Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points
Background: Patients with concurrent pulmonary hypertension (PH) and parenchymal lung diseases have a high risk of mortality. However, whether their outcomes are related to low normal lung volume (NLV) resulting from parenchymal lung diseases on chest high-resolution CT (HRCT) imaging remains unknow...
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Elsevier
2024-12-01
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| Series: | CHEST Pulmonary |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S294978922400028X |
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| author | Tadasu Okaya, MD. PhD Ayako Shigeta, MD. PhD Nobuhiro Tanabe, MD. PhD Koichiro Tatsumi, MD. PhD Hajime Yokota, MD. PhD Akira Nishiyama, MD. PhD Akira Naito, MD. PhD Ayumi Sekine Toshihiko Sugiura, MD. PhD Seiichiro Sakao, MD. PhD Takuji Suzuki, MD. PhD |
| author_facet | Tadasu Okaya, MD. PhD Ayako Shigeta, MD. PhD Nobuhiro Tanabe, MD. PhD Koichiro Tatsumi, MD. PhD Hajime Yokota, MD. PhD Akira Nishiyama, MD. PhD Akira Naito, MD. PhD Ayumi Sekine Toshihiko Sugiura, MD. PhD Seiichiro Sakao, MD. PhD Takuji Suzuki, MD. PhD |
| author_sort | Tadasu Okaya, MD. PhD |
| collection | DOAJ |
| description | Background: Patients with concurrent pulmonary hypertension (PH) and parenchymal lung diseases have a high risk of mortality. However, whether their outcomes are related to low normal lung volume (NLV) resulting from parenchymal lung diseases on chest high-resolution CT (HRCT) imaging remains unknown. Research Question: Would NLV on quantitative HRCT imaging affect disease behavior in patients with PH? Study Design and Methods: This retrospective observational study evaluated patients with physician-diagnosed group 1 and group 3 PH among 1,471 patients who underwent right heart catheterization. Using a 3-dimensional image analysis system for HRCT imaging, the percentage of NLV (–950 to –600 Hounsfield units) to the whole lungs (%NLV) was calculated. The optimal cutoff point of %NLV for predicting survival was examined using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method and Cox proportional hazards regression were used to detect the association between %NLV and prognosis. Multivariable logistic regression was performed to examine the association of %NLV with response to pulmonary vasodilators. Results: Overall, 157 patients (mean age, 53.1 ± 17.6 years; sex, n = 111 [70.7%] female patients) were included. ROC curve analysis showed that the optimal cutoff of %NLV for predicting survival was 83.2%. The patients with %NLV of ≥ 83.2% showed significantly higher 5-year survival than that of those with %NLV of < 83.2% (81.7% vs 36.6%; P < .0001). Multivariable logistic regression analysis revealed %NLV of < 83.2% as an independent prognostic factor (hazard ratio, 2.49 [95% CI, 1.14–5.44]; P = .022). Responders showed significantly higher %NLV than nonresponders (90.0 ± 5.1% vs 84.7 ± 9.2%; P = .0002). Multivariable regression analysis showed that only high %NLV predicted response (OR, 1.12 [95% CI, 1.01–1.23]; P = .016). Interpretation: Quantitative CT imaging analysis might allow numerical quantification of the lung condition and vasodilator-treatable area beyond subjective visual assessment in patients with PH. The %NLV could be a novel predictor of prognosis and treatment response in these patients. |
| format | Article |
| id | doaj-art-0ab5a53816964d4c8fe8a87d7eefc0fc |
| institution | DOAJ |
| issn | 2949-7892 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | CHEST Pulmonary |
