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Background <p>We compared the capabilities of quantitatively assessed paired inspiratory-expiratory area-detector computed tomography (ADCT) for pulmonary functional loss and disease severity evaluations between upright and supine ADCT in matched progressive pulmonary fibrosis (PPF) patients.</p> Materials and methods <p>This retrospective cohort consisted of age-, sex-, and underlying disease-matched patients with PPF who underwent paired inspiratory-expiratory CT on upright ADCT (<i>n</i> = 40) and supine ADCT (<i>n</i> = 40), pulmonary function tests, and disease severity assessment. Based on CT data, the absolute values of the logarithm of the Jacobian determinant and warp-field magnitude of the whole lung and all lobes were calculated. Stepwise regression analyses were performed.</p> Results <p>On supine ADCT, both indices of the left lower lobe (LLL) were the first and only steps for pulmonary function test results and CT-assessed disease severity (absolute value of the logarithm of the Jacobian determinant: 0.139 ≤ <i>r</i><sup>2</sup> ≤ 0.175, 0.007 ≤ <i>p</i> ≤ 0.018; absolute value of the warp-field magnitude: 0.371 ≤ <i>r</i><sup>2</sup> ≤ 0.447, <i>p</i> &lt; 0.001). However, on upright ADCT, both indices indicated that LLL was the first step and the right lower lobe was the second step for pulmonary function test results and CT-assessed disease severity (0.503 ≤ <i>r</i><sup>2</sup> ≤ 0.674, <i>p</i> &lt; 0.001 or 0.000 &lt; <i>p</i> ≤ 0.006 and 0.474 ≤ <i>r</i><sup>2</sup> ≤ 0.652, 0.002 ≤ <i>p</i> ≤ 0.045, respectively).</p> Conclusion <p>Upright ADCT has equal to or better potential than supine ADCT for detecting pulmonary functional loss and evaluating disease severity when paired inspiratory-expiratory ADCT is applied in PPF patients.</p> Relevance statement <p>Upright ADCT has superior potential to supine ADCT for pulmonary functional loss and disease severity evaluations when paired inspiratory-expiratory ADCT is performed in patients with progressive pulmonary fibrosis (PPF).</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Matched progressive pulmonary fibrosis patients compared functional loss and disease severity evaluations between inspiratory-expiratory upright and supine area-detector CT.</p> </ItemContent> <ItemContent> <p>Clinical parameters demonstrated better correlations with upright than with supine inspiratory-expiratory area-detector CT.</p> </ItemContent> <ItemContent> <p>Warp-field magnitude showed better correlations with disease severities than the logarithm of the Jacobian determinant on each area-detector CT.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>

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Comparison of biomechanical assessment between upright and supine inspiratory-expiratory area-detector CT in progressive pulmonary fibrosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月31日

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  • Yoshiharu Ohno,
  • Kota Aoyagi,
  • Yoshiyuki Ozawa,
  • Masahiko Nomura,
  • Hirona Kimata,
  • Yuya Ito,
  • Kenji Fujii,
  • Takahiro Ueda,
  • Junichiro Araoka,
  • Naruomi Akino,
  • Takeshi Yoshikawa,
  • Daisuke Takenaka,
  • Masahiko Endo,
  • Yasushi Hoshikawa,
  • Hidekata Yasuoka,
  • Tomoya Horiguchi,
  • Yasuhiro Goto,
  • Naozumi Hashimoto,
  • Kazuyoshi Imaizumi

摘要

Background

We compared the capabilities of quantitatively assessed paired inspiratory-expiratory area-detector computed tomography (ADCT) for pulmonary functional loss and disease severity evaluations between upright and supine ADCT in matched progressive pulmonary fibrosis (PPF) patients.

Materials and methods

This retrospective cohort consisted of age-, sex-, and underlying disease-matched patients with PPF who underwent paired inspiratory-expiratory CT on upright ADCT (n = 40) and supine ADCT (n = 40), pulmonary function tests, and disease severity assessment. Based on CT data, the absolute values of the logarithm of the Jacobian determinant and warp-field magnitude of the whole lung and all lobes were calculated. Stepwise regression analyses were performed.

Results

On supine ADCT, both indices of the left lower lobe (LLL) were the first and only steps for pulmonary function test results and CT-assessed disease severity (absolute value of the logarithm of the Jacobian determinant: 0.139 ≤ r2 ≤ 0.175, 0.007 ≤ p ≤ 0.018; absolute value of the warp-field magnitude: 0.371 ≤ r2 ≤ 0.447, p < 0.001). However, on upright ADCT, both indices indicated that LLL was the first step and the right lower lobe was the second step for pulmonary function test results and CT-assessed disease severity (0.503 ≤ r2 ≤ 0.674, p < 0.001 or 0.000 < p ≤ 0.006 and 0.474 ≤ r2 ≤ 0.652, 0.002 ≤ p ≤ 0.045, respectively).

Conclusion

Upright ADCT has equal to or better potential than supine ADCT for detecting pulmonary functional loss and evaluating disease severity when paired inspiratory-expiratory ADCT is applied in PPF patients.

Relevance statement

Upright ADCT has superior potential to supine ADCT for pulmonary functional loss and disease severity evaluations when paired inspiratory-expiratory ADCT is performed in patients with progressive pulmonary fibrosis (PPF).

Key Points

Matched progressive pulmonary fibrosis patients compared functional loss and disease severity evaluations between inspiratory-expiratory upright and supine area-detector CT.

Clinical parameters demonstrated better correlations with upright than with supine inspiratory-expiratory area-detector CT.

Warp-field magnitude showed better correlations with disease severities than the logarithm of the Jacobian determinant on each area-detector CT.

Graphical Abstract