Automated detection method of thoracic aorta calcification from non-contrast CT images using mediastinal anatomical label map

Progression of thoracic aortic calcification (TAC) has been shown to be associated with hard cardiovascular events including stroke and all-cause mortality as well as coronary events. In this study, we propose an automated detection method of TACs of non-contrast CT images using mediastinal anatomical label map. This method consists of two steps: (1) the construction of a mediastinal anatomical label map, and (2) the detection of TACs using the intensity and the mediastinal anatomical label map. The proposed method was applied to two non-contrast CT image datasets: 24 cases of chronic thromboembolic pulmonary hypertension (CTEPH) and 100 non-CTEPH cases of low-dose CT screening. The method was compared with two-dimensional U-Nets and the Swin UNETR. The results showed that the method achieved significantly higher F1 score of 0.937 than other methods for the non-CTEPH case dataset (p-value < 0.05, pairwise Wilcoxon signed rank test with Bonferroni correction)

Survey to determine the efficacy and safety of guideline-based pharmacological therapy for chronic obstructive pulmonary disease patients not previously receiving maintenance treatment

<div><p><b><i>Objective:</i></b> To investigate the potential beneficial effects of guideline-based pharmacological therapy on pulmonary function and quality of life (QOL) in Japanese chronic obstructive pulmonary disease (COPD) patients without prior treatment.</p><p><b><i>Research design and methods:</i></b> Multicenter survey, open-label study of 49 Japanese COPD patients aged ≥ 40 years; outpatients with >10 pack years of smoking history; ratio of forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) < 70%; predicted FEV₁ < 80%; treated with bronchodilators and/or inhaled corticosteroids as maintenance therapy until week 48.</p><p><b><i>Main outcome measures:</i></b> The primary endpoint was change in pulmonary function (trough FEV₁, trough FVC); secondary endpoints were QOL and physical activity at 48 weeks after initiation of therapy.</p><p><b><i>Results:</i></b> Airway reversibility was confirmed in untreated patients. Significant changes over time were not observed for FEV₁ and FVC, indicating lung function at initiation of treatment was maintained during the observation period. COPD assessment test scores showed statistical and clinical improvements. Cough, sputum, breathlessness, and shortness of breath were significantly improved.</p><p><b><i>Conclusions:</i></b> Lung function and QOL of untreated Japanese COPD patients improved and improvements were maintained by performing a therapeutic intervention that conformed to published guidelines.</p></div