass index, degree of obstruction, dyspnea severity, and exercise capacity index) quartiles, and emphysema measured as low-attenuation areas on high-resolution CT (HR-CT) lung scans. Using paraseptal emphysema as the reference group, we observed that a 1 ppb increase in O3 was associated with a 1.798-fold increased crude odds ratio of panlobular emphysema (p < 0.05). We observed that PM2.5 was associated with BODE quartiles, modified Medical Research Council (mMRC) dyspnea score, and exercise capacity (all p < 0.05). We found that PM2.5, NO2, and O3 were associated with an increased degree of upper lobe emphysema and lower lobe emphysema (all p < 0.05). Furthermore, we observed that an increase in PM2.5, NO2, and O3 was associated with greater increases in upper lobe emphysema than in lower lobe emphysema. In conclusion, exposure to O3 can be associated with a higher risk of panlobular emphysema than paraseptal emphysema in patients with COPD. Emphysema severity in lung lobes, especially the upper lobes, may be linked to air pollution exposure in COPD.
Collapse
Affiliation(s)
- Nguyen Thanh Tung
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Hsun Lu
- Department of Radiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan City, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Han-Pin Kuo
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Huynh Nguyen Xuan Thao
- Otorhinolaryngology Department, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Hoang Ba Dung
- Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Tran Phan Chung Thuy
- Otorhinolaryngology Department, Faculty of Medicine, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yun Kou
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
18
|
Mitra S, Prova SR, Sultana SA, Das R, Nainu F, Emran TB, Tareq AM, Uddin MS, Alqahtani AM, Dhama K, Simal-Gandara J. Therapeutic potential of indole alkaloids in respiratory diseases: A comprehensive review. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 90:153649. [PMID: 34325978 DOI: 10.1016/j.phymed.2021.153649] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Indole alkaloids are very promising for potential therapeutic purposes and appear to be particularly effective against respiratory diseases. Several experimental studies have been performed, both in vivo and in vitro, to evaluate the effectiveness of indole alkaloids for the management of respiratory disorders, including asthma, emphysema, tuberculosis, cancer, and pulmonary fibrosis. PURPOSE The fundamental objective of this review was to summarize the in-depth therapeutic potential of indole alkaloids against various respiratory disorders. STUDY DESIGN In addition to describing the therapeutic potential, this review also evaluates the toxicity of these alkaloids, which have been utilized for therapeutic benefits but have demonstrated toxic consequences. Some indole alkaloids, including scholaricine, 19-epischolaricine, vallesamine, and picrinine, which are derived from the plant Alstonia scholaris, have shown toxic effects in non-rodent models. METHODS This review also discusses clinical studies exploring the therapeutic efficacy of indole alkaloids, which have confirmed the promising benefits observed in vivo and in vitro. RESULTS The indole alkaloidal compounds have shown efficacy in subjects with respiratory diseases. CONCLUSION The available data established both preclinical and clinical studies confirm the potential of indole alkaloids to treat the respiratory disorders.
Collapse
Affiliation(s)
- Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Shajuthi Rahman Prova
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Sifat Ara Sultana
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Rajib Das
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh.
| | - Abu Montakim Tareq
- Department of Pharmacy, International Islamic University Chittagong, Chittagong 4318, Bangladesh
| | - Md Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka 1213, Bangladesh; Pharmakon Neuroscience Research Network, Dhaka 1207, Bangladesh
| | - Ali M Alqahtani
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India
| | - Jesus Simal-Gandara
- Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Faculty of Food Science and Technology, University of Vigo - Ourense Campus, E32004 Ourense, Spain.
| |
Collapse
|
19
|
Mondal S, Sadhu AK, Dutta PK. Automated diagnosis of pulmonary emphysema using multi-objective binary thresholding and hybrid classification. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Huang YCT, Wencker M, Driehuys B. Imaging in alpha-1 antitrypsin deficiency: a window into the disease. Ther Adv Chronic Dis 2021; 12_suppl:20406223211024523. [PMID: 34408834 PMCID: PMC8367205 DOI: 10.1177/20406223211024523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 05/25/2021] [Indexed: 12/21/2022] Open
Abstract
Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.
Collapse
Affiliation(s)
- Yuh-Chin Tony Huang
- Department of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Bastiaan Driehuys
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
21
|
Tumor size in patients with severe pulmonary emphysema might be underestimated on preoperative CT. Eur Radiol 2021; 32:163-173. [PMID: 34132872 DOI: 10.1007/s00330-021-08105-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the effect of emphysema on tumor diameter measured on preoperative computed tomography (CT) images versus pathological specimens. MATERIALS AND METHODS We investigated patients who underwent primary lung cancer surgery: 55 patients (57 tumors) with severe emphysema and 57 patients (57 tumors) without emphysema. The tumor diameters measured in the postoperative pathological specimens were compared with those measured on the axial CT images and on multiplanar reconstruction (MPR) CT images by two independent radiologists; a subgroup analysis according to tumor size was also performed. A paired or unpaired t test was performed, depending on the tested subjects. RESULTS In the emphysema group, the mean axial CT diameter was significantly smaller than the mean pathological diameter (p = 0.025/0.001 for reader 1/2), whereas in the non-emphysema group, the mean axial CT diameter was not significantly different from the pathological one for both readers. The difference between CT axial diameter and pathological diameter (= CT diameter - pathological diameter) was significantly smaller (i.e., had a stronger tendency toward underestimation on radiological measurements) in the emphysema group compared with the non-emphysema group (p = 0.014/0.008 for reader 1/2), and the difference was significantly smaller in tumors sized > 30 mm than tumors sized ≤ 20 mm in both groups. CONCLUSIONS Tumor size is significantly smaller on preoperative CT in patients with severe emphysema compared to patients without emphysema, especially in the case of large tumors. MPR measurement using the widest of three dimensions should be used to select T-stage for patients with severe emphysema. KEY POINTS • The presence of emphysema affects the accuracy of tumor size measurements on CT. • Compared to patients without emphysema, the tumor size in severe emphysema patients tends to be measured smaller in preoperative CT than the pathological specimen. • This trend is more evident when large tumors are measured on axial CT images alone.
Collapse
|
22
|
Doğan E, Tapan U, Oral Tapan Ö, Alaşan F, Olcay SS, Çınar Olcay T. A case of B.1.1.7 SARS-CoV-2 UK strain with an atypical radiological presentation. Monaldi Arch Chest Dis 2021; 91. [PMID: 34121378 DOI: 10.4081/monaldi.2021.1840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/28/2021] [Indexed: 11/23/2022] Open
Abstract
The new UK strain was first described in December 2020. It was seen for the first time in Turkey in February 2021. It is not yet known whether the new strain has different CT patterns compared to the classical type. We present a 68-years-old male patient with an atypical CT presentation in which GGOs are gathered around the areas of paraseptal emphysema accompanied by CT and clinical findings. This involvement is an unexpected pattern because of the atypical distribution of the GGO.
