XI International Meeting on Paracoccidioidomycosis

XI International Meeting on Paracoccidioidomycosis

Resume:137-1

Poster (Painel)

137-1

QUANTIFICATION OF PULMONARY FIBROSIS AND EMPHYSEMA IN PARACOCCIDIOIDOMYCOSIS- PATIENTS BY MATHEMATIC ALGORITM

Authors:

Matheus Alvarez (IBB - UNESP - Instituto de Biociencias de Botucatu-UNESP) ; Marcela de Oliveira (IBB - UNESP - Instituto de Biociencias de Botucatu-UNESP) ; Rinaldo Poncio Mendes (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; José Morceli (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; José Ricardo de Arruda Miranda (IBB - UNESP - Instituto de Biociencias de Botucatu-UNESP) ; Daniela Vanessa Moris (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Diana Rodrigues Pina (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP)

Abstract

Introduction. Pulmonary involvement of paracoccidioidomycosis (PCM) usually leads to residual fibrosis and emphysema, despite an efficacious treatment, the latter worsened by smoking, very frequent among our patients. This study aims at a quantitative estimation of fibrosis and pulmonary emphysema in patients with treated PCM. Material and Methods. We studied two male patients with pulmonary involvement by confirmed PCM, one of whom with active untreated disease and the other with lung sequelae, confirmed by a radiologist (JM), and a healthy individual (control), who were submitted to a high resolution CT scan (HRCT) of the chest, in DICOM format, from ICD's HCFMB - UNESP. The radiologist selected the areas of interest (fibrosis, emphysema and normal) to be evaluated by the quantitative method of the algorithm developed in this study. The quantification of the different lung structures, in HRCT, was performed from the Hounsfield scale, which distinguished the attenuation present in the different tissues for the construction of the algorithm developed in MATLAB ® environment. The algorithm compares the results of attenuation of the radiation with matter, between regions with changes (fibrosis and emphysema) and equivalent regions of the normal lung. This procedure was performed in the evaluation of the lung volume, of the three selected individuals. Results. The areas of interest indicated by the algorithm matched those selected by the radiologist as fibrosis and emphysema. The quantification showed 0.11%, 3.7% and 28% of fibrosis, respectively, for the lungs of the healthy control, the patient with active PCM and that one with sequelae. Moreover, emphysema was only detected in the patient with the residual form, quantified as 12.7%. Conclusion. The results show the validity and functionality of the algorithm developed in this study, and it is important to note that small variations of the fibrosis were easily detected by the algorithm. The amount of structures that can be misinterpreted with fibrosis varies among other factors with the amount of collagen present in the vessels, a factor that should be considered in comparing the degree of disease severity in different patients. This methodology brings singular contribution to the scientific community, and can be used in evaluating the evolutionary process of the disease.਀

Keyword: PULMONARY FIBROSIS, EMPHYSEMA, PARACOCCIDIOIDOMYCOSIS

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