Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study

Abstract Background Non-malignant chronic diseases remain a major public health concern. Given the alterations in lipid metabolism and deposition in the lung and its association with fibrotic interstitial lung disease (fILD) and chronic obstructive pulmonary disease (COPD), this study aimed to detec...

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Main Authors: Luca Salhöfer, Mathias Holtkamp, Francesco Bonella, Lale Umutlu, Johannes Wienker, Dirk Westhölter, Matthias Welsner, Christian Taube, Kaid Darwiche, Judith Kohnke, Jannis Straus, Nikolas Beck, Marko Frings, Sebastian Zensen, Rene Hosch, Giulia Baldini, Felix Nensa, Marcel Opitz, Johannes Haubold
Format: Article
Language:English
Published: SpringerOpen 2024-12-01
Series:European Radiology Experimental
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Online Access:https://doi.org/10.1186/s41747-024-00536-z
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author Luca Salhöfer
Mathias Holtkamp
Francesco Bonella
Lale Umutlu
Johannes Wienker
Dirk Westhölter
Matthias Welsner
Christian Taube
Kaid Darwiche
Judith Kohnke
Jannis Straus
Nikolas Beck
Marko Frings
Sebastian Zensen
Rene Hosch
Giulia Baldini
Felix Nensa
Marcel Opitz
Johannes Haubold
author_facet Luca Salhöfer
Mathias Holtkamp
Francesco Bonella
Lale Umutlu
Johannes Wienker
Dirk Westhölter
Matthias Welsner
Christian Taube
Kaid Darwiche
Judith Kohnke
Jannis Straus
Nikolas Beck
Marko Frings
Sebastian Zensen
Rene Hosch
Giulia Baldini
Felix Nensa
Marcel Opitz
Johannes Haubold
author_sort Luca Salhöfer
collection DOAJ
description Abstract Background Non-malignant chronic diseases remain a major public health concern. Given the alterations in lipid metabolism and deposition in the lung and its association with fibrotic interstitial lung disease (fILD) and chronic obstructive pulmonary disease (COPD), this study aimed to detect those alterations using computed tomography (CT)-based analysis of pulmonary fat attenuation volume (CTpfav). Methods This observational retrospective single-center study involved 716 chest CT scans from three subcohorts: control (n = 279), COPD (n = 283), and fILD (n = 154). Fully automated quantification of CTpfav based on lung segmentation and HU-thresholding. The pulmonary fat index (PFI) was derived by normalizing CTpfav to the CT lung volume. Statistical analyses were conducted using Kruskal–Wallis with Dunn’s post hoc tests. Results Patients with fILDs demonstrated a significant increase in CTpfav (median 71.0 mL, interquartile range [IQR] 59.7 mL, p < 0.001) and PFI (median 1.9%, IQR 2.4%, p < 0.001) when compared to the control group (CTpfav median 43.6 mL, IQR 16.94 mL; PFI median 0.9%, IQR 0.5%). In contrast, individuals with COPD exhibited significantly reduced CTpfav (median 36.2 mL, IQR 11.4 mL, p < 0.001) and PFI (median 0.5%, IQR 0.2%, p < 0.001). Conclusion The study underscores the potential of CTpfav and PFI as imaging biomarkers for detecting changes in lung lipid metabolism and deposition and demonstrates a possibility of tracking these alterations in patients with COPD and ILDs. Further research is needed to validate these findings and explore the clinical relevance of CTpfav and PFI in lung disease management. Relevance statement This study introduces a fully automated method for quantifying CTpfav, potentially establishing it as a new imaging biomarker for chronic lung diseases. Key Points This retrospective observational study employed an open-source, automated algorithm for the quantification of CT pulmonary fat attenuation volume (CTpfav). Patients with fibrotic interstitial lung disease (fILD) showed a significantly higher CTpfav and pulmonary fat index (PFI), i.e., CTpfav/CT lung volume, compared to a control group. Patients with chronic obstructive pulmonary disease (COPD) showed significantly lower CTpfav and PFI compared to the control group. CTpfav and PFI may each serve as imaging biomarkers for various lung diseases and warrant further investigation. Graphical Abstract