Collapse
Affiliation(s)
- Emrah Doğan
- Department of Radiology, Faculty of Medicine, Mugla Sitki Koçman University, Mugla.
| | | | | | - Fatih Alaşan
- Department of Radiology, Faculty of Medicine, Mugla Sitki Koçman University, Mugla.
| | - Sabri Serhan Olcay
- Department of Radiology, Faculty of Medicine, Mugla Sitki Koçman University, Mugla.
| | - Tuğba Çınar Olcay
- Department of Radiology, Faculty of Medicine, Mugla Sitki Koçman University, Mugla.
| |
Collapse
|
23
|
Zeng Y, Zhai XL, Wáng YXJ, Gao WW, Hu CM, Lin FS, Chai WS, Wang JY, Shi YL, Zhou XH, Yu HS, Lu XW. Illustration of a number of atypical computed tomography manifestations of active pulmonary tuberculosis. Quant Imaging Med Surg 2021; 11:1651-1667. [PMID: 33816198 DOI: 10.21037/qims-20-1323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Tuberculosis is a serious public health challenge facing mankind and one of the top ten causes of death. Diagnostic imaging plays an important role, particularly for the diagnosis and treatment planning of tuberculosis patients with negative microbiology results. This article illustrates a number of atypical computed tomography (CT) appearances of pulmonary tuberculosis (PTB), including (I) clustered micronodules (CMNs) sign; (II) reversed halo sign (RHS); (III) tuberculous pneumatocele; (IV) hematogenously disseminated PTB with predominantly diffuse ground glass opacity manifestation; (V) hematogenously disseminated PTB with randomly distributed non-miliary nodules; (VI) PTB changes occur on the background of emphysema or honeycomb changes of interstitial pneumonia; and (VII) PTB manifesting as organizing pneumonia. While the overall incidence of PTB is decreasing globally, the incidence of atypical manifestations of tuberculosis is increasing. A good understanding of the atypical CT imaging changes of active PTB shall help the diagnosis and differential diagnosis of PTB in clinical practice.
Collapse
Affiliation(s)
- Yi Zeng
- Department of Tuberculosis, Nanjing Public Health Medical Center, Nanjing Second Hospital, Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Xiao-Li Zhai
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei-Wei Gao
- Department of Tuberculosis, Nanjing Public Health Medical Center, Nanjing Second Hospital, Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Chun-Mei Hu
- Department of Tuberculosis, Nanjing Public Health Medical Center, Nanjing Second Hospital, Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Fei-Shen Lin
- Department of Tuberculosis, Nanjing Public Health Medical Center, Nanjing Second Hospital, Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Wen-Shu Chai
- Department of Respiratory Medicine, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Jian-Yun Wang
- Department of Radiology, Lanzhou Lung Hospital, Lanzhou, China
| | - Yan-Ling Shi
- Department of Radiology, Second Hospital of Daqing City, Daqing, China
| | - Xin-Hua Zhou
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, China
| | - Hui-Shan Yu
- Department of Radiology, Wuhan Pulmonary Hospital, Wuhan, China
| | - Xi-Wei Lu
- Department of Tuberculosis, Dalian Tuberculosis Hospital, Dalian, China
| |
Collapse
|
24
|
Vascular Ehlers-Danlos syndrome (vEDS): CT and histologic findings of pleural and lung parenchymal damage. Eur Radiol 2021; 31:6275-6285. [PMID: 33651202 DOI: 10.1007/s00330-021-07710-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/17/2020] [Accepted: 01/21/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To describe CT features of lung involvement in patients with vascular Ehlers-Danlos syndrome (vEDS), a rare genetic condition caused by pathogenic variants within the COL3A1 gene, characterized by recurrent arterial, digestive, and pulmonary events. MATERIAL AND METHODS All consecutive vEDS patients referred to the national tertiary referral center for vEDS, between 2004 and 2016, were included. Chest CT scans obtained during the initial vascular work-up were reviewed retrospectively by two chest radiologists for lung involvement. Five surgical samples underwent histologic examination. RESULTS Among 136 enrolled patients (83 women, 53 men; mean age 37 years) with molecularly confirmed vEDS, 24 (17.6%) had a history of respiratory events: 17 with pneumothorax, 4 with hemothorax, and 3 with hemoptysis that required thoracic surgery in 11. CT scans detected lung parenchymal abnormalities in 78 (57.3%) patients: emphysema (mostly centrilobular and paraseptal) in 44 (32.3%), comparable for smokers and non-smokers; clusters of calcified small pulmonary nodules in 9 (6.6%); and cavitated nodules in 4 (2.9%). Histologic examination of surgical samples found arterial abnormalities, emphysema with alveolar ruptures in 3, accompanied by diffuse hemorrhage and increased hemosiderin resorption. CONCLUSION In vEDS patients, identification of lung parenchymal abnormalities is common on CT. The most frequently observed CT finding was emphysema suggesting alveolar wall rupture which might facilitate the diagnostic screening of the disease in asymptomatic carriers of a genetic COL3A1 gene mutation. The prognostic value and evolution of these parenchymal abnormalities remain to be evaluated. KEY POINTS • Patients with vEDS can have lung parenchymal changes on top of or next to thoracal vascular abnormalities and that these changes can be present in asymptomatic cases. • The presence of these parenchymal changes is associated with a slightly higher incidence of respiratory events (although not statistically significant). • Identification of the described CT pattern by radiologists and chest physicians may facilitate diagnostic screening.
Collapse
|
25
|
Vestal BE, Carlson NE, Ghosh D. Filtering Spatial Point Patterns Using Kernel Densities. SPATIAL STATISTICS 2021; 41:100487. [PMID: 33409121 PMCID: PMC7781288 DOI: 10.1016/j.spasta.2020.100487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Understanding spatial inhomogeneity and clustering in point patterns arises in many contexts, ranging from disease outbreak monitoring to analyzing radiologically-based emphysema in biomedical images. This can often involve classifying individual points as being part of a feature/cluster or as being part of a background noise process. Existing methods for this task can struggle when there are differences in the size and/or density of individual clusters. In this work, we propose employing kernel density estimates of the underlying point process intensity function, using an existing data-driven approach to bandwidth selection, to separate feature points from noise. This is achieved by constructing a null distribution, either through asymptotic properties or Monte Carlo simulation, and comparing kernel density estimates to a given quantile of this distribution. We demonstrate that our method, termed Kernel Density and Simulation based Filtering (KDS-Filt), showed superior performance to existing alternative approaches, especially when there is inhomogeneity in cluster sizes and density. We also show the utility of KDS-Filt for identifying clinically relevant information about the spatial distribution of emphysema in lung computed tomography scans. The KDS-Filt methodology is available as part of the sncp R package, which can be downloaded at https://github.com/stop-pre16/sncp.
