Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial

Yuxin Chen; Qianting Lv; the SHIP-CT study group; Eleni Rosalina Andrinopoulou; Leticia Gallardo-Estrella; Jean Paul Charbonnier; Daan Caudri; Stephanie D. Davis; Margaret Rosenfeld; Felix Ratjen; Richard A. Kronmal; Karen D.Hinckley Stukovsky; Stephen Stick; Harm A.W.M. Tiddens

doi:10.1016/j.jcf.2023.05.013

Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial

Yuxin Chen
, Qianting Lv
, the SHIP-CT study group
, Eleni Rosalina Andrinopoulou
, Leticia Gallardo-Estrella
, Jean Paul Charbonnier
, Daan Caudri
, Stephanie D. Davis
, Margaret Rosenfeld
, Felix Ratjen
, Richard A. Kronmal
, Karen D.Hinckley Stukovsky
, Stephen Stick
, Harm A.W.M. Tiddens^*

^*Corresponding author for this work

Thirona
University of North Carolina School of Medicine
Children's Hospital and Regional Medical Center Seattle
University of Toronto
University of Washington
Wal-yan Respiratory Research Centre

Research output: Contribution to journal › Article › Academic › peer-review

22 Citations (Scopus)

136 Downloads (Pure)

Abstract

Background: SHIP-CT showed that 48-week treatment with inhaled 7% hypertonic saline (HS) reduced airway abnormalities on chest CT using the manual PRAGMA-CF method relative to isotonic saline (IS) in children aged 3-6 years with cystic fibrosis (CF). An algorithm was developed and validated to automatically measure bronchus and artery (BA) dimensions of BA-pairs on chest CT. Aim of the study was to assess the effect of HS on bronchial wall thickening and bronchial widening using the BA-analysis. Methods: The BA-analysis (LungQ, version 2.1.0.1, Thirona, Netherlands) automatically segments the bronchial tree and identifies the segmental bronchi (G₀) and distal generations (G₁-G₁₀). Dimensions of each BA-pair are measured: diameters of bronchial outer wall (B_out), bronchial inner wall (B_in), bronchial wall thickness (B_wt), and artery (A). BA-ratios are computed: B_out/A and B_in/A to detect bronchial widening and B_wt/A and B_wa/B_oa (=bronchial wall area/bronchial outer area) to detect bronchial wall thickening. Results: 113 baseline and 102 48-week scans of 115 SHIP-CT participants were analysed. LungQ measured at baseline and 48-weeks respectively 6,073 and 7,407 BA-pairs in the IS-group and 6,363 and 6,840 BA-pairs in the HS-group. At 48 weeks, B_wt/A (mean difference 0.011; 95%CI, 0.0017 to 0.020) and B_wa/B_oa (mean difference 0.030; 95% 0.009 to 0.052) was significantly higher (worse) in the IS-group compared to the HS-group representing more severe bronchial wall thickening in the IS-group (p=0.025 and p=0.019 respectively). B_wt/A and B_wa/B_oa decreased and B_in/A remained stable from baseline to 48 weeks in the HS while it declined in the IS-group (all p<0.001). There was no difference in progression of B_out/A between two treatment groups. Conclusion: The automatic BA-analysis showed a positive impact of inhaled HS on bronchial lumen and wall thickness, but no treatment effect on progression of bronchial widening over 48 weeks.

Original language	English
Pages (from-to)	916-925
Number of pages	10
Journal	Journal of Cystic Fibrosis
Volume	22
Issue number	5
Early online date	26 May 2023
DOIs	https://doi.org/10.1016/j.jcf.2023.05.013
Publication status	Published - Sept 2023

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© 2023

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Chen, Y., Lv, Q., the SHIP-CT study group, Andrinopoulou, E. R., Gallardo-Estrella, L., Charbonnier, J. P., Caudri, D., Davis, S. D., Rosenfeld, M., Ratjen, F., Kronmal, R. A., Stukovsky, K. D. H., Stick, S., & Tiddens, H. A. W. M. (2023). Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial. Journal of Cystic Fibrosis, 22(5), 916-925. https://doi.org/10.1016/j.jcf.2023.05.013

