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Quantitative texture-based analysis of pulmonary parenchymal features on chest CT: comparison with densitometric indices and short-term effect of changes in smoking habit

Chiara Romei, Roberto Castellana, Barbara Conti, Pietro Bemi, Alessandro Taliani, Francesco Pistelli, Ronald A. Karwoski, Laura Carrozzi, Annalisa De Liperi, Brian Bartholmai
European Respiratory Journal 2022 60: 2102618; DOI: 10.1183/13993003.02618-2021
Chiara Romei
1Dept Radiology, 2nd Radiology Unit, Pisa University-Hospital, Pisa, Italy
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  • For correspondence: chiara.romei@gmail.com
Roberto Castellana
2Diagnostic and Interventional Imaging, Pisa University-Hospital, Pisa, Italy
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Barbara Conti
3Dept of Respiratory Medicine, San Luca Hospital, Lucca, Italy
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Pietro Bemi
4Diagnostic Imaging, San Luca Hospital, Lucca, Italy
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Alessandro Taliani
4Diagnostic Imaging, San Luca Hospital, Lucca, Italy
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Francesco Pistelli
5Dept of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
6Cardiothoracic and Vascular Dept, Pisa University Hospital, Pisa, Italy
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  • ORCID record for Francesco Pistelli
Ronald A. Karwoski
7Biomedical Imaging Resource, Mayo Clinic, Rochester, MN, USA
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Laura Carrozzi
5Dept of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
6Cardiothoracic and Vascular Dept, Pisa University Hospital, Pisa, Italy
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Annalisa De Liperi
1Dept Radiology, 2nd Radiology Unit, Pisa University-Hospital, Pisa, Italy
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Brian Bartholmai
8Dept of Radiology, Mayo Clinic, Rochester, MN, USA
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Abstract

Purpose To investigate the correlations between densitometric and Computer Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER)-derived indices of pulmonary emphysema and their change in the short-term period for groups of patients with different smoking habits.

Method This retrospective study included 284 subjects from the ITALUNG trial (198 men and 86 women; mean±sd age 60±4 years) who underwent low-dose chest computed tomography at baseline and 2-year follow-up. Subjects were divided into four groups (persistent smokers, restarters, quitters and former smokers) according to their smoking habit at baseline and follow-up. Densitometric and texture analyses were performed, using CALIPER software. A correlation analysis was conducted between CALIPER-derived low-attenuation areas (LAAs) and densitometric indices, including the 15th percentile of the whole-lung attenuation histogram (Perc15) and the relative areas with density ≤−950 HU (RA950). Densitometric indices and LAAs were evaluated at baseline and variation assessed longitudinally with comparisons between groups with different smoking habit. Further analysis of parenchymal changes per pulmonary zone was performed.

Results LAAs were strongly correlated with Perc15 (rs=0.81; p<0.001) and RA950 (rs=0.905; p<0.001). At baseline, the group of smokers showed higher Perc15, lower RA950, lower LAAs (particularly mild sub-class of LAAs) than the group of ex-smokers (p<0.001). At 2-year follow-up, densitometric indices and LAAs increased in persistent smokers, former smokers and quitters (p<0.05). The progression was larger and statistically more significant in quitters (p<0.001).

Conclusion CALIPER texture analysis provides an objective measure comparable to traditional density/histogram features to assess the lung parenchymal changes in relation to different smoking habits.

Abstract

CALIPER texture analysis provides an objective measure comparable to traditional density/histogram features to assess the lung parenchymal changes in relation to different smoking habits https://bit.ly/3tiIF9a

Footnotes

  • Author contributions: C. Romei and R. Castellana take responsibility for the content of the manuscript, including the data and analysis. C. Romei and B. Bartholmai made substantial contribution to the study concept and design; R. Castellana was responsible for data analysis; C. Romei, R. Castellana, B. Conti, P. Bemi, A. Taliani, F. Pistelli, L. Carrozzi, R.A. Karwoski, A. De Liperi and B. Bartholmai were responsible for significant manuscript writing and/or critical revisions for important intellectual content. All the authors have read and approved the final version of the manuscript.

  • Conflict of interest: B. Bartholmai declares personal fees from Promedior, LLC, and from Imbio, LLC, outside the submitted work. Mayo Clinic has received grants from NIH/NHLBI, fees from Imbio, LLC, and Boehringer Ingelheim outside the submitted work. In addition, B. Bartholmai has a patent for Systems and Methods For Analyzing In Vivo Tissue Volumes Using Medical Imaging pending to Mayo Clinic. R.A. Karwoski declares personal fees from LLC, and from Imbio, LLC, outside the submitted work. The other authors of this manuscript declare no conflict of interest; the authors received no financial support for the research, authorship, and/or publication of this article.

  • Received October 3, 2021.
  • Accepted February 24, 2022.
  • Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
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Quantitative texture-based analysis of pulmonary parenchymal features on chest CT: comparison with densitometric indices and short-term effect of changes in smoking habit
Chiara Romei, Roberto Castellana, Barbara Conti, Pietro Bemi, Alessandro Taliani, Francesco Pistelli, Ronald A. Karwoski, Laura Carrozzi, Annalisa De Liperi, Brian Bartholmai
European Respiratory Journal Oct 2022, 60 (4) 2102618; DOI: 10.1183/13993003.02618-2021

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Quantitative texture-based analysis of pulmonary parenchymal features on chest CT: comparison with densitometric indices and short-term effect of changes in smoking habit
Chiara Romei, Roberto Castellana, Barbara Conti, Pietro Bemi, Alessandro Taliani, Francesco Pistelli, Ronald A. Karwoski, Laura Carrozzi, Annalisa De Liperi, Brian Bartholmai
European Respiratory Journal Oct 2022, 60 (4) 2102618; DOI: 10.1183/13993003.02618-2021
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