Collapse
Affiliation(s)
- Brian E. Vestal
- Center for Genes, Environment and Health, National Jewish Health, 1400 Jackson St, Denver, CO 80206, USA
- Department of Biostatistics and Informatics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Nichole E. Carlson
- Department of Biostatistics and Informatics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| | - Debashis Ghosh
- Department of Biostatistics and Informatics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO
| |
Collapse
|
26
|
Li F, Choi J, Zou C, Newell JD, Comellas AP, Lee CH, Ko H, Barr RG, Bleecker ER, Cooper CB, Abtin F, Barjaktarevic I, Couper D, Han M, Hansel NN, Kanner RE, Paine R, Kazerooni EA, Martinez FJ, O'Neal W, Rennard SI, Smith BM, Woodruff PG, Hoffman EA, Lin CL. Latent traits of lung tissue patterns in former smokers derived by dual channel deep learning in computed tomography images. Sci Rep 2021; 11:4916. [PMID: 33649381 PMCID: PMC7921389 DOI: 10.1038/s41598-021-84547-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease and the traditional variables extracted from computed tomography (CT) images may not be sufficient to describe all the topological features of lung tissues in COPD patients. We employed an unsupervised three-dimensional (3D) convolutional autoencoder (CAE)-feature constructor (FC) deep learning network to learn from CT data and derive tissue pattern-clusters jointly. We then applied exploratory factor analysis (EFA) to discover the unobserved latent traits (factors) among pattern-clusters. CT images at total lung capacity (TLC) and residual volume (RV) of 541 former smokers and 59 healthy non-smokers from the cohort of the SubPopulations and Intermediate Outcome Measures in the COPD Study (SPIROMICS) were analyzed. TLC and RV images were registered to calculate the Jacobian (determinant) values for all the voxels in TLC images. 3D Regions of interest (ROIs) with two data channels of CT intensity and Jacobian value were randomly extracted from training images and were fed to the 3D CAE-FC model. 80 pattern-clusters and 7 factors were identified. Factor scores computed for individual subjects were able to predict spirometry-measured pulmonary functions. Two factors which correlated with various emphysema subtypes, parametric response mapping (PRM) metrics, airway variants, and airway tree to lung volume ratio were discriminants of patients across all severity stages. Our findings suggest the potential of developing factor-based surrogate markers for new COPD phenotypes.
Collapse
Affiliation(s)
- Frank Li
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- IIHR-Hydroscience and Engineering, 2406 Seamans Center for the Engineering Art and Science, University of Iowa, Iowa City, IA, 52242, USA
| | - Jiwoong Choi
- Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, School of Medicine, University of Kansas, Kansas City, KS, USA
| | - Chunrui Zou
- IIHR-Hydroscience and Engineering, 2406 Seamans Center for the Engineering Art and Science, University of Iowa, Iowa City, IA, 52242, USA
- Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA
| | - John D Newell
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | | | - Chang Hyun Lee
- Department of Radiology, University of Iowa, Iowa City, IA, USA
- Department of Radiology, Seoul National University, Seoul, Republic of Korea
| | - Hongseok Ko
- Department of Radiology, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - R Graham Barr
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | | | | | - David Couper
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - MeiLan Han
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Robert Paine
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ella A Kazerooni
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Wanda O'Neal
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Stephen I Rennard
- Department of Internal Medicine, University of Nebraska College of Medicine, Omaha, NE, USA
| | - Benjamin M Smith
- Department of Medicine, Columbia University, New York, NY, USA
- Research Institute, McGill University Health Center, Montreal, Canada
| | | | - Eric A Hoffman
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
- Department of Radiology, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Ching-Long Lin
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA.
- IIHR-Hydroscience and Engineering, 2406 Seamans Center for the Engineering Art and Science, University of Iowa, Iowa City, IA, 52242, USA.
- Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA.
- Department of Radiology, University of Iowa, Iowa City, IA, USA.
| |
Collapse
|
27
|
Avanesov M, Well L, Laqmani A, Derlin T, Riccardi VM, Adam G, Mautner VF, Salamon J. Structural alteration of lung parenchyma in patients with NF1: a phenotyping study using multidetector computed tomography (MDCT). Orphanet J Rare Dis 2021; 16:29. [PMID: 33446201 PMCID: PMC7809820 DOI: 10.1186/s13023-021-01672-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 01/05/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diffuse interstitial lung disease have been described in Neurofibromatosis type 1 (NF1), but its diversity and prevalence remain unknown. The aim of this study was to assess the prevalence and characteristics of (NF1)-associated lung manifestations in a large single-center study using multidetector computed tomography (MDCT) and to evaluate the smoking history, patients' age, genetics, and the presence of malignant peripheral nerve sheath tumors (MPNST) as potential influencing factors for lung pathologies. METHODS In this retrospective study, 71 patients with NF1 were evaluated for the presence of distinctive lung manifestations like reticulations, consolidations, type of emphysema, pulmonary nodules and cysts. All patients underwent F-18-FDG PET/CT scans, which were reviewed by two experienced radiologists in consensus. Patients' subgroups were formed based on their smoking history (current smokers/previous smokers/never smokers), age (< 12 years, 12-18 years, > 18 years), and presence of MPNST (MPNST/no MPNST). In 57 patients (80%), genetic analysis of sequences coding for the neurofibromin on chromosome 17 was performed, which was correlated with different lung pathologies. RESULTS Among all NF1 patients (33 ± 14 years, 56% females), 17 patients (24%) were current smokers and 62 patients (87%) were > 18 years old. Pulmonary cysts, nodules, and paraseptal emphysema were the most common pulmonary findings (35%, 32%, 30%). The presence of pulmonary metastases, MPNST and centrilobular emphysema was associated with smoking. Cysts were observed only in adults, whereas no significant correlation between age and all other pulmonary findings was found (p > 0.05). Presence of MPNST was accompanied by higher rates of intrapulmonary nodules and pulmonary metastasis. Neither the presence nor absence of any of the specific gene mutations was associated with any particular lung pathology (p > 0.05). CONCLUSIONS All pulmonary findings in NF1 patients occurred independently from specific mutation subtypes, suggesting that many NF1 mutations can cause various pulmonary pathologies. The presence of pulmonary metastases, MPNST and centrilobular emphysema was associated with smoking, indicating the value of smoking secession or the advice not to start smoking in NF1 patients as preventive strategy for clinicians. For screening of pulmonary manifestations in NF1 patients, an MDCT besides medical history and physical examination is mandatory in clinical routine.
