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Per cent low attenuation volume and fractal dimension of low attenuation clusters on CT predict different long-term outcomes in COPD

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Title: Per cent low attenuation volume and fractal dimension of low attenuation clusters on CT predict different long-term outcomes in COPD
Authors: Shimizu, Kaoruko Browse this author →KAKEN DB
Tanabe, Naoya Browse this author →KAKEN DB
Tho, Nguyen Van Browse this author
Suzuki, Masaru Browse this author →KAKEN DB
Makita, Hironi Browse this author →KAKEN DB
Sato, Susumu Browse this author →KAKEN DB
Muro, Shigeo Browse this author →KAKEN DB
Mishima, Michiaki Browse this author →KAKEN DB
Hirai, Toyohiro Browse this author →KAKEN DB
Ogawa, Emiko Browse this author →KAKEN DB
Nakano, Yasutaka Browse this author →KAKEN DB
Konno, Satoshi Browse this author →KAKEN DB
Nishimura, Masaharu Browse this author →KAKEN DB
Keywords: computed tomography
fractal analysis
Issue Date: Feb-2020
Publisher: BMJ Publishing Group
Journal Title: Thorax
Volume: 75
Issue: 2
Start Page: 116
End Page: 122
Publisher DOI: 10.1136/thoraxjnl-2019-213525
Abstract: Background Fractal dimension (D) characterises the size distribution of low attenuation clusters on CT and assesses the spatial heterogeneity of emphysema that per cent low attenuation volume (%LAV) cannot detect. This study tested the hypothesis that %LAV and D have different roles in predicting decline in FEV1, exacerbation and mortality in patients with COPD. Methods Chest inspiratory CT scans in the baseline and longitudinal follow-up records for FEV1, exacerbation and mortality prospectively collected over 10 years in the Hokkaido COPD Cohort Study were examined (n=96). The associations between CT measures and long-term outcomes were replicated in the Kyoto University cohort (n=130). Results In the Hokkaido COPD cohort, higher %LAV, but not D, was associated with a greater decline in FEV1 and 10-year mortality, whereas lower D, but not %LAV, was associated with shorter time to first exacerbation. Multivariable analysis for the Kyoto University cohort confirmed that lower D at baseline was independently associated with shorter time to first exacerbation and that higher LAV% was independently associated with increased mortality after adjusting for age, height, weight, FEV1 and smoking status. Conclusion These well-established cohorts clarify the different prognostic roles of %LAV and D, whereby lower D is associated with a higher risk of exacerbation and higher %LAV is associated with a rapid decline in lung function and long-term mortality. Combination of %LAV and fractal D may identify COPD subgroups at high risk of a poor clinical outcome more sensitively.
Rights: This article has been accepted for publication in [Journal, Year]following peer review, and the Version of Record can be accessed online at c Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 清水 薫子

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