Objective quantification of fibrosis / inflammatory process in patients with pulmonary tuberculosis using chest x-ray examinations

Author(s)

Marcela de Oliveira

• Document type: Doctoral Thesis
• Press: Botucatu. 2017-07-04.
• Institution: Universidade Estadual Paulista (Unesp). Instituto de Biociências. Botucatu
• Defense date: 2017-04-17
• Advisor: Diana Rodrigues de Pina; Paulo Câmara Marques Pereira

Abstract

Tuberculosis (TB) is an infectious disease of great concern worldwide. Its etiological agent, Mycobacterium tuberculosis, is the most important mycobacteria species concerning public health. Its etiological agent has increased its resistant to drug treatments, leading to a change in the therapeutic regimens. Since 2009, TB has been treated with four drugs: rifampicin, isoniazid, pyrazinamide and ethambutol (scheme II). Prior to this time, treatment was performed through combination of three drugs: rifampicin, isoniazid, and pyrazinamide (scheme I). X ray exam is the most used diagnostic imaging method to follow-up patients with TB. The objective of this research was the objective quantification of the pulmonary areas affected by tuberculosis using X ray exams and to associate it with serum exams (albumin, erythrocyte sedimentation rate and C-reactive protein) and pulmonary effort in the pre and post-treatment stages of tuberculosis. This procedure of association between the examinations was performed with two anti-tuberculosis regimens (scheme I and II). The objective quantification of pulmonary involvement was performed using a computational algorithm previously developed. The correlation between the objective quantification of pulmonary involvement and serum exams has shown that during the inflammatory process of the disease there is an increase in the pulmonary region affected and had a reduction in lung impairment of 73.23±11.57% and 69.52±17.06% for schemes I and II, respectively. The two medication regimens used in the treatment have the same efficacy, showing no statistically significant difference for the reduction of pulmonary compromise (p>0.05). The degree of functional lung damage (pulmonary effort) was directly proportional to the objective quantification of pulmonary involvement. This research presented a scientific innovation in applying a computational algorithm to objectively quantify the pulmonary involvement of patients with tuberculosis in different treatment regimens and to correlate these results with serum exams and pulmonary effort. (AU)

• FAPESP's process: 15/01948-3 - Objective Quantification of Fibrosis/Inflammatory Process in Patients with Pulmonary Tuberculosis Using X-ray Chest Exams.
• Grantee: Marcela de Oliveira
• Support Opportunities: Scholarships in Brazil - Doctorate