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Establishment of non-invasive image assessment method for early detection and therapeutic effect determination of pulmonary hypertension by ultra-high-resolution computed tomography

Research Project

Project/Area Number 20K08048
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 52040:Radiological sciences-related
Research InstitutionShiga University of Medical Science

Principal Investigator

Nagatani Yukihiro  滋賀医科大学, 医学部, 講師 (80402725)

Co-Investigator(Kenkyū-buntansha) 酒井 宏  滋賀医科大学, 医学部, 講師 (00595100)
仲川 宏昭  滋賀医科大学, 医学部, 助教 (70799478)
中山 良平  立命館大学, 理工学部, 教授 (20402688)
Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2022: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2021: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2020: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
Keywords肺高血圧症 / 超高精細CT / 膠原病関連間質性肺炎 / 平均小血管断面積 / 超高精CT / 膠原病 / 間質性肺炎 / 逐次近似再構成 / 血管拡張薬 / 人工知能
Outline of Research at the Start

肺高血圧症は、治療手段や選択肢が増加し生命予後が改善されつつある疾患であるが、さらなる予後改善にむけ早期診断の重要性が高まっている。本研究では、前段階から重症例まで様々な程度の肺高血圧症患者の超高精細CT画像データを解析することにより、「肺高血圧症における早期診断並び に治療効果判定の非侵襲的かつ客観的な画像評価モダリティー」の確立を目指す。

Outline of Final Research Achievements

Normal-resolution simulated images (NRsim) were generated based on super high-resolution (SHR)images obtained in clinical examinations in 11 pulmonary hypertension (PH), 9 connective tissue disease-related interstitial lung disease without PD(CTD-IP), and 11 control subjects(CS). By using binarized image data with a threshold of -720 HU, the percentage of the cross-sectional area of pulmonary small vessel area (%CSA) and average vessel dimension(AVD) for pulmonary small vessels with 0 to 5 mm2 were measured in the predefined three trans-axial planes including the aortic arch, tracheal bifurcation and the orifice of the right pulmonary inferior vein. On SHR images, %CSA of 2 to 5 mm2 in PH tended to be smaller than CTD-IP, in addition, AVD of 0 to 2 mm2 in PH was smaller as compared with CS, and demonstrated to have a negative strong correlation with systolic as well as mean pulmonary artery pressure. In contrast, no significant association was found on NRsim images.

Academic Significance and Societal Importance of the Research Achievements

一般的な胸部CTの際の放射線被曝(約9.4mSv)を下回る線量下の超高精細CTでえられた胸部CTデータの最適な二値化画像での平均血管断面積が、対照群と比較し、肺高血圧症で小さく、肺高血圧症が中等度・高度となるにつれて小さくなったという結果は、非侵襲的な診断モダリティーである超高精細CTが、肺野微小動脈のリモデリングを直接的に評価できる可能性を示したものであり、非常に有用と考えられる。肺高血圧症多岐にわたる病因から生じる病態であるため、今後さらなる症例の蓄積により、確立された評価指標となれば、臨床的な意義は非常に高いと考えられる。

Report

(5 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (1 results)

All 2023

All Presentation (1 results) (of which Int'l Joint Research: 1 results)

  • [Presentation] Diagnostic ability for the presence and severity of pulmonary hypertension on super-high-resolution non-enhanced chest computed tomography2023

    • Author(s)
      Yukihiro Nagatani M.D. 1), Hiroshi Sakai M.D. PhD. 2) , Hiroaki Nakagawa M.D. PhD. 3) Ryo Uemura M.D.1), Noritoshi Ushio R.T. 1), Yoshiyuki Watanabe M.D. PhD. 1)
    • Organizer
      Radiological Society of North America
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research

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Published: 2020-04-28   Modified: 2025-01-30  

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