Functional respiratory imaging in relation to classical outcome measures in cystic fibrosis: a cross-sectional study

BMC Pulmonary Medicine

Annemiek Snoeckx¹  Jan De Backer²  Maarten Lanclus²  Wilfried De Backer³  Eline Lauwers⁴  Kim Van Hoorenbeeck⁵  Stijn Verhulst⁵  Kris Ides⁶ 

[1]Department of Radiology, Antwerp University Hospital, Edegem, Belgium

[2]Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

[3]FLUIDDA NV, Kontich, Belgium

[4]FLUIDDA NV, Kontich, Belgium

[5]Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

[6]Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2160, Wilrijk, Belgium

[7]Infla-Med Research Consortium of Excellence, University of Antwerp, Antwerp, Belgium

[8]Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2160, Wilrijk, Belgium

[9]Infla-Med Research Consortium of Excellence, University of Antwerp, Antwerp, Belgium

[10]Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium

[11]Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2160, Wilrijk, Belgium

[12]Infla-Med Research Consortium of Excellence, University of Antwerp, Antwerp, Belgium

[13]Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium

[14]CoSys Research Lab, Faculty of Applied Engineering, University of Antwerp, Antwerp, Belgium

[15]Flanders Make Strategic Research Center, Lommel, Belgium

关键词: Cystic fibrosis;    Chest computed tomography;    Functional respiratory imaging;    Quantitative measures;   

DOI  :  10.1186/s12890-021-01622-3

来源: Springer

【 摘 要 】

BackgroundFunctional Respiratory Imaging (FRI) combines HRCT scans with computational fluid dynamics to provide objective and quantitative information about lung structure and function. FRI has proven its value in pulmonary diseases such as COPD and asthma, but limited studies have focused on cystic fibrosis (CF). This study aims to investigate the relation of multiple FRI parameters to validated imaging parameters and classical respiratory outcomes in a CF population.MethodsCF patients aged > 5 years scheduled for a chest CT were recruited in a cross-sectional study. FRI outcomes included regional airway volume, airway wall volume, airway resistance, lobar volume, air trapping and pulmonary blood distribution. Besides FRI, CT scans were independently evaluated by 2 readers using the CF-CT score. Spirometry and the 6-Minute Walk Test (6MWT) were also performed. Statistical tests included linear mixed-effects models, repeated measures correlations, Pearson and Spearman correlations.Results39 CT scans of 24 (17M/7F) subjects were analyzed. Patients were 24 ± 9 years old and had a ppFEV1 of 71 ± 25% at the time of the first CT. All FRI parameters showed significant low-to-moderate correlations with the total CF-CT score, except for lobar volume. When considering the relation between FRI parameters and similar CF-CT subscores, significant correlations were found between parameters related to airway volume, air trapping and airway wall thickening. Air trapping, lobar volume after normal expiration and pulmonary blood distribution showed significant associations with all spirometric parameters and oxygen saturation at the end of 6MWT. In addition, air trapping was the only parameter related to the distance covered during 6MWT. A subgroup analysis showed considerably higher correlations in patients with mild lung disease (ppFEV1 ≥ 70%) compared to patients with moderate to severe lung disease (ppFEV1 < 70%) when comparing FRI to CF-CT scores.ConclusionsMultiple structural characteristics determined by FRI were associated with abnormalities determined by CF-CT score. Air trapping and pulmonary blood distribution appeared to be the most clinically relevant FRI parameters for CF patients due to their associations with classical outcome measures. The FRI methodology could particularly be of interest for patients with mild lung disease, although this should be confirmed in future research.

【 授权许可】

CC BY