Three-Dimensional Computed Tomography Measurements of Pulmonary Artery Volumes: Development and Application
Notice bibliographique
Résumé
Chronic obstructive pulmonary disease (COPD) is a major contributor to hospitalizations and healthcare costs in North America. While the hallmark of COPD is airflow limitation, it is also associated with abnormalities of the cardiovascular system. Enlargement of the pulmonary artery (PA) is a morphological marker of pulmonary hypertension, and was previously shown to predict acute exacerbations using a one-dimensional (1D) diameter measurement of the main PA. We hypothesized that a three-dimensional (3D) quantification of PA size would be more sensitive than 1D methods and encompass morphological changes along the entire central PA. Hence, we developed a 3D measurement of the main (MPA), left (LPA) and right (RPA) pulmonary arteries as well as total PA volume (TPA) volume from thoracic x-ray computed tomography (CT) imaging. Three observers performed five repeated measurements for 15 ex-smokers. There was a strong agreement (r2 = 0.76) between PA volume and PA diameter measurements, which was used as the gold standard. Intra-rater measurement reproducibility was evaluated by calculating the coefficient of variation (CV) using five rounds of measurements and revealed excellent agreement (CV < 8%) between measurements. Inter-rater measurement variability was also evaluated using intraclass correlation analysis which revealed strong agreement (ICCMPA=0.98) between observers.\nIn an application of this tool, we sought to explore the relationship between PA volumes and lung structure-function as determined by spirometry, hyperpolarized helium-3 magnetic resonance imaging (MRI) and CT in 124 ex-smokers, with (n=68) and without (n=56) airflow limitation, and in a control group of 35 healthy never-smokers. We observed significantly greater MPA (p=.014), RPA (p=.001) and TPA (p=.003) volumes in ex-smokers with airflow limitation when compared to ex-smokers without airflow limitation. We also observed significantly greater PA volumes in both ex-smoker subgroups when compared with the never-smoker control group. Modest but significant correlations were observed for PA volumes and measurements of lung structure and function. However, this was not observed when analyzing ex-smokers with airflow limitation alone, suggesting that pulmonary artery enlargement may occur secondary to COPD in our subject group. Multivariate zero-inflated Poisson regression analysis revealed TPA volume to be a significant (p=.03) predictor of acute exacerbations of COPD.\nIn conclusion, we developed a reproducible technique for quantifying the volume of the PA. We showed that pulmonary artery enlargement may be secondary to COPD in our subject group. We also showed that total pulmonary artery volume was a significant predictor of COPD exacerbations and could be considered as a biomarker for predicting the occurrence of exacerbation events. Automated measurements of pulmonary artery abnormalities once developed, can be used to further evaluate healthy volunteers and patients with COPD.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».