Collapse
Affiliation(s)
- Maxim Avanesov
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Lennart Well
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Azien Laqmani
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | | | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Victor-Felix Mautner
- Clinic and Polyclinic for Neurology, Neurofibromatosis Outpatient Clinic, UKE, Hamburg, Germany
| | - Johannes Salamon
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
28
|
Isaac A, Nehemiah HK, Isaac A, Kannan A. Computer-Aided Diagnosis system for diagnosis of pulmonary emphysema using bio-inspired algorithms. Comput Biol Med 2020; 124:103940. [PMID: 32858484 DOI: 10.1016/j.compbiomed.2020.103940] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023]
Abstract
Pulmonary emphysema is a condition characterized by the destruction and permanent enlargement of the alveoli of the lungs. The destruction of gas-exchanging alveoli causes shortness of breath followed by a chronic cough and sputum production. A Computer-Aided Diagnosis (CAD) framework for diagnosing pulmonary emphysema from chest Computed Tomography (CT) slices has been designed and implemented in this study. The process of implementing the CAD framework includes segmenting the lung tissues and extracting the regions of interest (ROIs) using the Spatial Intuitionistic Fuzzy C-Means clustering algorithm. The ROIs that were considered in this work were emphysematous lesions - namely, centrilobular, paraseptal, and bullae that were labelled by an expert radiologist. The shape, texture, and run-length features were extracted from each ROI. A wrapper approach that employed four bio-inspired algorithms - namely, Moth-Flame Optimization (MFO), Firefly Optimization (FFO), Artificial Bee Colony Optimization, and Ant Colony Optimization - with the accuracy of the support vector machine classifier as the fitness function was used to select the optimal feature subset. The selected features of each bio-inspired algorithm were trained independently using the Extreme Learning Machine classifier based on the tenfold cross-validation technique. The framework was tested on real-time and public emphysema datasets to perform binary classification of lung CT slices of patients with and without the presence of emphysema. The framework that used MFO and FFO for feature selection produced superior results regarding accuracy, precision, recall, and specificity for the real-time dataset and the public dataset, respectively, when compared to the other bio-inspired algorithms.
Collapse
Affiliation(s)
- Anisha Isaac
- Ramanujan Computing Centre, Anna University, Chennai, 600025, TN, India
| | - H Khanna Nehemiah
- Ramanujan Computing Centre, Anna University, Chennai, 600025, TN, India.
| | - Anubha Isaac
- Department of Computer Science and Engineering, Anna University, Chennai, 600025, TN, India
| | - A Kannan
- Department of Information Science and Technology, Anna University, Chennai, 600025, TN, India
| |
Collapse
|
29
|
Lee KC, Kang EY, Yong HS, Kim C, Lee KY, Hwang SH, Oh YW. A Stepwise Diagnostic Approach to Cystic Lung Diseases for Radiologists. Korean J Radiol 2020; 20:1368-1380. [PMID: 31464115 PMCID: PMC6715565 DOI: 10.3348/kjr.2019.0057] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/22/2019] [Indexed: 02/07/2023] Open
Abstract
Lung cysts are commonly seen on computed tomography (CT), and cystic lung diseases show a wide disease spectrum. Thus, correct diagnosis of cystic lung diseases is a challenge for radiologists. As the first diagnostic step, cysts should be distinguished from cavities, bullae, pneumatocele, emphysema, honeycombing, and cystic bronchiectasis. Second, cysts can be categorized as single/localized versus multiple/diffuse. Solitary/localized cysts include incidental cysts and congenital cystic diseases. Multiple/diffuse cysts can be further categorized according to the presence or absence of associated radiologic findings. Multiple/diffuse cysts without associated findings include lymphangioleiomyomatosis and Birt-Hogg-Dubé syndrome. Multiple/diffuse cysts may be associated with ground-glass opacity or small nodules. Multiple/diffuse cysts with nodules include Langerhans cell histiocytosis, cystic metastasis, and amyloidosis. Multiple/diffuse cysts with ground-glass opacity include pneumocystis pneumonia, desquamative interstitial pneumonia, and lymphocytic interstitial pneumonia. This stepwise radiologic diagnostic approach can be helpful in reaching a correct diagnosis for various cystic lung diseases.
Collapse
Affiliation(s)
- Kyu Chong Lee
- Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Eun Young Kang
- Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea.
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Cherry Kim
- Department of Radiology, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan, Korea
| | - Ki Yeol Lee
- Department of Radiology, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan, Korea
| | - Sung Ho Hwang
- Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Korea
| | - Yu Whan Oh
- Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Korea
| |
Collapse
|
30
|
Poggiali E, Vercelli A, Iannicelli T, Tinelli V, Celoni L, Magnacavallo A. COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad. Eur J Case Rep Intern Med 2020; 7:001742. [PMID: 32665932 PMCID: PMC7350957 DOI: 10.12890/2020_001742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 01/21/2023] Open
Abstract
We describe the case of a male patient admitted to our emergency department during the Italian COVID-19 epidemic, for progressive worsening dyspnoea. A diagnosis of pneumothorax and diffuse interstitial lung involvement was promptly made by lung ultrasound and confirmed by an HRCT scan. A chest CT scan also showed diffuse emphysema, as observed in chronic obstructive pulmonary disease (COPD), and small consolidations in the lower lobes, suggestive for COVID-19 pneumonia. A chest tube was immediately inserted in the emergency room with complete resolution of the dyspnoea. A nasopharyngeal swab for 2019-nCoV was positive. Unfortunately, the patient died from COVID-19-related acute respiratory distress syndrome after 48 days of hospitalization. LEARNING POINTS Coronavirus disease (COVID-19) can cause death from severe acute respiratory distress syndrome (ARDS).Pneumothorax is a common complication of chronic obstructive pulmonary disease (COPD).The combination of COVID-19, COPD and pneumothorax can prove fatal.
Collapse
Affiliation(s)
- Erika Poggiali
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Andrea Vercelli
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Teresa Iannicelli
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Valentina Tinelli
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Laura Celoni
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | |
Collapse
|
31
|
Peng L, Lin L, Hu H, Zhang Y, Li H, Iwamoto Y, Han XH, Chen YW. Semi-Supervised Learning for Semantic Segmentation of Emphysema With Partial Annotations. IEEE J Biomed Health Inform 2019; 24:2327-2336. [PMID: 31902784 DOI: 10.1109/jbhi.2019.2963195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Segmentation and quantification of each subtype of emphysema is helpful to monitor chronic obstructive pulmonary disease. Due to the nature of emphysema (diffuse pulmonary disease), it is very difficult for experts to allocate semantic labels to every pixel in the CT images. In practice, partially annotating is a better choice for the radiologists to reduce their workloads. In this paper, we propose a new end-to-end trainable semi-supervised framework for semantic segmentation of emphysema with partial annotations, in which a segmentation network is trained from both annotated and unannotated areas. In addition, we present a new loss function, referred to as Fisher loss, to enhance the discriminative power of the model and successfully integrate it into our proposed framework. Our experimental results show that the proposed methods have superior performance over the baseline supervised approach (trained with only annotated areas) and outperform the state-of-the-art methods for emphysema segmentation.
