A lung image reconstruction from computed radiography images as a tool to tuberculosis treatment control

 

Marcela de Oliveira¹, Sergio Barbosa Duarte², Guilherme Giacomini¹, Paulo Câmara Marques Pereira³, Lenice do Rosário de Souza³, José Ricardo de Arruda Miranda¹, Diana Rodrigues de Pina³

 

1 Universidade Estadual Paulista, Instituto de Biociências de Botucatu, Departamento de Física e Biofísica, Botucatu, SP, Brasil

2 Centro Brasileiro de Pesquisas Físicas, Departamento de Altas Energias, Rio de Janeiro, RJ, Brasil

3 Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil.

 

ABSTRACT

Background:

Background: Tuberculosis (TB) is an infectious lung disease with high worldwide incidence that severely compromises the quality of life in affected individuals. Clinical tests are currently employed to monitor pulmonary status and treatment progression. The present study aimed to apply a three-dimensional (3D) reconstruction method based on chest radiography to quantify lung-involvement volume of TB acute-phase patients before and after treatment. In addition, these results were compared with indices from conventional clinical exams to show the coincidence level.

 

Methods:

A 3D lung reconstruction method using patient chest radiography was applied to quantify lung-involvement volume using retrospective examinations of 50 patients who were diagnosed with pulmonary TB and treated with two different drugs schemes. Twenty-five patients were treated with Scheme I (rifampicin, isoniazid, and pyrazinamide), whereas twenty-five patients were treated with Scheme II (rifampicin, isoniazid, pyrazinamide, and ethambutol). Acute-phase reaction: Serum exams included C-reactive protein levels, erythrocyte sedimentation rate, and albumin levels. Pulmonary function was tested posttreatment.

 

Results:

We found strong agreement between lung involvement and serum indices pre- and posttreatment. Comparison of the functional severity degree with lung involvement based on 3D image quantification for both treatment schemes found a high correlation.

 

Conclusions:

The present 3D reconstruction method produced a satisfactory agreement with the acute-phase reaction, most notably a higher significance level with the C-reactive protein. We also found a quite reasonable coincidence between the 3D reconstruction method and the degree of functional lung impairment posttreatment. The performance of the quantification method was satisfactory when comparing the two treatment schemes. Thus, the 3D reconstruction quantification method may be useful tools for monitoring TB treatment. The association with serum indices are not only inexpensive and sensitive but also may be incorporated into the assessment of patients during TB treatment.

 

Keywords Tuberculosis; Quantification; Lung involvement; Serum tests; Pulmonary function tests

 

Received: May 11, 2018.

Accepted: October 08, 2018.

 

Correspondence: drpina@fmb.unesp.br

 

Competing interests

The authors declare that they have no competing interests.

 

Authors’ contribution

MO, PCMP and DRP developed the idea for the study. GG developed the algorithm. MO, DRP, SBD, LRS and JRAM analyzed the data. PCMP provided TB patients. MO, SBD, JRAM and DRP wrote the manuscript. All authors read and approved the final manuscript.