Tweet
BMJ Open Respir Res
. 2024 Apr 24;11(1):e002234.
doi: 10.1136/bmjresp-2023-002234. Lung volume measurement using chest CT in COVID-19 patients: a cohort study in Japan
Shiro Otake 1 , Yusuke Shiraishi 2 , Shotaro Chubachi 3 , Naoya Tanabe 2 , Tomoki Maetani 2 , Takanori Asakura 4 , Ho Namkoong 4 , Takashi Shimada 1 , Shuhei Azekawa 1 , Kensuke Nakagawara 1 , Hiromu Tanaka 1 , Takahiro Fukushima 1 , Mayuko Watase 5 , Hideki Terai 1 , Mamoru Sasaki 6 , Soichiro Ueda 6 , Yukari Kato 7 , Norihiro Harada 7 , Shoji Suzuki 8 , Shuichi Yoshida 8 , Hiroki Tateno 8 , Yoshitake Yamada 9 , Masahiro Jinzaki 9 , Toyohiro Hirai 10 , Yukinori Okada 11 12 , Ryuji Koike 13 , Makoto Ishii 14 , Naoki Hasegawa 15 , Akinori Kimura 16 , Seiya Imoto 17 , Satoru Miyano 18 , Seishi Ogawa 19 20 , Takanori Kanai 21 , Koichi Fukunaga 1
Affiliations
Objective: This study aimed to investigate the utility of CT quantification of lung volume for predicting critical outcomes in COVID-19 patients.
Methods: This retrospective cohort study included 1200 hospitalised patients with COVID-19 from 4 hospitals. Lung fields were extracted using artificial intelligence-based segmentation, and the percentage of the predicted (%pred) total lung volume (TLC (%pred)) was calculated. The incidence of critical outcomes and posthospitalisation complications was compared between patients with low and high CT lung volumes classified based on the median percentage of predicted TLCct (n=600 for each). Prognostic factors for residual lung volume loss were investigated in 208 patients with COVID-19 via a follow-up CT after 3 months.
Results: The incidence of critical outcomes was higher in the low TLCct (%pred) group than in the high TLCct (%pred) group (14.2% vs 3.3%, p<0.0001). Multivariable analysis of previously reported factors (age, sex, body mass index and comorbidities) demonstrated that CT-derived lung volume was significantly associated with critical outcomes. The low TLCct (%pred) group exhibited a higher incidence of bacterial infection, heart failure, thromboembolism, liver dysfunction and renal dysfunction than the high TLCct (%pred) group. TLCct (%pred) at 3 months was similarly divided into two groups at the median (71.8%). Among patients with follow-up CT scans, lung volumes showed a recovery trend from the time of admission to 3 months but remained lower in critical cases at 3 months.
Conclusion: Lower CT lung volume was associated with critical outcomes, posthospitalisation complications and slower improvement of clinical conditions in COVID-19 patients.
Keywords: COVID-19; imaging/CT MRI etc.
. 2024 Apr 24;11(1):e002234.
doi: 10.1136/bmjresp-2023-002234. Lung volume measurement using chest CT in COVID-19 patients: a cohort study in Japan
Shiro Otake 1 , Yusuke Shiraishi 2 , Shotaro Chubachi 3 , Naoya Tanabe 2 , Tomoki Maetani 2 , Takanori Asakura 4 , Ho Namkoong 4 , Takashi Shimada 1 , Shuhei Azekawa 1 , Kensuke Nakagawara 1 , Hiromu Tanaka 1 , Takahiro Fukushima 1 , Mayuko Watase 5 , Hideki Terai 1 , Mamoru Sasaki 6 , Soichiro Ueda 6 , Yukari Kato 7 , Norihiro Harada 7 , Shoji Suzuki 8 , Shuichi Yoshida 8 , Hiroki Tateno 8 , Yoshitake Yamada 9 , Masahiro Jinzaki 9 , Toyohiro Hirai 10 , Yukinori Okada 11 12 , Ryuji Koike 13 , Makoto Ishii 14 , Naoki Hasegawa 15 , Akinori Kimura 16 , Seiya Imoto 17 , Satoru Miyano 18 , Seishi Ogawa 19 20 , Takanori Kanai 21 , Koichi Fukunaga 1
Affiliations
- PMID: 38663888
- DOI: 10.1136/bmjresp-2023-002234
Objective: This study aimed to investigate the utility of CT quantification of lung volume for predicting critical outcomes in COVID-19 patients.
Methods: This retrospective cohort study included 1200 hospitalised patients with COVID-19 from 4 hospitals. Lung fields were extracted using artificial intelligence-based segmentation, and the percentage of the predicted (%pred) total lung volume (TLC (%pred)) was calculated. The incidence of critical outcomes and posthospitalisation complications was compared between patients with low and high CT lung volumes classified based on the median percentage of predicted TLCct (n=600 for each). Prognostic factors for residual lung volume loss were investigated in 208 patients with COVID-19 via a follow-up CT after 3 months.
Results: The incidence of critical outcomes was higher in the low TLCct (%pred) group than in the high TLCct (%pred) group (14.2% vs 3.3%, p<0.0001). Multivariable analysis of previously reported factors (age, sex, body mass index and comorbidities) demonstrated that CT-derived lung volume was significantly associated with critical outcomes. The low TLCct (%pred) group exhibited a higher incidence of bacterial infection, heart failure, thromboembolism, liver dysfunction and renal dysfunction than the high TLCct (%pred) group. TLCct (%pred) at 3 months was similarly divided into two groups at the median (71.8%). Among patients with follow-up CT scans, lung volumes showed a recovery trend from the time of admission to 3 months but remained lower in critical cases at 3 months.
Conclusion: Lower CT lung volume was associated with critical outcomes, posthospitalisation complications and slower improvement of clinical conditions in COVID-19 patients.
Keywords: COVID-19; imaging/CT MRI etc.