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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/4007

Title: Fractal dimension in CT low attenuation areas is predictive of long-term oxygen therapy initiation in COPD patients: Results from two observational cohort studies.
Other Titles: CTにおける低吸収領域のフラクタル次元は、COPD患者の長期酸素療法開始を予測する : 2つのコホート研究結果より
Authors: Ibaraki, Takahiro
Tomoda, Koich
Fujioka, Nobuhiro
Sakaguchi, Kazuhiro
Fujita, Yukio
Yamamoto, Yoshifumi
Hontsu, Shigeto
Yamauchi, Motoo
Yoshikawa, Masanori
Tanabe, Naoya
Tanimura, Kazuya
Sato, Susumu
Saeki, Keigo
Muro, Shigeo
Keywords: COPD
Computed tomography
Fractal property
Long term oxygen therapy (LTOT)
Pulmonary function test
Issue Date: Jan-2022
Publisher: Elsevier
Citation: Respiratory investigation Vol.60 No.1 p.137-145 (2022 Jan)
Abstract: Background: Some chronic obstructive pulmonary disease (COPD) patients develop hypoxemia with disease progression, with some even requiring long-term oxygen therapy (LTOT). Lung function, especially diffusing capacity, and the annual decline in PaO₂, are reported to be predictive factors of chronic respiratory failure. However, the association between lung morphometry evaluated using computed tomography (CT) images and LTOT initiation is unknown. Methods: We retrospectively evaluated the relationship between clinical indices, including pulmonary function, body mass index (BMI), and CT parameters, at baseline and LTOT initiation in two prospective COPD cohorts. In the Nara Medical University cohort (n = 76), the low attenuation area (LAA) and its fractal dimension (fractal D) were adapted as the indices for parenchymal destruction in CT images. The association between these CT measurements and LTOT initiation was replicated in the Kyoto University cohort (n = 130). Results: In the Nara Medical University cohort, lower BMI (hazard ratio [HR]:0.70, p = 0.006), lower % diffusing capacity (%DLCO) (HR: 0.92, p = 0.006), lower %DLCO/VA (HR, 0.90, p = 0.008), higher RV/TLC (HR, 1.26, p = 0.012), higher LAA% (HR: 1.18, p = 0.001), and lower fractal D (HR: 3.27 × 10⁻⁸, p < 0.001) were associated with LTOT initiation. Multivariate analysis in the Kyoto University cohort confirmed that lower %DLCO and lower fractal D were independently associated with LTOT initiation, whereas LAA% was not. Conclusion: Fractal D, which is the index for morphometric complexity of LAA in CT analysis, is predictive of LTOT initiation in COPD patients.
Description: 博士(医学)・甲第824号・令和4年3月15日
© 2021 The Authors Published by Elsevier B.V. on behalf of The Japanese Respiratory Society.
URI: http://hdl.handle.net/10564/4007
ISSN: 22125345
DOI: https://doi.org/10.1016/j.resinv.2021.09.001
Academic Degrees and number: 24601A824
Degree-granting date: 2022-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2021年度

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