Collapse
|
32
|
Kinoshita Y, Watanabe K, Ishii H, Kushima H, Fujita M, Nabeshima K. Distribution of emphysema and fibrosis in idiopathic pulmonary fibrosis with coexisting emphysema. Histopathology 2019; 74:1103-1108. [PMID: 30715748 DOI: 10.1111/his.13831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/31/2019] [Indexed: 11/28/2022]
Abstract
AIMS Combined pulmonary fibrosis and emphysema (CPFE) is a syndrome that results from tobacco smoking. Emphysema and fibrosis in CPFE patients have been considered to exist separately, with emphysema in the upper lobes and interstitial pneumonia in the lower lobes. The aim of this study was to examine the intrapulmonary distribution of fibrosis and emphysema in clinically diagnosed patients with idiopathic pulmonary fibrosis (IPF) and coexisting emphysema. METHODS AND RESULTS Among IPF patients (n = 40) who had been autopsied or pneumonectomised for lung transplantation from 1993 to 2018, we retrospectively selected patients with IPF and coexisting emphysema (n = 19) on the basis of the appearance on chest computed tomography (IPF patients with emphysema). We then histologically determined the intrapulmonary distribution of emphysema and fibrosis in the upper lobes and the lower lobes separately. In 15 of the 19 IPF patients with emphysema (79%), fibrosis and emphysema coexisted in the upper lobes and the lower lobes. No patients showed emphysema exclusively in the upper lobes and fibrosis exclusively in the lower lobes. CONCLUSIONS In the autopsied and pneumonectomised specimens of IPF patients with emphysema, craniocaudal separation of emphysema and fibrosis (emphysema in the upper lobes and interstitial pneumonia in the lower lobes) was histologically rare; coexistence or collision of fibrosis and emphysema in each lobe was common.
Collapse
Affiliation(s)
- Yoshiaki Kinoshita
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan.,Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
| | - Kentaro Watanabe
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan.,General Medical Research Centre, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Hisako Kushima
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
| |
Collapse
|
33
|
Peng L, Chen YW, Lin L, Hu H, Li H, Chen Q, Ling X, Wang D, Han X, Iwamoto Y. Classification and Quantification of Emphysema Using a Multi-Scale Residual Network. IEEE J Biomed Health Inform 2019; 23:2526-2536. [DOI: 10.1109/jbhi.2018.2890045] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
34
|
Hochhegger B, Langer FW, Irion K, Souza A, Moreira J, Baldisserotto M, Pallaoro Y, Muller E, Medeiros TM, Altmayer S, Marchiori E. Pulmonary Acinus: Understanding the Computed Tomography Findings from an Acinar Perspective. Lung 2019; 197:259-265. [PMID: 30900014 DOI: 10.1007/s00408-019-00214-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/05/2019] [Indexed: 12/17/2022]
Abstract
The lung acinus is the most distal portion of the airway responsible for the gas exchange. The normal acini are not visible on conventional computed tomography (CT), but the advent of micro-CT improved the understanding of the microarchitecture of healthy acini. The comprehension of the acinar architecture is pivotal for the understanding of CT findings of diseases that involve the acini. Centriacinar emphysema, for example, presents as round areas of low attenuation due to the destruction of the most central acini with compensatory enlargement of proximal acini due to alveolar wall destruction. In pulmonary fibrosis, intralobular septal fibrosis manifests as acinar wall thickening with an overlap of acinar collapse and compensatory dilation of surrounding acini constituting the cystic disease typical of the usual interstitial pneumonia pattern. This is a state-of-the-art review to describe the acinar structure from the micro-CT perspective and display how the comprehension of the acinar structure can aid in the interpretation of its microarchitecture disruption on conventional CT.
Collapse
Affiliation(s)
- Bruno Hochhegger
- Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil. .,Postgraduate program, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil. .,LABIMED - Medical Imaging Research Lab, Department of Radiology, Pavilhão, Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020-160, Brazil.
| | - Felipe W Langer
- Department of Radiology and Imaging Diagnosis, Federal University of Santa Maria, Santa Maria, Brazil
| | - Klaus Irion
- Department of Radiology, Liverpool Heart and Chest Hospital, Thomas Dr, Liverpool, L14 3PE, UK
| | - Arthur Souza
- Department of Radiology, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | - José Moreira
- Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
| | - Matteo Baldisserotto
- Postgraduate program, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Yana Pallaoro
- Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
| | - Enrico Muller
- Postgraduate program, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tassia Machado Medeiros
- Postgraduate program, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Stephan Altmayer
- Medical Imaging Research Laboratory, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, Brazil
| | - Edson Marchiori
- Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
35
|
Casha AR, Bertolaccini L, Camilleri L, Manche A, Gauci M, Melikyan G, Gatt R, Dudek K, Solli P, Grima JN. Pathophysiological mechanism of post-lobectomy air leaks. J Thorac Dis 2018; 10:3689-3700. [PMID: 30069367 DOI: 10.21037/jtd.2018.05.116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Air leak post-lobectomy continues to remain a significant clinical problem, with upper lobectomy associated with higher air leak rates. This paper investigated the pathophysiological role of pleural stress in the development of post-lobectomy air leak. Methods Preoperative characteristics and postoperative data from 367 consecutive video assisted thoracic surgery (VATS) lobectomy resections from one centre were collected prospectively between January 2014 and March 2017. Computer modelling of a lung model using finite element analysis (FEA) was used to calculate pleural stress in differing areas of the lung. Results Air leak following upper lobectomy was significantly higher than after middle or lower lobectomy (6.3% versus 2.5%, P=0.044), resulting in a significant six-day increase in mean hospital stay, P=0.004. The computer simulation model of the lung showed that an apical bullet shape was subject to eightyfold higher stress than the base of the lung model. Conclusions After upper lobectomy, the bullet shape of the apex of the exposed lower lobe was associated with high pleural stress, and a reduction in mechanical support by the chest wall to the visceral pleura due to initial post-op lack of chest wall confluence. It is suggested that such higher stress in the lower lobe apex explains the higher parenchymal air leak post-upper lobectomy. The pleural stress model also accounts for the higher incidence of right-sided prolonged air leak post-resection.
