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タイトル: Quantitative analysis of computed tomography of the lungs in patients with lymphangioleiomyomatosis treated with sirolimus
著者: Ko, Yuki
Asakawa, Katsuaki
Tobino, Kazunori
Oguma, Tsuyoshi  KAKEN_id
Hirai, Toyohiro
Takada, Toshinori
Takahashi, Kazuhisa
Seyama, Kuniaki
著者名の別形: 神, 幸希
朝川, 勝明
飛野, 和則
小熊, 毅
平井, 豊博
高田, 俊範
髙橋, 和久
瀬山, 邦明
キーワード: Respiratory system
Physiology
Women's health
Radiology
Clinical research
Histogram
mTOR inhibitors
Lung density
Skewness
Airflow obstruction
Kurtosis
発行日: Feb-2020
出版者: Elsevier BV
誌名: Heliyon
巻: 6
号: 2
論文番号: e03345
抄録: Objectives: We aimed to study sirolimus-related lung parenchymal changes by quantitative analysis of computed tomography (CT) of the lungs in patients with lymphangioleiomyomatosis (LAM). Methods: We studied 20 participants from the Multicenter Lymphangioleiomyomatosis Sirolimus Trial for Safety study, who had undergone both thin-section CT scans and pulmonary function tests at baseline, 12, and 24 months. Quantitative CT parameters such as CT-derived total lung capacity, percentage of low attenuation area (LAA%), lung density histogram, fractal property of low attenuation area, and airway dimensions were analyzed, and correlations were conducted between the longitudinal change in each quantitative CT measurement and changes in pulmonary function were examined. Among 20 participants, pre-trial (n = 8) and post-trial (n = 16) CT data were also analyzed to deduce pathophysiologic implications of the serial changes in CT parameters during trial periods. Results: FEV1 significantly increased from baseline to 24 months (slope 3.71 ± 1.50 ml/month) whereas FVC didn't during sirolimus therapy. Strikingly, LAA%, and skewness and kurtosis of density histogram significantly increased from baseline to 24 months, while mean and mode CT values significantly decreased from baseline to 24 months. Statistically significant positive correlations were found between ΔFEV1 and Δskewness (r = 0.465, p = 0.045). Taking the changes in lung density during pre-trial period into consideration, sirolimus decreases the area of -800 to -750 Housefield unit (HU) density and inhibits the decrease of -950 to -800 HU area during treatment, then producing the increased LAA% during the trial and post-trial periods. Given few sirolimus-related changes in airway dimensions, possible changes in lung mechanics may have contributed to increased FEV1. Conclusion: Our study suggests that the lung density histogram parameters, kurtosis, and skewness, may be useful as indicators of the efficacy of sirolimus.
著作権等: © 2020 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
URI: http://hdl.handle.net/2433/245755
DOI(出版社版): 10.1016/j.heliyon.2020.e03345
PubMed ID: 32072050
出現コレクション:学術雑誌掲載論文等

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