@article{23ae96032f724d4db83d9c57140b96fc,

title = "Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial",

abstract = "Background: SHIP-CT showed that 48-week treatment with inhaled 7\% hypertonic saline (HS) reduced airway abnormalities on chest CT using the manual PRAGMA-CF method relative to isotonic saline (IS) in children aged 3-6 years with cystic fibrosis (CF). An algorithm was developed and validated to automatically measure bronchus and artery (BA) dimensions of BA-pairs on chest CT. Aim of the study was to assess the effect of HS on bronchial wall thickening and bronchial widening using the BA-analysis. Methods: The BA-analysis (LungQ, version 2.1.0.1, Thirona, Netherlands) automatically segments the bronchial tree and identifies the segmental bronchi (G0) and distal generations (G1-G10). Dimensions of each BA-pair are measured: diameters of bronchial outer wall (Bout), bronchial inner wall (Bin), bronchial wall thickness (Bwt), and artery (A). BA-ratios are computed: Bout/A and Bin/A to detect bronchial widening and Bwt/A and Bwa/Boa (=bronchial wall area/bronchial outer area) to detect bronchial wall thickening. Results: 113 baseline and 102 48-week scans of 115 SHIP-CT participants were analysed. LungQ measured at baseline and 48-weeks respectively 6,073 and 7,407 BA-pairs in the IS-group and 6,363 and 6,840 BA-pairs in the HS-group. At 48 weeks, Bwt/A (mean difference 0.011; 95\%CI, 0.0017 to 0.020) and Bwa/Boa (mean difference 0.030; 95\% 0.009 to 0.052) was significantly higher (worse) in the IS-group compared to the HS-group representing more severe bronchial wall thickening in the IS-group (p=0.025 and p=0.019 respectively). Bwt/A and Bwa/Boa decreased and Bin/A remained stable from baseline to 48 weeks in the HS while it declined in the IS-group (all p<0.001). There was no difference in progression of Bout/A between two treatment groups. Conclusion: The automatic BA-analysis showed a positive impact of inhaled HS on bronchial lumen and wall thickness, but no treatment effect on progression of bronchial widening over 48 weeks.",

author = "Yuxin Chen and Qianting Lv and \{the SHIP-CT study group\} and Andrinopoulou, \{Eleni Rosalina\} and Leticia Gallardo-Estrella and Charbonnier, \{Jean Paul\} and Daan Caudri and Davis, \{Stephanie D.\} and Margaret Rosenfeld and Felix Ratjen and Kronmal, \{Richard A.\} and Stukovsky, \{Karen D.Hinckley\} and Stephen Stick and Tiddens, \{Harm A.W.M.\}",

note = "Publisher Copyright: {\textcopyright} 2023",

year = "2023",

month = sep,

doi = "10.1016/j.jcf.2023.05.013",

language = "English",

volume = "22",

pages = "916--925",

journal = "Journal of Cystic Fibrosis",

issn = "1569-1993",

publisher = "Elsevier",

number = "5",

}

Chen, Y, Lv, Q, the SHIP-CT study group, Andrinopoulou, ER, Gallardo-Estrella, L, Charbonnier, JP, Caudri, D, Davis, SD, Rosenfeld, M, Ratjen, F, Kronmal, RA, Stukovsky, KDH, Stick, S & Tiddens, HAWM 2023, 'Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial', Journal of Cystic Fibrosis, vol. 22, no. 5, pp. 916-925. https://doi.org/10.1016/j.jcf.2023.05.013

Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial. / Chen, Yuxin; Lv, Qianting; the SHIP-CT study group et al.
In: Journal of Cystic Fibrosis, Vol. 22, No. 5, 09.2023, p. 916-925.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial

AU - Chen, Yuxin

AU - Lv, Qianting

AU - the SHIP-CT study group

AU - Andrinopoulou, Eleni Rosalina

AU - Gallardo-Estrella, Leticia

AU - Charbonnier, Jean Paul

AU - Caudri, Daan

AU - Davis, Stephanie D.

AU - Rosenfeld, Margaret

AU - Ratjen, Felix

AU - Kronmal, Richard A.

AU - Stukovsky, Karen D.Hinckley

AU - Stick, Stephen

AU - Tiddens, Harm A.W.M.