Collapse
Affiliation(s)
- Aaron R Casha
- Department of Cardiothoracic Surgery, Mater Dei Hospital, Malta.,Faculty of Medicine, Medical School, University of Malta, Malta
| | - Luca Bertolaccini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Liberato Camilleri
- Department of Statistics and Operational Research, Faculty of Science, University of Malta, Malta
| | | | - Marilyn Gauci
- Department of Anaesthesia, Mater Dei Hospital, Malta
| | - Gor Melikyan
- Department of Cardiothoracic Surgery, Mater Dei Hospital, Malta
| | - Ruben Gatt
- Metamaterials Unit, Faculty of Science, University of Malta, Malta
| | - Krzysztof Dudek
- Metamaterials Unit, Faculty of Science, University of Malta, Malta
| | - Piergiorgio Solli
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Joseph N Grima
- Metamaterials Unit, Faculty of Science, University of Malta, Malta
| |
Collapse
|
36
|
Gafoor K, Patel S, Girvin F, Gupta N, Naidich D, Machnicki S, Brown KK, Mehta A, Husta B, Ryu JH, Sarosi GA, Franquet T, Verschakelen J, Johkoh T, Travis W, Raoof S. Cavitary Lung Diseases. Chest 2018. [DOI: 10.1016/j.chest.2018.02.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
|
37
|
Editing out five Serpina1 paralogs to create a mouse model of genetic emphysema. Proc Natl Acad Sci U S A 2018; 115:2788-2793. [PMID: 29453277 PMCID: PMC5856518 DOI: 10.1073/pnas.1713689115] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chronic obstructive pulmonary disease affects 10% of the worldwide population, and the leading genetic cause is a genetic disease, α-1 antitrypsin (AAT) deficiency. Humans have only one gene that codes for the AAT protein, but mice have up to six, which made it impossible for decades to create a mouse model of the disease. Here we succeeded in creating this mouse model using CRISPR technology to target all of the mouse genes at once. Importantly, this mouse model spontaneously develops lung disease and recapitulates many aspects of the human disease. We anticipate that this model will be highly relevant not only to the preclinical development of therapeutics for AAT deficiency, but also to emphysema and smoking research. Chronic obstructive pulmonary disease affects 10% of the worldwide population, and the leading genetic cause is α-1 antitrypsin (AAT) deficiency. Due to the complexity of the murine locus, which includes up to six Serpina1 paralogs, no genetic animal model of the disease has been successfully generated until now. Here we create a quintuple Serpina1a–e knockout using CRISPR/Cas9-mediated genome editing. The phenotype recapitulates the human disease phenotype, i.e., absence of hepatic and circulating AAT translates functionally to a reduced capacity to inhibit neutrophil elastase. With age, Serpina1 null mice develop emphysema spontaneously, which can be induced in younger mice by a lipopolysaccharide challenge. This mouse models not only AAT deficiency but also emphysema and is a relevant genetic model and not one based on developmental impairment of alveolarization or elastase administration. We anticipate that this unique model will be highly relevant not only to the preclinical development of therapeutics for AAT deficiency, but also to emphysema and smoking research.
Collapse
|
38
|
Yoshikawa A, Sato S, Tanaka T, Hashisako M, Kashima Y, Tsuchiya T, Yamasaki N, Nagayasu T, Yamamoto H, Fukuoka J. Breakdown of lung framework and an increase in pores of Kohn as initial events of emphysema and a cause of reduction in diffusing capacity. Int J Chron Obstruct Pulmon Dis 2016; 11:2287-2294. [PMID: 27695315 PMCID: PMC5033613 DOI: 10.2147/copd.s114281] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Pulmonary emphysema is the pathological prototype of chronic obstructive pulmonary disease and is also associated with other lung diseases. We considered that observation with different approaches may provide new insights for the pathogenesis of emphysema. Patients and methods We reviewed tissue blocks of the lungs of 25 cases with/without emphysema and applied a three-dimensional observation method to the blocks. Based on the three-dimensional characteristics of the alveolar structure, we considered one face of the alveolar polyhedron as a structural unit of alveoli and called it a framework unit (FU). We categorized FUs based on their morphological characteristics and counted their number to evaluate the destructive changes in alveoli. We also evaluated the number and the area of pores of Kohn in FUs. We performed linear regression analysis to estimate the effect of these data on pulmonary function tests. Results In multivariable regression analysis, a decrease in the number of FUs without an alveolar wall led to a significant decrease in the diffusing capacity of the lung for carbon monoxide (DLCO) and DLCO per unit alveolar volume, and an increase in the area of pores of Kohn had a significant effect on an increase in residual capacity. Conclusion A breakdown in the lung framework and an increase in pores of Kohn are associated with a decrease in DLCO and DLCO per unit alveolar volume with/without emphysema.
Collapse
Affiliation(s)
- Akira Yoshikawa
- Nagasaki Educational and Diagnostic Center of Pathology (NEDCP), Department of Pathology
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Nagasaki; Division of Biostatistics, Kurume University School of Medicine, Fukuoka
| | - Tomonori Tanaka
- Nagasaki Educational and Diagnostic Center of Pathology (NEDCP), Department of Pathology
| | - Mikiko Hashisako
- Nagasaki Educational and Diagnostic Center of Pathology (NEDCP), Department of Pathology; Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Yukio Kashima
- Department of Pathology, Hyogo Prefectural Awaji Medical Center, Sumoto; Department of Pathology
| | - Tomoshi Tsuchiya
- Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoya Yamasaki
- Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Yamamoto
- Clinical Research Center, Nagasaki University Hospital, Nagasaki
| | - Junya Fukuoka
- Nagasaki Educational and Diagnostic Center of Pathology (NEDCP), Department of Pathology; Department of Pathology
| |
Collapse
|
39
|
Kligerman S, Franks TJ, Galvin JR. Clinical-Radiologic-Pathologic Correlation of Smoking-Related Diffuse Parenchymal Lung Disease. Radiol Clin North Am 2016; 54:1047-1063. [PMID: 27719975 DOI: 10.1016/j.rcl.2016.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The direct toxicity of cigarette smoke and the body's subsequent response to this lung injury leads to a wide array of pathologic manifestations and disease states that lead to both reversible and irreversible injury to the large airways, small airways, alveolar walls, and alveolar spaces. These include emphysema, bronchitis, bronchiolitis, acute eosinophilic pneumonia, pulmonary Langerhans cell histiocytosis, respiratory bronchiolitis, desquamative interstitial pneumonia, and pulmonary fibrosis. Although these various forms of injury have different pathologic and imaging manifestations, they are all part of the spectrum of smoking-related diffuse parenchymal lung disease.
