Observational studyBMC pulmonary medicine2018
Fractal analysis of low attenuation clusters on computed tomography in chronic obstructive pulmonary disease.
Observational study in BMC pulmonary medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 22 citations in OpenAlex.
- Article
- Automated Segmentation and Measurements of Pulmonary Cysts in Lymphangioleiomyomatosis across Multiple CT Scanner Platforms over a Period of Two Decades.Bioengineering (Basel, Switzerland) · 2023Article
- Energy expenditure and physical activity in COPD by doubly labelled water method and an accelerometer.ERJ open research · 2021Article
- Distinguishing Adenocarcinomas from Granulomas in the CT scan of the chest: performance degradation evaluation in the automatic segmentation framework.BMC research notes · 2021Article
- Multifractal based image processing for estimating the complexity of COVID-19 dynamics.The European physical journal. Special topics · 2021Article
- Fractal Analysis of Lung Structure in Chronic Obstructive Pulmonary Disease.Frontiers in physiology · 2020Review
- Radiomic measures from chest high-resolution computed tomography associated with lung function in sarcoidosis.The European respiratory journal · 2019Article
- Associations of airway tree to lung volume ratio on computed tomography with lung function and symptoms in chronic obstructive pulmonary disease.Respiratory research · 2019Observational
- Annual Body Weight Change and Prognosis in Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary diseaseArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe fractal dimension characterizing the cumulative size distribution of low attenuation area (LAA) clusters, identified with a fixed threshold such as - 950 Hounsfield Units (HU), on computed tomography (CT) sensitively detects parenchymal destruction in chronic obstructive pulmonary disease (COPD) even when the percent LAA (LAA%), a standard emphysema index, is unchanged. This study examines whether the cumulative size distribution of LAA clusters, defined with thresholds of the 15th, 25th, and 35th percentiles of a CT density histogram instead of the fixed-threshold of - 950 HU, exhibits a fractal property and whether its fractal dimension (D'15, D'25, and D'35, respectively) provides additional structural information in emphysematous lungs that is difficult to detect with the conventional - 950-HU-based fractal dimension (D950).
methodsChest inspiratory CT scans and pulmonary functions were cross-sectionally examined in 170 COPD subjects. A proxy for the inspiration level at CT scan was obtained by dividing CT-measured total lung volume (CT-TLV) by physiologically measured total lung capacity. Moreover, long-term (> 5 years) changes in D950 and the new fractal dimensions were longitudinally evaluated in 17 current and 42 former smokers with COPD.
resultsD950, but not D'15, D'25, or D'35 was weakly correlated with the proxy for the inspiration. D950, D'25, and D'35 but not D'15 correlated with LAA% and diffusion capacity. In the long-term longitudinal study, LAA% was increased and D950 and D'35 were decreased in both current and former smokers, while D'25 was decreased only in current smokers and D'15 was not changed in either group. The longitudinal changes in D'25 but not those in LAA%, D950, D'15, and D'35 were greater in current smokers than in former smokers. This greater change in D'25 in current smokers was confirmed after adjusting the change in CT-TLV and the baseline D'25.
conclusionsD'25 reflects diffusion capacity in emphysematous lungs and is robust against inspiration levels during CT scans. This new fractal dimension might provide additional structural information that is difficult to detect with the conventional D950 and LAA% and allow for more sensitive evaluation of emphysema progression over time.
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