Morbidity and Mortality in Patients with Idiopathic Pulmonary Fibrosis Undergoing Diagnostic Surgical Lung Biopsy

Morbidity and Mortality In Patients With Idiopathic Pulmonary Fibrosis Undergoing Diagnostic Surgical Lung Biopsy.Previous studies have shown conflicting results about safety of surgical lung biopsy (SLB) in usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) patients. Study design: we performed a retrospective analysis of all patients who underwent SLB between 2003 and 2013 at the University Hospital of Modena (Italy), to assess morbidity and mortality among patients with UIP/IPF , as compared to patients with other diffuse parenchymal lung diseases (non UIP/IPF). Results: we analyzed 73 patients with (n=29) and without (n=44) UIP/IPF, in which medical history, histology, and survival status were collected. UIP/IPF was diagnosed according to international guidelines. In 59 patients lung biopsy was performed via video-assisted thoracoscopy; in 14 patients thoracotomy was conducted. No intraoperative complications were observed. Postoperative complications were not significantly different between groups and consisted of fever (n=1 in UIP/IPF group; n=4 in non-UIP/IPF group), pneumothorax (n=1 in non-UIP/IPF), pleural effusion (n=1 in non-UIP/IPF), and acute exacerbation (n=1 in both groups, who died). There was no 30-day, 60-day and 90-day mortality. Conclusions: we conclude that surgical lung biopsy can be safely performed in patients with suspected UIP/IPF

A Multicentre Evaluation of Dosiomics Features Reproducibility, Stability and Sensitivity

Dosiomics is a texture analysis method to produce dose features that encode the spatial 3D distribution of radiotherapy dose. Dosiomic studies, in a multicentre setting, require assessing the features’ stability to dose calculation settings and the features’ capability in distinguishing different dose distributions. Dose distributions were generated by eight Italian centres on a shared image dataset acquired on a dedicated phantom. Treatment planning protocols, in terms of planning target volume coverage and dose–volume constraints to the organs at risk, were shared among the centres to produce comparable dose distributions for measuring reproducibility/stability and sensitivity of dosiomic features. In addition, coefficient of variation (CV) was employed to evaluate the dosiomic features’ variation. We extracted 38,160 features from 30 different dose distributions from six regions of interest, grouped by four features’ families. A selected group of features (CV < 3 for the reproducibility/stability studies, CV > 1 for the sensitivity studies) were identified to support future multicentre studies, assuring both stable features when dose distributions variation is minimal and sensitive features when dose distribution variations need to be clearly identified. Dosiomic is a promising tool that could support multicentre studies, especially for predictive models, and encode the spatial and statistical characteristics of the 3D dose distribution