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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2022.tde-03012023-105429
Document
Author
Full name
Francisco Aristófanes Coêlho Sarmento Neto
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2022
Supervisor
Committee
Santos, Marcel Koenigkam (President)
Hochhegger, Bruno
Paula, Wagner Diniz de
Title in Portuguese
Avaliação quantitativa automática das tomografias computadorizadas de alta resolução de pacientes com doenças intersticiais pulmonares
Keywords in Portuguese
Análise quantitativa
Doença intersticial pulmonar
Tomografia de alta resolução
Tórax
Abstract in Portuguese
A tomografia computadorizada de alta resolução (TCAR) do tórax tem um papel fundamental na avaliação clínica e manejo das doenças intersticiais pulmonares (DIPs). Este grupo heterogêneo inclui doenças com prognósticos e opções de tratamento bastante diferentes. As ferramentas quantitativas podem auxiliar tanto na propedêutica diagnóstica quanto na avaliação evolutiva, melhorando a caracterização e gradação destas doenças, e aumentando a reprodutibilidade em sua avaliação. Este é um estudo retrospectivo e unicêntrico que avaliou grande quantidade de pacientes em investigação de DIP fibrosante. Inicialmente, foram realizadas releituras das TCARs e classificação dos padrões de doença intersticial segundo o consenso da ATS/ERS/JRS/ALAT de 2018. Em seguida, foi realizada a análise quantitativa das imagens de TCAR pelo programa científico YACTA. Por fim, as variáveis demográficas e clínicas, a distribuição do padrão de fibrose e faveolamento, e as variáveis obtidas com a análise quantitativa realizada pelo programa Yacta foram comparadas entre grupos de DIP segundo o consenso ATS/ERS/JRS/ALAT de 2018 e de acordo com os padrões radiológicos de pneumonia intersticial idiopática. Os dados da análise quantitativa realizada por programa automático demonstraram que os pacientes com padrão radiológico de pneumonia intersticial usual (PIU) pelos critérios ATS/ERS/JRS/ALAT de 2018 apresentaram menor volume pulmonar, maior densidade pulmonar média e maior volume pulmonar vascular absoluto. Dentre os demais padrões tomográficos das pneumopatias intersticiais idiopáticas (PIIs), o padrão de pneumonia intersticial bronquiolocêntrica demonstrou menor volume pulmonar e maior densidade pulmonar média. A doença colagenovascular foi a mais prevalente no estudo. Este estudo auxilia a fortalecer o papel da análise quantitativa da TCAR de tórax, que está se tornando importante ferramenta para complementar a avaliação visual das doenças intersticiais pulmonares e pode fornecer suporte à decisão quanto ao diagnóstico, prognóstico e avaliação longitudinal deste grupo de doenças.
Title in English
Automatic quantitative assessment of high-resolution computed tomography of patients with interstitial lung diseases
Keywords in English
High-resolution tomography
Interstitial lung disease
Quantitative analysis
Thorax
Abstract in English
High-resolution computed tomography (HRCT) of the lungs has a fundamental role in the clinical evaluation and management of interstitial lung diseases (ILDs). This heterogeneous group includes diseases with widely differing prognoses and treatment options. Quantitative analysis can assist in both accurate diagnosis and longitudinal assessment, improving the characterization and gradation of these diseases, and increasing reproducibility in their evaluation. This is a retrospective single-center study that evaluated a large number of patients under investigation for fibrosing ILDs. Initially, were CT scans were re-read and ILD patterns were classified according to the 2018 ATS/ERS/JRS/ALAT consensus. Then, quantitative analysis of HRCT images was performed by the YACTA scientific program. Finally, the demographic and clinical variables, the distribution of fibrosis and honeycombing pattern, and the variables obtained from the quantitative analysis performed by Yacta program were compared between ILDs groups according to the 2018 ATS/ERS/JRS/ALAT consensus and according to the radiological patterns of idiopathic interstitial pneumonia. The data from quantitative analysis performed by automatic program showed that patients with radiological pattern of usual interstitial pneumonia (UIP) by the 2018 ATS/ERS/JRS/ALAT criteria had lower lung volume, higher mean lung density and higher absolute vascular lung volume. Among the tomographic patterns of idiopathic interstitial pneumonias (IIPs), the bronchiolocentric interstitial pneumonia pattern demonstrated smaller lung volume and higher mean lung density. Collagen vascular disease was the most prevalent in the study. This study helps to strengthen the role of quantitative chest HRCT analysis, which is becoming an essencial tool to complement the visual assessment of interstitial lung diseases and may provide decision support regarding diagnosis, prognosis and longitudinal evaluation of this group of diseases.
 
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Publishing Date
2023-01-12
 
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