Collapse
Affiliation(s)
- Seth Kligerman
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21231, USA.
| | - Teri J Franks
- Department of Defense, Defense Health Agency, Joint Pathology Center, 606 Stephen Sitter Avenue, Silver Spring, MD 20910-1290, USA
| | - Jeffrey R Galvin
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21231, USA; Department of Thoracic Radiology, American Institute for Radiologic Pathology, 1010 Wayne Avenue, Suite 320, Silver Spring, MD 20910, USA
| |
Collapse
|
40
|
Raoof S, Bondalapati P, Vydyula R, Ryu JH, Gupta N, Raoof S, Galvin J, Rosen MJ, Lynch D, Travis W, Mehta S, Lazzaro R, Naidich D. Cystic Lung Diseases: Algorithmic Approach. Chest 2016; 150:945-965. [PMID: 27180915 DOI: 10.1016/j.chest.2016.04.026] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 02/16/2016] [Accepted: 04/06/2016] [Indexed: 12/14/2022] Open
Abstract
Cysts are commonly seen on CT scans of the lungs, and diagnosis can be challenging. Clinical and radiographic features combined with a multidisciplinary approach may help differentiate among various disease entities, allowing correct diagnosis. It is important to distinguish cysts from cavities because they each have distinct etiologies and associated clinical disorders. Conditions such as emphysema, and cystic bronchiectasis may also mimic cystic disease. A simplified classification of cysts is proposed. Cysts can occur in greater profusion in the subpleural areas, when they typically represent paraseptal emphysema, bullae, or honeycombing. Cysts that are present in the lung parenchyma but away from subpleural areas may be present without any other abnormalities on high-resolution CT scans. These are further categorized into solitary or multifocal/diffuse cysts. Solitary cysts may be incidentally discovered and may be an age related phenomenon or may be a remnant of prior trauma or infection. Multifocal/diffuse cysts can occur with lymphoid interstitial pneumonia, Birt-Hogg-Dubé syndrome, tracheobronchial papillomatosis, or primary and metastatic cancers. Multifocal/diffuse cysts may be associated with nodules (lymphoid interstitial pneumonia, light-chain deposition disease, amyloidosis, and Langerhans cell histiocytosis) or with ground-glass opacities (Pneumocystis jirovecii pneumonia and desquamative interstitial pneumonia). Using the results of the high-resolution CT scans as a starting point, and incorporating the patient's clinical history, physical examination, and laboratory findings, is likely to narrow the differential diagnosis of cystic lesions considerably.
Collapse
Affiliation(s)
| | | | | | | | - Nishant Gupta
- Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati
| | | | - Jeff Galvin
- Department of Radiology, University of Maryland
| | - Mark J Rosen
- Pulmonary, Critical Care and Sleep Medicine, North Shore University Hospital
| | - David Lynch
- Department of Radiology, National Jewish Health
| | - William Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center
| | | | - Richard Lazzaro
- Department of Thoracic Surgery, Lenox Hill Hospital, Northwell Health
| | | |
Collapse
|
41
|
Baik JH, Ko JM, Park HJ. Pitfalls in Radiographic Interpretation of Emphysema Patients. Can Assoc Radiol J 2016; 67:277-83. [PMID: 27147485 DOI: 10.1016/j.carj.2015.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 01/15/2023] Open
Abstract
Emphysema commonly accompanies various complications such as pneumonia. Sometimes, these comorbidities look so strange on images, because destroyed airspaces could change the usual disease progression. So, we demonstrated various cases of common comorbidities with unusual radiographic findings in emphysema patients. Awareness of various findings of emphysema with commonly coexistent diseases may aid in the proper diagnosis and management of emphysema patients.
Collapse
Affiliation(s)
- Jun Hyun Baik
- Department of Radiology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jeong Min Ko
- Department of Radiology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Hyun Jin Park
- Department of Radiology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
| |
Collapse
|
42
|
Ota H, Kawai H, Kuriyama S. The Presence of a Reticulated Trabecula-Like Structure Increases the Risk for the Recurrence of Primary Spontaneous Pneumothorax after Thoracoscopic Bullectomy. Ann Thorac Cardiovasc Surg 2016; 22:139-45. [PMID: 26875751 DOI: 10.5761/atcs.oa.15-00306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Deteriorated alveolar structure at the base of blebs and bullae is known as the reticulated trabecula-like structure. Its clinical significance in primary spontaneous pneumothorax (PSP) remains unclear. This study aimed to investigate the impact of the structure on recurrence of PSP after video-assisted thoracoscopic surgery (VATS) bullectomy. METHODS Between April 2010 and March 2014, 80 cases of PSP in 76 patients who underwent VATS bullectomy using endoscopic staplers were included. The staple line was covered with polyglycolic acid sheets and fibrin glue. Cases were assigned to a normal alveolar structure (NAS) group (n = 54) and a reticulated trabecula-like structure (RT) group (n = 26) based on the histological analysis. Factors associated with recurrence were analysed using logistic regression. RESULTS The reticulated trabecula-like structure was significantly related to apical lung blebs. The recurrence rate of PSP was significantly higher in the RT group than in the NAS group (38.5% vs. 3.7%; P <0.001). On multivariate analysis, the reticulated trabecula-like structure was an independent factor for recurrence of PSP after VATS bullectomy. CONCLUSION The change of alveolar structure at the base of apical lung blebs would increase the risk for recurrence of PSP after VATS bullectomy.
Collapse
Affiliation(s)
- Hideki Ota
- Department of Thoracic Surgery, Akita Red Cross Hospital, Akita, Akita, Japan
| | | | | |
Collapse
|
43
|
Oakes JM, Hofemeier P, Vignon-Clementel IE, Sznitman J. Aerosols in healthy and emphysematous in silico pulmonary acinar rat models. J Biomech 2015; 49:2213-2220. [PMID: 26726781 DOI: 10.1016/j.jbiomech.2015.11.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 11/21/2015] [Indexed: 12/24/2022]
Abstract
There has been relatively little attention given on predicting particle deposition in the respiratory zone of the diseased lungs despite the high prevalence of chronic obstructive pulmonary disease (COPD). Increased alveolar volume and deterioration of alveolar septum, characteristic of emphysema, may alter the amount and location of particle deposition compared to healthy lungs, which is particularly important for toxic or therapeutic aerosols. In an attempt to shed new light on aerosol transport and deposition in emphysematous lungs, we performed numerical simulations in models of healthy and emphysematous acini motivated by recent experimental lobar-level data in rats (Oakes et al., 2014a). Compared to healthy acinar structures, models of emphysematous subacini were created by removing inter-septal alveolar walls and enhancing the alveolar volume in either a homogeneous or heterogeneous fashion. Flow waveforms and particle properties were implemented to match the experimental data. The occurrence of flow separation and recirculation within alveolar cavities was found in proximal generations of the healthy zones, in contrast to the radial-like airflows observed in the diseased regions. In agreement with experimental data, simulations point to particle deposition concentrations that are more heterogeneously distributed in the diseased models compared with the healthy one. Yet, simulations predicted less deposition in the emphysematous models in contrast to some experimental studies, a likely consequence due to the shallower penetration depths and modified flow topologies in disease compared to health. These spatial-temporal particle transport simulations provide new insight on deposition in the emphysematous acini and shed light on experimental observations.
