Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study
Abstract Background Patients with ARDS have heterogeneous lungs which exposes them to the risk of lung injury exacerbation by mechanical ventilation. Functional lung CT imaging gives a comprehensive description of regional lung mechanical behaviour. Here, we investigated whether CT registration-base...
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BMC
2025-05-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-025-03232-7 |
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| author | Mehdi Shekarnabi Alicia Guillien Nicolas Terzi Florian Sigaud Laurent Bitker Emmanuel Roux Touria Ahaouari Eduardo Enrique Dávila Serrano Loic Boussel Gilbert Ferretti Hodane Yonis Mehdi Mezidi Ines Noirot Louis Chauvelot François Dhelft Maxime Gaillet Valérie Siroux Maciej Orkisz Jean-Christophe Richard Sam Bayat |
| author_facet | Mehdi Shekarnabi Alicia Guillien Nicolas Terzi Florian Sigaud Laurent Bitker Emmanuel Roux Touria Ahaouari Eduardo Enrique Dávila Serrano Loic Boussel Gilbert Ferretti Hodane Yonis Mehdi Mezidi Ines Noirot Louis Chauvelot François Dhelft Maxime Gaillet Valérie Siroux Maciej Orkisz Jean-Christophe Richard Sam Bayat |
| author_sort | Mehdi Shekarnabi |
| collection | DOAJ |
| description | Abstract Background Patients with ARDS have heterogeneous lungs which exposes them to the risk of lung injury exacerbation by mechanical ventilation. Functional lung CT imaging gives a comprehensive description of regional lung mechanical behaviour. Here, we investigated whether CT registration-based regional lung function parameters are associated with survival in patients with COVID-ARDS. Methods We conducted a two-centre prospective observational study of adult COVID-ARDS patients with an indication for CT within 72 h of onset. Dual volume CT images were aligned using image-registration. Regional lung functional parameters, and their spatial distributions, were analysed by univariable Cox proportional hazard models with survival as the main outcome. Selected variables based on the univariable analysis were included in a stepwise Cox model adjusted for age, sex, body mass index and SAPSII. Results 94 patients were included in the study. Recruitment was associated with a higher (HR = 1.45, p = 0.023) hazard of death, while apical (sΔVz) and central (sΔVx) displacement of specific volume change centre-of-mass were associated with a lower hazard of death (HR = 0.72, p = 0.041; HR = 0.68, p = 0.031, respectively). Conclusions Our data show that in addition to recruitment, the spatial distribution of specific volume change, a surrogate measure of regional lung ventilation, is associated with the risk of death in mechanically ventilated COVID-19 ARDS patients. Our findings suggest that CT image-registration based functional biomarkers may have prognostic value in COVID-ARDS patients. Trial registration This study was retrospectively registered in Clinical Trials under NCT06113276 ( https://clinicaltrials.gov/study/NCT06113276 ) on 27/10/2023. |
| format | Article |
| id | doaj-art-1e3c7684d89147eaaf25c8d9676a2fbb |
| institution | DOAJ |
| issn | 1465-993X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Respiratory Research |
| spelling | doaj-art-1e3c7684d89147eaaf25c8d9676a2fbb2025-08-20T03:09:20ZengBMCRespiratory Research1465-993X2025-05-012611910.1186/s12931-025-03232-7Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational studyMehdi Shekarnabi0Alicia Guillien1Nicolas Terzi2Florian Sigaud3Laurent Bitker4Emmanuel Roux5Touria Ahaouari6Eduardo Enrique Dávila Serrano7Loic Boussel8Gilbert Ferretti9Hodane Yonis10Mehdi Mezidi11Ines Noirot12Louis Chauvelot13François Dhelft14Maxime Gaillet15Valérie Siroux16Maciej Orkisz17Jean-Christophe Richard18Sam Bayat19Synchrotron Radiation for Biomedicine Laboratory (STROBE), INSERM UA07, Univ. Grenoble AlpesTeam of environmental epidemiology applied to development and respiratory health, Institute for Advanced Biosciences, Univ Grenoble Alpes, Inserm U1209, CNRSService de Médecine Intensive Réanimation, CHU Grenoble-AlpesService de Médecine Intensive Réanimation, CHU Grenoble-AlpesINSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Univ. Lyon, Université Claude Bernard Lyon 1INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Univ. Lyon, Université Claude Bernard Lyon 1Synchrotron Radiation for Biomedicine Laboratory (STROBE), INSERM UA07, Univ. Grenoble AlpesINSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Univ. Lyon, Université Claude Bernard Lyon 1INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Univ. Lyon, Université Claude Bernard Lyon 1Service de Radiologie Diagnostique Et Interventionnelle, Université Grenoble Alpes, CHU Grenoble-AlpesService de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de LyonService de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de LyonService de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de LyonService de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de LyonService de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de LyonService de Médecine Intensive Réanimation, Hôpital de la Croix Rousse, Hospices Civils de LyonTeam of environmental epidemiology applied to development and respiratory health, Institute for Advanced Biosciences, Univ Grenoble Alpes, Inserm U1209, CNRSINSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Univ. Lyon, Université Claude Bernard Lyon 1INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1294, Univ. Lyon, Université Claude Bernard Lyon 1Synchrotron Radiation for Biomedicine Laboratory (STROBE), INSERM UA07, Univ. Grenoble AlpesAbstract Background Patients with ARDS have heterogeneous lungs which exposes them to the risk of lung injury exacerbation by mechanical ventilation. Functional lung CT imaging gives a comprehensive description of regional lung mechanical behaviour. Here, we investigated whether CT registration-based regional lung function parameters are associated with survival in patients with COVID-ARDS. Methods We conducted a two-centre prospective observational study of adult COVID-ARDS patients with an indication for CT within 72 h of onset. Dual volume CT images were aligned using image-registration. Regional lung functional parameters, and their spatial distributions, were analysed by univariable Cox proportional hazard models with survival as the main outcome. Selected variables based on the univariable analysis were included in a stepwise Cox model adjusted for age, sex, body mass index and SAPSII. Results 94 patients were included in the study. Recruitment was associated with a higher (HR = 1.45, p = 0.023) hazard of death, while apical (sΔVz) and central (sΔVx) displacement of specific volume change centre-of-mass were associated with a lower hazard of death (HR = 0.72, p = 0.041; HR = 0.68, p = 0.031, respectively). Conclusions Our data show that in addition to recruitment, the spatial distribution of specific volume change, a surrogate measure of regional lung ventilation, is associated with the risk of death in mechanically ventilated COVID-19 ARDS patients. Our findings suggest that CT image-registration based functional biomarkers may have prognostic value in COVID-ARDS patients. Trial registration This study was retrospectively registered in Clinical Trials under NCT06113276 ( https://clinicaltrials.gov/study/NCT06113276 ) on 27/10/2023.https://doi.org/10.1186/s12931-025-03232-7Acute respiratory distress syndromeSARS-CoV-2Computed tomographyImage registration, lung functional imaging |
| spellingShingle | Mehdi Shekarnabi Alicia Guillien Nicolas Terzi Florian Sigaud Laurent Bitker Emmanuel Roux Touria Ahaouari Eduardo Enrique Dávila Serrano Loic Boussel Gilbert Ferretti Hodane Yonis Mehdi Mezidi Ines Noirot Louis Chauvelot François Dhelft Maxime Gaillet Valérie Siroux Maciej Orkisz Jean-Christophe Richard Sam Bayat Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study Respiratory Research Acute respiratory distress syndrome SARS-CoV-2 Computed tomography Image registration, lung functional imaging |
| title | Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study |
| title_full | Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study |
| title_fullStr | Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study |
| title_full_unstemmed | Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study |
| title_short | Prognostic value of functional CT imaging in COVID-ARDS: a two-centre prospective observational study |
| title_sort | prognostic value of functional ct imaging in covid ards a two centre prospective observational study |
| topic | Acute respiratory distress syndrome SARS-CoV-2 Computed tomography Image registration, lung functional imaging |
| url | https://doi.org/10.1186/s12931-025-03232-7 |
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