Journal article
Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes
American journal of respiratory and critical care medicine, Vol.195(7), pp.921-929
04/01/2017
DOI: 10.1164/rccm.201607-1385OC
PMCID: PMC5387708
PMID: 27767347
Abstract
Rationale: Adaptive multiple features method (AMFM) lung texture analysis software recognizes high-resolution computed tomography (HRCT) patterns.
Objectives: To evaluate AMFM and visual quantification of HRCT patterns and their relationship with disease progression in idiopathic pulmonary fibrosis.
Methods: Patients with idiopathic pulmonary fibrosis in a clinical trial of prednisone, azathioprine, and N-acetylcysteine underwent HRCT at study start and finish. Proportion of lung occupied by ground glass, ground glass-reticular (GGR), honeycombing, emphysema, and normal lung densities were measured by AMFM and three radiologists, documenting baseline disease extent and postbaseline change. Disease progression includes composite mortality, hospitalization, and 10% FVC decline.
Measurements and Main Results: Agreement between visual and AMFM measurements was moderate for GGR (Pearson's correlation r = 0.60, P < 0.0001; mean difference = -0.03 with 95% limits of agreement of -0.19 to 0.14). Baseline extent of GGR was independently associated with disease progression when adjusting for baseline Gender-Age-Physiology stage and smoking status (hazard ratio per 10% visual GGR increase = 1.98, 95% confidence interval [CI] = 1.20-3.28,P = 0.008; and hazard ratio per 10% AMFM GGR increase = 1.36, 95% CI = 1.01-1.84, P = 0.04). Postbaseline visual and AMFM GGR trajectories were correlated with postbaseline FVC trajectory (r = -0.30, 95% CI = -0.46 to -0.11, P = 0.002; and r = -0.25, 95% CI = -0.42 to -0.06, P = 0.01, respectively).
Conclusions: More extensive baseline visual and AMFM fibrosis (as measured by GGR'densities) is independently associated with elevated hazard for disease progression. Postbaseline change in AMFM-measured and visually measured GGR densities are modestly correlated with change in FVC. AMFM-measured fibrosis is an automated adjunct to existing prognostic markers and may allow for study enrichment with subjects at increased disease progression risk.
Details
- Title: Subtitle
- Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes
- Creators
- Margaret L. Salisbury - University of Michigan–Ann ArborDavid A. Lynch - University of DenverEdwin J. R. Van Beek - University of EdinburghElla A. Kazerooni - Samuel and Jean Frankel Cardiovascular CenterJunfeng Guo - University of IowaMeng Xia - University of Michigan–Ann ArborSusan Murray - Biostatistical ConsultingKevin J. Anstrom - Duke UniversityEric Yow - Duke UniversityFernando J. Martinez - Cornell UniversityEric A. Hoffman - University of IowaKevin R. Flaherty - University of Michigan–Ann ArborIPFnet Investigators
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.195(7), pp.921-929
- Publisher
- Amer Thoracic Soc
- DOI
- 10.1164/rccm.201607-1385OC
- PMID
- 27767347
- PMCID
- PMC5387708
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Number of pages
- 9
- Grant note
- U10 HL080371; R01 HL091743; T32 HL007749-21; K24 HL111316 / National Institutes of Health/NHLBI; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) K24HL111316 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) P30ES005605 / NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Environmental Health Sciences (NIEHS)
- Language
- English
- Date published
- 04/01/2017
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318717602771
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