Quantitative spectral computed tomography detects different patterns of airway wall thickening and contrast enhancement in infective lung disease: a feasibility study.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2025-06-19 DOI:10.1007/s00330-025-11752-5

Philip Konietzke, Johanna Thomä, Oliver Weinheimer, Thuy D Do, Willi L Wagner, Arndt L Bodenberger, Wolfram Stiller, Tim F Weber, Claus P Heußel, Hans-Ulrich Kauczor, Mark O Wielpütz

{"title":"Quantitative spectral computed tomography detects different patterns of airway wall thickening and contrast enhancement in infective lung disease: a feasibility study.","authors":"Philip Konietzke, Johanna Thomä, Oliver Weinheimer, Thuy D Do, Willi L Wagner, Arndt L Bodenberger, Wolfram Stiller, Tim F Weber, Claus P Heußel, Hans-Ulrich Kauczor, Mark O Wielpütz","doi":"10.1007/s00330-025-11752-5","DOIUrl":null,"url":null,"abstract":"Objectives: We aimed to show that spectral computed tomography (CT) can identify different patterns of airway wall thickening and contrast enhancement in lung-healthy controls, coronavirus disease 2019 (COVID-19), and non-COVID-19 pneumonia patients, reflecting airway inflammation in both pneumonia subtypes and airway neovascularization in COVID-19.Materials and methods: 331 subjects (age 58.9 ± 17.2 years) with 218 arterial and 113 venous phase spectral CT acquisitions were retrospectively recruited: 119 lung-healthy controls, 45 with COVID-19 and 167 with non-COVID-19 pneumonia. Scientific software was used for segmenting the airway tree. Wall thickness (WT5-10) and the difference in median maximum airway wall attenuation (slope of the spectral attenuation curve) between 40 keV and 100 keV display energy were calculated and aggregated for subsegmental airway generations 5-10 (λHU5-10). Descriptive statistics, correlations, t-tests, and ANOVA analyses were performed.Results: Arterial phase WT5-10 was similarly increased in COVID-19 (1.70 ± 0.44 mm) and non-COVID-19 (1.64 ± 0.53 mm) pneumonia compared to controls (1.18 ± 0.34 mm, p < 0.001). Arterial phase λHU5-10 was significantly higher in patients with COVID-19 pneumonia (3.09 ± 2.27 HU/keV) than in non-COVID-19 pneumonia (2.18 ± 1.54 HU/keV, p < 0.01) and lung-healthy controls (2.06 ± 1.11 HU/keV, p < 0.01).Conclusion: Spectral CT shows significant differences in segmental wall thickness and airway contrast enhancement between COVID-19 and non-COVID-19 pneumonia and lung-healthy controls. Airway contrast enhancement may be a feasible measure to detect airway inflammation in pneumonia and neovascularization in COVID-19 pneumonia.Key points: Question Is spectral CT airway contrast enhancement a feasible quantitative method to detect airway inflammation or neovascularisation? Findings Spectral CT shows significant differences in segmental wall thickness and airway contrast enhancement between COVID-19 and non-COVID-19 pneumonia, and lung-healthy controls. Clinical relevance Spectral CT can be used to assess inflammatory airway diseases such as cystic fibrosis, COPD, asthma and bronchiectasis.","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-025-11752-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: We aimed to show that spectral computed tomography (CT) can identify different patterns of airway wall thickening and contrast enhancement in lung-healthy controls, coronavirus disease 2019 (COVID-19), and non-COVID-19 pneumonia patients, reflecting airway inflammation in both pneumonia subtypes and airway neovascularization in COVID-19.

Materials and methods: 331 subjects (age 58.9 ± 17.2 years) with 218 arterial and 113 venous phase spectral CT acquisitions were retrospectively recruited: 119 lung-healthy controls, 45 with COVID-19 and 167 with non-COVID-19 pneumonia. Scientific software was used for segmenting the airway tree. Wall thickness (WT_5-10) and the difference in median maximum airway wall attenuation (slope of the spectral attenuation curve) between 40 keV and 100 keV display energy were calculated and aggregated for subsegmental airway generations 5-10 (λHU_5-10). Descriptive statistics, correlations, t-tests, and ANOVA analyses were performed.

Results: Arterial phase WT_5-10 was similarly increased in COVID-19 (1.70 ± 0.44 mm) and non-COVID-19 (1.64 ± 0.53 mm) pneumonia compared to controls (1.18 ± 0.34 mm, p < 0.001). Arterial phase λHU_5-10 was significantly higher in patients with COVID-19 pneumonia (3.09 ± 2.27 HU/keV) than in non-COVID-19 pneumonia (2.18 ± 1.54 HU/keV, p < 0.01) and lung-healthy controls (2.06 ± 1.11 HU/keV, p < 0.01).

Conclusion: Spectral CT shows significant differences in segmental wall thickness and airway contrast enhancement between COVID-19 and non-COVID-19 pneumonia and lung-healthy controls. Airway contrast enhancement may be a feasible measure to detect airway inflammation in pneumonia and neovascularization in COVID-19 pneumonia.

Key points: Question Is spectral CT airway contrast enhancement a feasible quantitative method to detect airway inflammation or neovascularisation? Findings Spectral CT shows significant differences in segmental wall thickness and airway contrast enhancement between COVID-19 and non-COVID-19 pneumonia, and lung-healthy controls. Clinical relevance Spectral CT can be used to assess inflammatory airway diseases such as cystic fibrosis, COPD, asthma and bronchiectasis.

查看原文本刊更多论文

定量光谱计算机断层扫描检测感染性肺病气道壁增厚和对比增强的不同模式：一项可行性研究。

目的：我们旨在证明CT可以识别肺健康对照组、2019冠状病毒病（COVID-19）和非COVID-19肺炎患者气道壁增厚和造影剂增强的不同模式，反映COVID-19肺炎亚型和气道新生血管的气道炎症。材料与方法：回顾性招募331例（年龄58.9±17.2岁），218例动脉相谱CT显示，113例静脉相谱CT显示，其中119例肺健康对照，45例新冠肺炎，167例非新冠肺炎。采用Scientific软件对气道树进行分割。计算并汇总亚段气道第5-10代（λHU5-10）的壁厚（WT5-10）和40 keV和100 keV显示能量之间的最大气道壁衰减中位数差（光谱衰减曲线斜率）。进行描述性统计、相关性、t检验和方差分析。结果：新冠肺炎（1.70±0.44 mm）和非新冠肺炎（1.64±0.53 mm）患者动脉期WT5-10明显高于对照组（1.18±0.34 mm），新冠肺炎患者（3.09±2.27 HU/keV）明显高于非新冠肺炎（2.18±1.54 HU/keV）。结论：频谱CT显示，新冠肺炎与非新冠肺炎及肺健康对照组在节段壁厚度和气道对比增强方面存在显著差异。气道造影增强可能是检测肺炎气道炎症和COVID-19肺炎新生血管的可行措施。频谱CT气道造影增强是检测气道炎症或新生血管的一种可行的定量方法吗？频谱CT显示，COVID-19肺炎与非COVID-19肺炎及肺健康对照组在肺段壁厚度和气道对比增强上存在显著差异。频谱CT可用于评估炎性气道疾病，如囊性纤维化、慢性阻塞性肺病、哮喘和支气管扩张。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.