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spelling doaj-art-e34d3e65c863431fb85afd6cb29239db2025-08-20T02:20:48ZengSpringerOpenEuropean Radiology Experimental2509-92802024-12-01811910.1186/s41747-024-00536-zFully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot studyLuca Salhöfer0Mathias Holtkamp1Francesco Bonella2Lale Umutlu3Johannes Wienker4Dirk Westhölter5Matthias Welsner6Christian Taube7Kaid Darwiche8Judith Kohnke9Jannis Straus10Nikolas Beck11Marko Frings12Sebastian Zensen13Rene Hosch14Giulia Baldini15Felix Nensa16Marcel Opitz17Johannes Haubold18Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenCenter for Interstitial and Rare Lung Diseases, Department of Pneumology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenDepartment of Pneumology, University Hospital EssenDepartment of Pneumology, University Hospital EssenDepartment of Pneumology, University Hospital EssenDepartment of Pneumology, University Hospital EssenDepartment of Pneumology, University Hospital EssenInstitute for Artificial Intelligence in Medicine, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute for Artificial Intelligence in Medicine, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenAbstract Background Non-malignant chronic diseases remain a major public health concern. Given the alterations in lipid metabolism and deposition in the lung and its association with fibrotic interstitial lung disease (fILD) and chronic obstructive pulmonary disease (COPD), this study aimed to detect those alterations using computed tomography (CT)-based analysis of pulmonary fat attenuation volume (CTpfav). Methods This observational retrospective single-center study involved 716 chest CT scans from three subcohorts: control (n = 279), COPD (n = 283), and fILD (n = 154). Fully automated quantification of CTpfav based on lung segmentation and HU-thresholding. The pulmonary fat index (PFI) was derived by normalizing CTpfav to the CT lung volume. Statistical analyses were conducted using Kruskal–Wallis with Dunn’s post hoc tests. Results Patients with fILDs demonstrated a significant increase in CTpfav (median 71.0 mL, interquartile range [IQR] 59.7 mL, p < 0.001) and PFI (median 1.9%, IQR 2.4%, p < 0.001) when compared to the control group (CTpfav median 43.6 mL, IQR 16.94 mL; PFI median 0.9%, IQR 0.5%). In contrast, individuals with COPD exhibited significantly reduced CTpfav (median 36.2 mL, IQR 11.4 mL, p < 0.001) and PFI (median 0.5%, IQR 0.2%, p < 0.001). Conclusion The study underscores the potential of CTpfav and PFI as imaging biomarkers for detecting changes in lung lipid metabolism and deposition and demonstrates a possibility of tracking these alterations in patients with COPD and ILDs. Further research is needed to validate these findings and explore the clinical relevance of CTpfav and PFI in lung disease management. Relevance statement This study introduces a fully automated method for quantifying CTpfav, potentially establishing it as a new imaging biomarker for chronic lung diseases. Key Points This retrospective observational study employed an open-source, automated algorithm for the quantification of CT pulmonary fat attenuation volume (CTpfav). Patients with fibrotic interstitial lung disease (fILD) showed a significantly higher CTpfav and pulmonary fat index (PFI), i.e., CTpfav/CT lung volume, compared to a control group. Patients with chronic obstructive pulmonary disease (COPD) showed significantly lower CTpfav and PFI compared to the control group. CTpfav and PFI may each serve as imaging biomarkers for various lung diseases and warrant further investigation. Graphical Abstracthttps://doi.org/10.1186/s41747-024-00536-zBody compositionLung diseases (interstitial)Lung volume measurementsPulmonary disease (chronic obstructive)Tomography (x-ray computed)
spellingShingle Luca Salhöfer
Mathias Holtkamp
Francesco Bonella
Lale Umutlu
Johannes Wienker
Dirk Westhölter
Matthias Welsner
Christian Taube
Kaid Darwiche
Judith Kohnke
Jannis Straus
Nikolas Beck
Marko Frings
Sebastian Zensen
Rene Hosch
Giulia Baldini
Felix Nensa
Marcel Opitz
Johannes Haubold
Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study
European Radiology Experimental
Body composition
Lung diseases (interstitial)
Lung volume measurements
Pulmonary disease (chronic obstructive)
Tomography (x-ray computed)
title Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study
title_full Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study
title_fullStr Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study
title_full_unstemmed Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study
title_short Fully automatic quantification of pulmonary fat attenuation volume by CT: an exploratory pilot study
title_sort fully automatic quantification of pulmonary fat attenuation volume by ct an exploratory pilot study
topic Body composition
Lung diseases (interstitial)
Lung volume measurements
Pulmonary disease (chronic obstructive)
Tomography (x-ray computed)
url https://doi.org/10.1186/s41747-024-00536-z
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