Three-dimensional image analysis for staging chronic rhinosinusitis

Autor:	Fuad M. Baroody, Jonathan Garneau, Megan K. Ford, Samuel G. Armato, Daniel Thomas Ginat, Michael Ramirez, Sooyoung Lim, Katherine McKeough, Jayant M. Pinto
Rok vydání:	2017
Předmět:	medicine.medical_specialty Imaging biomarker business.industry Chronic rhinosinusitis medicine.disease Tertiary care Spiral computed tomography 03 medical and health sciences 0302 clinical medicine Otorhinolaryngology Quality of life Paranasal Sinus Diseases Immunology and Allergy Medicine Radiology 030223 otorhinolaryngology business Sinusitis 030217 neurology & neurosurgery Disease burden
Zdroj:	International Forum of Allergy & Rhinology. 7:1052-1057
ISSN:	2042-6976
DOI:	10.1002/alr.22014
Popis:	Background Traditional methods of staging chronic rhinosinusitis (CRS) through imaging do not differentiate between degrees of partial mucosal sinus inflammation, thus limiting their utility as imaging biomarkers. We hypothesized that software-aided, quantitative measurement of sinus inflammation would generate a metric of disease burden that would correlate with clinical parameters in patients with suspected sinus disease. Methods Adults with rhinologic complaints undergoing computed tomography imaging were recruited at an urban, academic, tertiary care center (n = 45 with Lund-Mackay [LM] scores ≥4). Three-dimensional (3D) volumetric image analysis was performed using a semiautomated method to obtain a “Chicago-modified Lund-Mackay” (Chicago MLM) score, which provides a continuous scale to quantify extent of opacification. Linear regression was used to test the association of the Chicago MLM score with concurrent symptoms (Total Nasal Symptom Score [TNSS]) and disease-specific quality of life, based on the Sinonasal Outcome Test-22 (SNOT-22). Results Chicago MLM scores were significantly associated with both symptoms (p = 0.037) and disease-specific quality of life (p = 0.007). Inflammation in the ethmoid and sphenoid sinuses appeared to influence these associations. These findings were even more robust when analysis was limited to patients with more severe disease (LM >6). Conclusion The quantitative measurement of sinus inflammation by computer-aided 3D analysis correlates modestly with both symptoms and disease-specific quality of life. Posterior sinuses appear to have the greatest impact on these findings, potentially providing an anatomic target for clinicians to base therapy. The Chicago MLM score is a promising imaging biomarker for clinical and research use.
Databáze:	OpenAIRE
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