| spelling | doaj-art-0ab5a53816964d4c8fe8a87d7eefc0fc2025-08-20T03:13:51ZengElsevierCHEST Pulmonary2949-78922024-12-012410006210.1016/j.chpulm.2024.100062Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home PointsTadasu Okaya, MD. PhD0Ayako Shigeta, MD. PhD1Nobuhiro Tanabe, MD. PhD2Koichiro Tatsumi, MD. PhD3Hajime Yokota, MD. PhD4Akira Nishiyama, MD. PhD5Akira Naito, MD. PhD6Ayumi Sekine7Toshihiko Sugiura, MD. PhD8Seiichiro Sakao, MD. PhD9Takuji Suzuki, MD. PhD10Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan; CORRESPONDENCE TO: Ayako ShigetaDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Respiratory Medicine, Chibaken Saiseikai Narashino Hospital, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Radiology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Radiology, Tsudanuma Central General Hospital, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Respiratory Medicine, Graduate School of Medicine, International University of Health and Welfare, Chiba, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, JapanBackground: Patients with concurrent pulmonary hypertension (PH) and parenchymal lung diseases have a high risk of mortality. However, whether their outcomes are related to low normal lung volume (NLV) resulting from parenchymal lung diseases on chest high-resolution CT (HRCT) imaging remains unknown. Research Question: Would NLV on quantitative HRCT imaging affect disease behavior in patients with PH? Study Design and Methods: This retrospective observational study evaluated patients with physician-diagnosed group 1 and group 3 PH among 1,471 patients who underwent right heart catheterization. Using a 3-dimensional image analysis system for HRCT imaging, the percentage of NLV (–950 to –600 Hounsfield units) to the whole lungs (%NLV) was calculated. The optimal cutoff point of %NLV for predicting survival was examined using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method and Cox proportional hazards regression were used to detect the association between %NLV and prognosis. Multivariable logistic regression was performed to examine the association of %NLV with response to pulmonary vasodilators. Results: Overall, 157 patients (mean age, 53.1 ± 17.6 years; sex, n = 111 [70.7%] female patients) were included. ROC curve analysis showed that the optimal cutoff of %NLV for predicting survival was 83.2%. The patients with %NLV of ≥ 83.2% showed significantly higher 5-year survival than that of those with %NLV of < 83.2% (81.7% vs 36.6%; P < .0001). Multivariable logistic regression analysis revealed %NLV of < 83.2% as an independent prognostic factor (hazard ratio, 2.49 [95% CI, 1.14–5.44]; P = .022). Responders showed significantly higher %NLV than nonresponders (90.0 ± 5.1% vs 84.7 ± 9.2%; P = .0002). Multivariable regression analysis showed that only high %NLV predicted response (OR, 1.12 [95% CI, 1.01–1.23]; P = .016). Interpretation: Quantitative CT imaging analysis might allow numerical quantification of the lung condition and vasodilator-treatable area beyond subjective visual assessment in patients with PH. The %NLV could be a novel predictor of prognosis and treatment response in these patients.http://www.sciencedirect.com/science/article/pii/S294978922400028XCT imagingparenchymal lung diseasespulmonary hypertensionquantitative CT |
| spellingShingle | Tadasu Okaya, MD. PhD Ayako Shigeta, MD. PhD Nobuhiro Tanabe, MD. PhD Koichiro Tatsumi, MD. PhD Hajime Yokota, MD. PhD Akira Nishiyama, MD. PhD Akira Naito, MD. PhD Ayumi Sekine Toshihiko Sugiura, MD. PhD Seiichiro Sakao, MD. PhD Takuji Suzuki, MD. PhD Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points CHEST Pulmonary CT imaging parenchymal lung diseases pulmonary hypertension quantitative CT |
| title | Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points |
| title_full | Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points |
| title_fullStr | Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points |
| title_full_unstemmed | Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points |
| title_short | Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary HypertensionTake-home Points |
| title_sort | significance of normal lung volume on quantitative ct imaging analysis in group 1 and group 3 pulmonary hypertensiontake home points |
| topic | CT imaging parenchymal lung diseases pulmonary hypertension quantitative CT |
| url | http://www.sciencedirect.com/science/article/pii/S294978922400028X |
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