PY - 2023/9

Y1 - 2023/9

N2 - Background: SHIP-CT showed that 48-week treatment with inhaled 7% hypertonic saline (HS) reduced airway abnormalities on chest CT using the manual PRAGMA-CF method relative to isotonic saline (IS) in children aged 3-6 years with cystic fibrosis (CF). An algorithm was developed and validated to automatically measure bronchus and artery (BA) dimensions of BA-pairs on chest CT. Aim of the study was to assess the effect of HS on bronchial wall thickening and bronchial widening using the BA-analysis. Methods: The BA-analysis (LungQ, version 2.1.0.1, Thirona, Netherlands) automatically segments the bronchial tree and identifies the segmental bronchi (G0) and distal generations (G1-G10). Dimensions of each BA-pair are measured: diameters of bronchial outer wall (Bout), bronchial inner wall (Bin), bronchial wall thickness (Bwt), and artery (A). BA-ratios are computed: Bout/A and Bin/A to detect bronchial widening and Bwt/A and Bwa/Boa (=bronchial wall area/bronchial outer area) to detect bronchial wall thickening. Results: 113 baseline and 102 48-week scans of 115 SHIP-CT participants were analysed. LungQ measured at baseline and 48-weeks respectively 6,073 and 7,407 BA-pairs in the IS-group and 6,363 and 6,840 BA-pairs in the HS-group. At 48 weeks, Bwt/A (mean difference 0.011; 95%CI, 0.0017 to 0.020) and Bwa/Boa (mean difference 0.030; 95% 0.009 to 0.052) was significantly higher (worse) in the IS-group compared to the HS-group representing more severe bronchial wall thickening in the IS-group (p=0.025 and p=0.019 respectively). Bwt/A and Bwa/Boa decreased and Bin/A remained stable from baseline to 48 weeks in the HS while it declined in the IS-group (all p<0.001). There was no difference in progression of Bout/A between two treatment groups. Conclusion: The automatic BA-analysis showed a positive impact of inhaled HS on bronchial lumen and wall thickness, but no treatment effect on progression of bronchial widening over 48 weeks.

AB - Background: SHIP-CT showed that 48-week treatment with inhaled 7% hypertonic saline (HS) reduced airway abnormalities on chest CT using the manual PRAGMA-CF method relative to isotonic saline (IS) in children aged 3-6 years with cystic fibrosis (CF). An algorithm was developed and validated to automatically measure bronchus and artery (BA) dimensions of BA-pairs on chest CT. Aim of the study was to assess the effect of HS on bronchial wall thickening and bronchial widening using the BA-analysis. Methods: The BA-analysis (LungQ, version 2.1.0.1, Thirona, Netherlands) automatically segments the bronchial tree and identifies the segmental bronchi (G0) and distal generations (G1-G10). Dimensions of each BA-pair are measured: diameters of bronchial outer wall (Bout), bronchial inner wall (Bin), bronchial wall thickness (Bwt), and artery (A). BA-ratios are computed: Bout/A and Bin/A to detect bronchial widening and Bwt/A and Bwa/Boa (=bronchial wall area/bronchial outer area) to detect bronchial wall thickening. Results: 113 baseline and 102 48-week scans of 115 SHIP-CT participants were analysed. LungQ measured at baseline and 48-weeks respectively 6,073 and 7,407 BA-pairs in the IS-group and 6,363 and 6,840 BA-pairs in the HS-group. At 48 weeks, Bwt/A (mean difference 0.011; 95%CI, 0.0017 to 0.020) and Bwa/Boa (mean difference 0.030; 95% 0.009 to 0.052) was significantly higher (worse) in the IS-group compared to the HS-group representing more severe bronchial wall thickening in the IS-group (p=0.025 and p=0.019 respectively). Bwt/A and Bwa/Boa decreased and Bin/A remained stable from baseline to 48 weeks in the HS while it declined in the IS-group (all p<0.001). There was no difference in progression of Bout/A between two treatment groups. Conclusion: The automatic BA-analysis showed a positive impact of inhaled HS on bronchial lumen and wall thickness, but no treatment effect on progression of bronchial widening over 48 weeks.

UR - https://www.scopus.com/pages/publications/85160299227

U2 - 10.1016/j.jcf.2023.05.013

DO - 10.1016/j.jcf.2023.05.013

M3 - Article

C2 - 37246053

AN - SCOPUS:85160299227

SN - 1569-1993

VL - 22

SP - 916

EP - 925

JO - Journal of Cystic Fibrosis

JF - Journal of Cystic Fibrosis

IS - 5

ER -

Chen Y, Lv Q, the SHIP-CT study group, Andrinopoulou ER, Gallardo-Estrella L, Charbonnier JP et al. Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial. Journal of Cystic Fibrosis. 2023 Sept;22(5):916-925. Epub 2023 May 26. doi: 10.1016/j.jcf.2023.05.013

Automatic bronchus and artery analysis on chest computed tomography to evaluate the effect of inhaled hypertonic saline in children aged 3-6 years with cystic fibrosis in a randomized clinical trial

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