Automated method of bronchus and artery dimension measurement in an adult bronchiectasis population

Angelina L P Pieters; Qianting Lv; Jennifer J Meerburg; Tjeerd van der Veer; Eleni-Rosalina Andrinopoulou; Pierluigi Ciet; James D Chalmers; Michael R Loebinger; Charles S Haworth; J Stuart Elborn; Harm A W M Tiddens

doi:10.1183/23120541.00231-2024

Automated method of bronchus and artery dimension measurement in an adult bronchiectasis population

ERJ Open Res. 2024 Dec 9;10(6):00231-2024. doi: 10.1183/23120541.00231-2024. eCollection 2024 Nov.

Authors

Angelina L P Pieters^{1

2

3}, Qianting Lv^{1

2

3}, Jennifer J Meerburg^{1

2}, Tjeerd van der Veer⁴, Eleni-Rosalina Andrinopoulou⁵, Pierluigi Ciet^{1

6}, James D Chalmers⁷, Michael R Loebinger^{8

9}, Charles S Haworth^{10

11}, J Stuart Elborn¹², Harm A W M Tiddens^{1

2

13}

Affiliations

¹ Erasmus MC, University Medical Center Rotterdam, Department of Radiology and Nuclear Medicine, Rotterdam, The Netherlands.
² Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatrics, division of Respiratory Medicine and Allergology, Rotterdam, The Netherlands.
³ These authors contributed equally.
⁴ Erasmus MC, University Medical Center Rotterdam, Department of Respiratory Medicine, Rotterdam, The Netherlands.
⁵ Erasmus MC, University Medical Center Rotterdam, Department of Biostatistics. Department of Epidemiology, Rotterdam, The Netherlands.
⁶ Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
⁷ College of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
⁸ Host Defence Unit, Royal Brompton Hospital, London, UK.
⁹ NHLI, Imperial College London, London, UK.
¹⁰ Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge, UK.
¹¹ University of Cambridge, Cambridge, UK.
¹² School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
¹³ Thirona, Nijmegen, The Netherlands.

Abstract

Aim: Bronchiectasis (BE) is a disease defined by irreversible dilatation of the airway. Computed tomography (CT) plays an important role in the detection and quantification of BE. The aim of this study was three-fold: 1) to assess bronchus-artery (BA) dimensions using fully automated software in a cohort of BE disease patients; 2) to compare BA dimensions with semi-quantitative BEST-CT (Bronchiectasis Scoring Technique for CT) scores for BE and bronchial wall thickening; and 3) to explore the structure-function relationship between BA-method lumen dimensions and spirometry outcomes.

Methods: Baseline CTs of BE patients who participated in a clinical trial were collected retrospectively. CTs were analysed manually with the BEST-CT scoring system and automatically using LungQ (v.2.1.0.1, Thirona, The Netherlands), which measures the following BA dimensions: diameters of bronchial outer wall (B_out), bronchial inner wall (B_in) and artery (A), and bronchial wall thickness (B_wt) and computes BA ratios (B_out/A and B_in/A) to assess bronchial widening. To assess bronchial wall thickness, we used the B_wt/A ratio and the ratio between the bronchus wall area (B_wa) and the area defined by the outer airway (B_oa) (B_wa/B_oa).

Results: In total, 65 patients and 16 900 BA pairs were analysed by the automated BA method. The median (range) percentage of BA pairs defined as widened was 69 (55-84)% per CT using a cut-off value of 1.5 for B_out/A, and 53 (42-65)% of bronchial wall were thickened using a cut-off value of 0.14 for B_wt/A. BA dimensions were correlated with comparable outcomes for the BEST-CT scoring method with a correlation coefficient varying between 0.21 to 0.51. The major CT BA determinants of airflow obstruction were bronchial wall thickness (p=0.001) and a narrower bronchial inner diameter (p=0.003).

Conclusion: The automated BA method, which is an accurate and sensitive tool, demonstrates a stronger correlation between visual and automated assessment and lung function when using a higher cut-off value to define bronchiectasis.