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Objective Quantification of Fibrosis/Inflammatory Process in Patients with Pulmonary Tuberculosis Using X-ray Chest Exams.

Grant number: 15/01948-3
Support type:Scholarships in Brazil - Doctorate
Effective date (Start): September 01, 2015
Effective date (End): April 30, 2017
Field of knowledge:Health Sciences - Medicine - Medical Radiology
Principal Investigator:Diana Rodrigues de Pina Miranda
Grantee:Marcela de Oliveira
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil


It is estimated that each year one death every 10 seconds (about 2 million deaths) in the world is attributed to tuberculosis. The World Health Organization (WHO), since 1993, considers TB a global emergency. TB can cause pleural effusion, atelectasis, pulmonary condensation and even after effective treatment, TB leaves pulmonary sequelae such as fibrosis and emphysema, compromising the quality of life of patients. Evaluations of sequelae above mentioned, are usually subjectively accomplished by radiology specialists. The subjective evaluation may indicate variations between the same observer and between different observers. The radiological changes caused by TB are best viewed in computed tomography images of high resolution (HRCT), with rare computer programs helping more precisely the lung damage (fibrosis and emphysema). However examining x-rays is still the most accomplished diagnostic imaging method in the monitoring of patients diagnosed with TB and of least cost to the institution.The proposal of this research is the objective and accurate quantification of lung areas affected by fibrosis / inflammatory process in patients with pulmonary TB, pre- and post-treatment by two medication regimens (1. RIP: Rifampicin, Isoniazid, Pyrazinamide and 2. RIPE: Rifampicin, Isoniazid, Pyrazinamide and Ethambutol), using x-rays of the chest, to determine which treatment provided less lung damage.This evaluation will be held from new applications on the equivalence between the quantification of fibrosis / inflammatory process between HRCT scans (three-dimensional) and x-rays (planar). Thus it is possible to estimate the radiological findings caused by TB in conventional x-ray examinations, more accurately while compared to the subjective assessment by specialist radiology. To achieve this goal, algorithms will be developed in Matlab environment that classify and quantify these radiological findings between exams. It is still proposal of this research to perform the comparison between serum tests (hemoglobin, hematocrit, albumin, erythrocyte, speed hemosedimentation and C-reactive protein CRP) and pulmonary effort with the degree of impairment (fibrosis / inflammatory process) objectively quantified in this study.This research project has great originality and innovation to objectively quantify the pulmonary involvement of TB patients in two different medication regimens, providing possible degrees of commitment for each treatment and being possible to carry out the correlation between the clinical area and technology, involving the comparison of measurements carried out by the algorithm and the results of tests of pulmonary effort, monitored by serum exams.

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DE OLIVEIRA, MARCELA; DUARTE, SERGIO BARBOSA; GIACOMINI, GUILHERME; MARQUES PEREIRA, PAULO CAMARA; DE SOUZA, LENICE DO ROSARIO; DE ARRUDA MIRANDA, JOSE RICARDO; DE PINA, DIANA RODRIGUES. A lung image reconstruction from computed radiography images as a tool to tuberculosis treatment control. Journal of Venomous Animals and Toxins including Tropical Diseases, v. 25, FEB 14 2019. Web of Science Citations: 0.
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
OLIVEIRA, Marcela de. Quantificação objetiva de fibroseprocesso inflamatório em pacientes com tuberculose pulmonar utilizando exames de raios x de tórax. 2017. Doctoral Thesis - Universidade Estadual Paulista "Júlio de Mesquita Filho" Instituto de Biociências (Campus de Botucatu)..

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