Diagnostics (Jul 2024)

Evaluation of Progressive Architectural Distortion in Idiopathic Pulmonary Fibrosis Using Deformable Registration of Sequential CT Images

  • Naofumi Yasuda,
  • Tae Iwasawa,
  • Tomohisa Baba,
  • Toshihiro Misumi,
  • Shihyao Cheng,
  • Shingo Kato,
  • Daisuke Utsunomiya,
  • Takashi Ogura

DOI
https://doi.org/10.3390/diagnostics14151650
Journal volume & issue
Vol. 14, no. 15
p. 1650

Abstract

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Background: Monitoring the progression of idiopathic pulmonary fibrosis (IPF) using CT primarily focuses on assessing the extent of fibrotic lesions, without considering the distortion of lung architecture. Objectives: To evaluate three-dimensional average displacement (3D-AD) quantification of lung structures using deformable registration of serial CT images as a parameter of local lung architectural distortion and predictor of IPF prognosis. Materials and Methods: Patients with IPF evaluated between January 2016 and March 2017 who had undergone CT at least twice were retrospectively included (n = 114). The 3D-AD was obtained by deformable registration of baseline and follow-up CT images. A computer-aided quantification software measured the fibrotic lesion volume. Cox regression analysis evaluated these variables to predict mortality. Results: The 3D-AD and the fibrotic lesion volume change were significantly larger in the subpleural lung region (5.2 mm (interquartile range (IQR): 3.6–7.1 mm) and 0.70% (IQR: 0.22–1.60%), respectively) than those in the inner region (4.7 mm (IQR: 3.0–6.4 mm) and 0.21% (IQR: 0.004–1.12%), respectively). Multivariable logistic analysis revealed that subpleural region 3D-AD and fibrotic lesion volume change were independent predictors of mortality (hazard ratio: 1.12 and 1.23; 95% confidence interval: 1.02–1.22 and 1.10–1.38; p = 0.01 and p < 0.001, respectively). Conclusions: The 3D-AD quantification derived from deformable registration of serial CT images serves as a marker of lung architectural distortion and a prognostic predictor in patients with IPF.

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