tetano
Editor, Senior Moderator
J Thorac Dis
. 2023 Jul 31;15(7):3646-3661.
doi: 10.21037/jtd-22-1488. Epub 2023 Jul 3. COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT
Vincent Geudens[SUP] 1 [/SUP], Jan Van Slambrouck[SUP] 1 [/SUP], Gitte Aerts[SUP] 1 [/SUP], Lynn Willems[SUP] 1 [/SUP], Tinne Goos[SUP] 1 [/SUP], Janne Kaes[SUP] 1 [/SUP], Andrea Zajacova[SUP] 2 [/SUP], Iwein Gyselinck[SUP] 1 [/SUP], Celine Aelbrecht[SUP] 1 [/SUP], Astrid Vermaut[SUP] 1 [/SUP], Hanne Beeckmans[SUP] 1 [/SUP], Marie Vermant[SUP] 1 [/SUP], Charlotte De Fays[SUP] 3 [/SUP], Annelore Sacreas[SUP] 1 [/SUP], Lucia Aversa[SUP] 1 [/SUP], Michaela Orlitova[SUP] 4 [/SUP], Arno Vanstapel[SUP] 1 [/SUP], Ivan Josipovic[SUP] 5 [/SUP], Matthieu N Boone[SUP] 5 [/SUP], John E McDonough[SUP] 6 [/SUP], Birgit Weynand[SUP] 7 [/SUP], Charles Pilette[SUP] 3 [/SUP], Wim Janssens[SUP] 1 [/SUP], Lieven Dupont[SUP] 1 [/SUP], Wim A Wuyts[SUP] 1 [/SUP], Geert M Verleden[SUP] 1 [/SUP], Dirk E Van Raemdonck[SUP] 1 [/SUP], Robin Vos[SUP] 1 [/SUP], Ghislaine Gayan-Ramirez[SUP] 1 [/SUP], Laurens J Ceulemans[SUP] #[/SUP][SUP] 1 [/SUP], Bart M Vanaudenaerde[SUP] #[/SUP][SUP] 1 [/SUP]
Affiliations
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19) which can lead to acute respiratory distress syndrome (ARDS) and evolve to pulmonary fibrosis. Computed tomography (CT) is used to study disease progression and describe radiological patterns in COVID-19 patients. This study aimed to assess disease progression regarding lung volume and density over time on follow-up in vivo chest CT and give a unique look at parenchymal and morphological airway changes in "end-stage" COVID-19 lungs using ex vivo microCT.
Methods: Volumes and densities of the lung/lobes of three COVID-19 patients were assessed using follow-up in vivo CT and ex vivo whole lung microCT scans. Airways were quantified by airway segmentations on whole lung microCT and small-partition microCT. As controls, three discarded healthy donor lungs were used. Histology was performed in differently affected regions in the COVID-19 lungs.
Results: In vivo, COVID-19 lung volumes decreased while density increased over time, mainly in lower lobes as previously shown. Ex vivo COVID-19 lung volumes decreased by 60% and all lobes were smaller compared to controls. Airways were more visible on ex vivo microCT in COVID-19, probably due to fibrosis and increased airway diameter. In addition, small-partition microCT showed more deformation of (small) airway morphology and fibrotic organization in severely affected regions with heterogeneous distributions within the same lung which was confirmed by histology.
Conclusions: COVID-19-ARDS and subsequent pulmonary fibrosis alters lung architecture and airway morphology which is described using in vivo CT, ex vivo microCT, and histology.
Keywords: Airway morphology; coronavirus disease-19 (COVID-19); ex vivo micro-computed tomography (ex vivo microCT); in vivo chest CT; lung density and volume.
. 2023 Jul 31;15(7):3646-3661.
doi: 10.21037/jtd-22-1488. Epub 2023 Jul 3. COVID-19 progression in hospitalized patients using follow-up in vivo CT and ex vivo microCT
Vincent Geudens[SUP] 1 [/SUP], Jan Van Slambrouck[SUP] 1 [/SUP], Gitte Aerts[SUP] 1 [/SUP], Lynn Willems[SUP] 1 [/SUP], Tinne Goos[SUP] 1 [/SUP], Janne Kaes[SUP] 1 [/SUP], Andrea Zajacova[SUP] 2 [/SUP], Iwein Gyselinck[SUP] 1 [/SUP], Celine Aelbrecht[SUP] 1 [/SUP], Astrid Vermaut[SUP] 1 [/SUP], Hanne Beeckmans[SUP] 1 [/SUP], Marie Vermant[SUP] 1 [/SUP], Charlotte De Fays[SUP] 3 [/SUP], Annelore Sacreas[SUP] 1 [/SUP], Lucia Aversa[SUP] 1 [/SUP], Michaela Orlitova[SUP] 4 [/SUP], Arno Vanstapel[SUP] 1 [/SUP], Ivan Josipovic[SUP] 5 [/SUP], Matthieu N Boone[SUP] 5 [/SUP], John E McDonough[SUP] 6 [/SUP], Birgit Weynand[SUP] 7 [/SUP], Charles Pilette[SUP] 3 [/SUP], Wim Janssens[SUP] 1 [/SUP], Lieven Dupont[SUP] 1 [/SUP], Wim A Wuyts[SUP] 1 [/SUP], Geert M Verleden[SUP] 1 [/SUP], Dirk E Van Raemdonck[SUP] 1 [/SUP], Robin Vos[SUP] 1 [/SUP], Ghislaine Gayan-Ramirez[SUP] 1 [/SUP], Laurens J Ceulemans[SUP] #[/SUP][SUP] 1 [/SUP], Bart M Vanaudenaerde[SUP] #[/SUP][SUP] 1 [/SUP]
Affiliations
- PMID: 37559650
- PMCID: PMC10407474
- DOI: 10.21037/jtd-22-1488
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease-19 (COVID-19) which can lead to acute respiratory distress syndrome (ARDS) and evolve to pulmonary fibrosis. Computed tomography (CT) is used to study disease progression and describe radiological patterns in COVID-19 patients. This study aimed to assess disease progression regarding lung volume and density over time on follow-up in vivo chest CT and give a unique look at parenchymal and morphological airway changes in "end-stage" COVID-19 lungs using ex vivo microCT.
Methods: Volumes and densities of the lung/lobes of three COVID-19 patients were assessed using follow-up in vivo CT and ex vivo whole lung microCT scans. Airways were quantified by airway segmentations on whole lung microCT and small-partition microCT. As controls, three discarded healthy donor lungs were used. Histology was performed in differently affected regions in the COVID-19 lungs.
Results: In vivo, COVID-19 lung volumes decreased while density increased over time, mainly in lower lobes as previously shown. Ex vivo COVID-19 lung volumes decreased by 60% and all lobes were smaller compared to controls. Airways were more visible on ex vivo microCT in COVID-19, probably due to fibrosis and increased airway diameter. In addition, small-partition microCT showed more deformation of (small) airway morphology and fibrotic organization in severely affected regions with heterogeneous distributions within the same lung which was confirmed by histology.
Conclusions: COVID-19-ARDS and subsequent pulmonary fibrosis alters lung architecture and airway morphology which is described using in vivo CT, ex vivo microCT, and histology.
Keywords: Airway morphology; coronavirus disease-19 (COVID-19); ex vivo micro-computed tomography (ex vivo microCT); in vivo chest CT; lung density and volume.