title: Semi-automated Quantification of Lung Density on Chest CT Used as a Predictive Biomarker of Pulmonary Venous Hypertension.
abstract: We sought to determine if lung densities derived from computed tomography scans could be used to identify patients with pulmonary venous hypertension (Group II pulmonary hypertension [PH]), and to compare the performance of this metric with previously described metrics.
  
  
  
  Patients were retrospectively included from a single-center cohort of patients with aortic stenosis being evaluated for transcatheter aortic valve replacement from April 2009 to July 2014. Fifty-four patients met inclusion criteria. Thirty-three had PH (pulmonary arterial pressure [PAP] ≥25 mmHg). Thirty-two had Group II PH (pulmonary capillary wedge pressure [PCWP] ≥15 mmHg). Mean lung density (mLD) was measured from chest computed tomography scans using semi-automated techniques. Aortic diameter (mAo) and main pulmonary artery diameter (mPA) were measured manually. These metrics were correlated with PAP and PCWP values.
  
  
  
  mLD was significantly correlated with PCWP (R = 0.45, P = .0006) and significantly higher in patients with elevated PCWP (P = .006). mPA was weakly correlated with PCWP (R = 0.28, P = .04), but not significantly different in patients with elevated PCWP. mPA/mAo was not significantly correlated with PCWP, nor was it significantly different in patients with elevated PCWP. mLD, mPA, and mPA/mAo were all significantly correlated with PAP and were significantly higher in patients with PH.
  
  
  
  Of all metrics, only mLD was significantly correlated with PCWP and served to differentiate patients with elevated and normal PCWP. As such, mLD may contribute to a noninvasive biomarker of pulmonary venous hypertension.
authors.affiliation: Department of Radiology, Weill Cornell Medical College, 525 E. 68th St., New York, NY 10065.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Dean
authors.affiliation: Department of Radiology, Weill Cornell Medical College, 525 E. 68th St., New York, NY 10065; Department of Cardiology, Weill Cornell Medical College, New York, New York.
authors.forename: Fay
authors.initials: F
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: Polydoros N
authors.initials: PN
authors.lastname: Kampaktsis
authors.affiliation: Department of Pulmonology, Immunology, Allergy and Critical Care, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: M Patricia
authors.initials: MP
authors.lastname: George
authors.affiliation: Department of Health Care Policy and Research, Weill Cornell Medical College, New York, New York.
authors.forename: Ashley
authors.initials: A
authors.lastname: Giambrone
authors.affiliation: Imaging Data Evaluation and Analytics Laboratory (IDEAL), Department of Radiology, Weill Cornell Medical College, New York, New York.
authors.forename: Adrienne B
authors.initials: AB
authors.lastname: Coya
authors.affiliation: Department of Radiology, Weill Cornell Medical College, 525 E. 68th St., New York, NY 10065. Electronic address: juluruk@mskcc.org.
authors.forename: Krishna
authors.initials: K
authors.lastname: Juluru
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Lung density; pulmonary venous hypertension