Collapse
Affiliation(s)
- Jessica M Oakes
- Department of Mechanical Engineering, University of California Berkeley, Berkeley, CA 94709,USA; INRIA Paris-Rocquencourt, 78153 Le Chesnay Cedex, France; Sorbonne Universités, UPMC Univ Paris 6, Laboratoire Jacques-Louis Lions, 75252 Paris, France
| | - Philipp Hofemeier
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel
| | - Irene E Vignon-Clementel
- INRIA Paris-Rocquencourt, 78153 Le Chesnay Cedex, France; Sorbonne Universités, UPMC Univ Paris 6, Laboratoire Jacques-Louis Lions, 75252 Paris, France
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel.
| |
Collapse
|
44
|
Sheikh K, Coxson HO, Parraga G. This
is what
COPD
looks like. Respirology 2015; 21:224-36. [DOI: 10.1111/resp.12611] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 06/22/2015] [Accepted: 06/24/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Khadija Sheikh
- Robarts Research Institute London Canada
- Department of Medical BiophysicsThe University of Western Ontario London Canada
| | - Harvey O Coxson
- UBC Centre for Heart Lung InnovationSt. Paul's Hospital Vancouver Canada
- Department of RadiologyUniversity of British Columbia Vancouver Canada
| | - Grace Parraga
- Robarts Research Institute London Canada
- Department of Medical BiophysicsThe University of Western Ontario London Canada
| |
Collapse
|
45
|
Ley-Zaporozhan J, Ley S. [HRCT technique with low-dose protocols for interstitial lung diseases]. Radiologe 2015; 54:1153-8. [PMID: 25427600 DOI: 10.1007/s00117-014-2733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
CLINICAL/METHODICAL ISSUE For optimal visualization of the lung parenchyma a dedicated computed tomography (CT) examination protocol has to be selected. STANDARD RADIOLOGICAL METHODS High resolution CT (HRCT) is the best technique for non-invasive evaluation of the lung parenchyma. ACHIEVEMENTS Given the possibility to examine the complete lungs within one breath hold, assessment of disease severity and distribution is easily possible. Various parameters have to be considered to generate optimal image quality and best possible clinical results. PRACTICAL RECOMMENDATIONS This review article discusses the various image acquisition parameters for HRCT as well as the issue of dose reduction.
Collapse
Affiliation(s)
- J Ley-Zaporozhan
- Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Lindwurmstr. 4, 80337, München, Deutschland,
| | | |
Collapse
|
46
|
Karata H, Tanaka T, Egashira R, Tabata K, Otani K, Hayashi R, Hori T, Fukuoka J. Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema. Int J Chron Obstruct Pulmon Dis 2015; 10:1299-303. [PMID: 26185436 PMCID: PMC4501445 DOI: 10.2147/copd.s83521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We report an educational autopsy case of combined pulmonary fibrosis and emphysema. Radiological patterns of the upper lung were considered as mostly emphysema, but pathological observation revealed significant interstitial fibrosis of usual interstitial pneumonia as a major pathology. The patient eventually developed acute exacerbation of background interstitial pneumonia. Careful radiological and pathological correlation of the current case indicates that regions with distal acinar emphysema on computed tomography image may possess histologically marked dense fibrosis of lethal interstitial pneumonia.
Collapse
Affiliation(s)
- Hiroki Karata
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomonori Tanaka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoko Egashira
- Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan
| | - Kazuhiro Tabata
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kyoko Otani
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryuji Hayashi
- Department of Internal Medicine, University of Toyama, Faculty of Medicine, Toyama, Japan
| | - Takashi Hori
- Laboratory of Pathology, Toyama University Hospital, Toyama, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
47
|
Berman BP, Pandey A, Li Z, Jeffries L, Trouard TP, Oliva I, Cortopassi F, Martin DR, Altbach MI, Bilgin A. Volumetric MRI of the lungs during forced expiration. Magn Reson Med 2015; 75:2295-302. [DOI: 10.1002/mrm.25798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Benjamin P. Berman
- Program in Applied Mathematics; University of Arizona; Tucson Arizona USA
| | - Abhishek Pandey
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona USA
| | - Zhitao Li
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona USA
| | - Lindsie Jeffries
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona USA
| | - Theodore P. Trouard
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona USA
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Isabel Oliva
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Felipe Cortopassi
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Diego R. Martin
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Maria I. Altbach
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| | - Ali Bilgin
- Department of Electrical and Computer Engineering; University of Arizona; Tucson Arizona USA
- Department of Biomedical Engineering; University of Arizona; Tucson Arizona USA
- Department of Medical Imaging; University of Arizona; Tucson Arizona USA
| |
Collapse
|
48
|
Shroff G. Human embryonic stem cells (hESCs) in the treatment of emphysematous COPD: a case report. Clin Case Rep 2015; 3:632-4. [PMID: 26273458 PMCID: PMC4527812 DOI: 10.1002/ccr3.310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/04/2015] [Accepted: 05/13/2015] [Indexed: 12/13/2022] Open
Abstract
Emphysema results in narrowing of the small airways due to inhaling of cigarette smoke and other noxious particles. Oxygen therapy, corticosteroids, and bronchodilators increase the risk of pneumonia, arrhythmia, and fractures in long term. Therapy with human embryonic stem cells resulted in improved symptoms of a patient with emphysema.
Collapse
|
49
|
Barjaktarevic I, Springmeyer S, Gonzalez X, Sirokman W, Coxson HO, Cooper CB. Diffusing Capacity for Carbon Monoxide Correlates Best With Tissue Volume From Quantitative CT Scanning Analysis. Chest 2015; 147:1485-1493. [DOI: 10.1378/chest.14-1693] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
50
|
Zhang WJ, Hubbard Cristinacce PL, Bondesson E, Nordenmark LH, Young SS, Liu YZ, Singh D, Naish JH, Parker GJM. MR Quantitative Equilibrium Signal Mapping: A Reliable Alternative to CT in the Assessment of Emphysema in Patients with Chronic Obstructive Pulmonary Disease. Radiology 2015; 275:579-88. [DOI: 10.1148/radiol.14132953] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|