Analytic Morphomics Predict Outcomes After Lung Transplantation

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Presentation transcript:

Analytic Morphomics Predict Outcomes After Lung Transplantation Michael J. Pienta, MS, Peng Zhang, PhD, Brian A. Derstine, MS, Binu Enchakalody, MS, William B. Weir, MD, Tyler Grenda, MD, Rebecca Goulson, BS, Rishindra M. Reddy, MD, Andrew C. Chang, MD, Stewart C. Wang, MD, PhD, Jules Lin, MD The Annals of Thoracic Surgery Volume 105, Issue 2, Pages 399-405 (February 2018) DOI: 10.1016/j.athoracsur.2017.08.049 Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

The Annals of Thoracic Surgery 2018 105, 399-405DOI: (10. 1016/j The Annals of Thoracic Surgery 2018 105, 399-405DOI: (10.1016/j.athoracsur.2017.08.049) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Morphomic analysis with the use of standard chest computed tomographies (CTs) that show (A) anatomic indexing of the vertebral levels to create an anatomic coordinate system, (B) lung density (LD) measurements in which LD3 (green) to LD5 (purple) represent areas of increasing density, and (C) visceral and subcutaneous fat area after delineation of skin (purple) and fascia (yellow). The Annals of Thoracic Surgery 2018 105, 399-405DOI: (10.1016/j.athoracsur.2017.08.049) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Receiver operating characteristic curves for initial ventilator support more than 48 hours after transplantation. The full model (blue), including morphomic factors, was better than the clinical model (black) alone at predicting initial ventilator support more than 48 hours (area under receiver operating characteristic 0.786 versus 0.746). The Annals of Thoracic Surgery 2018 105, 399-405DOI: (10.1016/j.athoracsur.2017.08.049) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Receiver operating characteristic curves for air leak more than 5 days. The full model (blue), including morphomic factors, was better than the clinical model (black) alone at predicting air leak more than 5 days (area under receiver operating characteristic 0.893 versus 0.857). The Annals of Thoracic Surgery 2018 105, 399-405DOI: (10.1016/j.athoracsur.2017.08.049) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Scatter plot of the relation between subcutaneous fat area/total body cross-sectional area and body mass index (BMI), demonstrating several patients with low subcutaneous fat/total body cross-sectional area despite having a BMI in the normal range. Vertical lines mark boundaries of BMI categories as follows: <18.5 is underweight, 18.5 to 24.9 is normal weight, 25 to 29.9 is overweight, and greater than 30 is obese. The Annals of Thoracic Surgery 2018 105, 399-405DOI: (10.1016/j.athoracsur.2017.08.049) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions