{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:18:38Z","timestamp":1768447118481,"version":"3.49.0"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To conduct a volumetric and movement analysis of lung parenchyma in prone positioning using deep neural networks (DNNs).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>We included patients with suspected interstitial lung abnormalities or disease who underwent full-inspiratory supine and prone chest CT at a single institution between June 2021 and March 2022. A thoracic radiologist visually assessed the fibrosis extent in the total lung (using units of 10%) on supine CT. After preprocessing the images into 192\u00d7192\u00d7192 resolution, a DNN automatically segmented the whole lung and pulmonary lobes in prone and supine CT images. Affine registration matched the patient\u2019s center and location, and the DNN deformably registered prone and supine CT images to calculate the x-, y-, z-axis, and 3D pixel movements.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In total, 108 CT pairs had successful registration. Prone positioning significantly increased the left lower (90.2\u00b169.5 mL, <jats:italic>P<\/jats:italic> = 0.000) and right lower lobar volumes (52.5\u00b174.2 mL, <jats:italic>P<\/jats:italic> = 0.000). During deformable registration, the average maximum whole-lung pixel movements between the two positions were 1.5, 1.9, 1.6, and 2.8 cm in each axis and 3D plane. Compared to patients with &lt;30% fibrosis, those with \u226530% fibrosis had smaller volume changes (<jats:italic>P<\/jats:italic>&lt;0.001) and smaller pixel movements in all axes between the positions (<jats:italic>P<\/jats:italic> = 0.000\u20130.007). Forced vital capacity (FVC) correlated with the left lower lobar volume increase (Spearman correlation coefficient, 0.238) and the maximum whole-lung pixel movements in all axes (coefficients, 0.311 to 0.357).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Prone positioning led to the preferential expansion of the lower lobes, correlated with FVC, and lung fibrosis limited lung expansion during prone positioning.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299366","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T18:43:36Z","timestamp":1709232216000},"page":"e0299366","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Deep learning segmentation and registration-driven lung parenchymal volume and movement CT analysis in prone positioning"],"prefix":"10.1371","volume":"19","author":[{"given":"Hyungin","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3700-0165","authenticated-orcid":true,"given":"Soon Ho","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"issue":"2","key":"pone.0299366.ref001","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1177\/0885066620980399","article-title":"Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19: A Cohort Study and Analysis of Physiology","volume":"36","author":"MC Shelhamer","year":"2021","journal-title":"Journal of Intensive Care Medicine"},{"issue":"1","key":"pone.0299366.ref002","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.chest.2016.06.032","article-title":"Treatment of ARDS With Prone Positioning.","volume":"151","author":"EL Scholten","year":"2017","journal-title":"Chest"},{"issue":"4","key":"pone.0299366.ref003","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1164\/rccm.200501-004OC","article-title":"Effect of prone position on regional shunt, aeration, and perfusion in experimental acute lung injury","volume":"172","author":"T Richter","year":"2005","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"issue":"23","key":"pone.0299366.ref004","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1056\/NEJMoa1214103","article-title":"Prone Positioning in Severe Acute Respiratory Distress Syndrome.","volume":"368","author":"C Guerin","year":"2013","journal-title":"New England Journal of Medicine"},{"issue":"5","key":"pone.0299366.ref005","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1097\/CCM.0000000000005486","article-title":"Prone Position and COVID-19: Mechanisms and Effects.","volume":"50","author":"L Gattinoni","year":"2022","journal-title":"Critical Care Medicine"},{"issue":"2","key":"pone.0299366.ref006","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1164\/ajrccm.161.2.9810037","article-title":"Effect of the prone position on patients with hydrostatic pulmonary edema compared with patients with acute respiratory distress syndrome and pulmonary fibrosis","volume":"161","author":"G Nakos","year":"2000","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"issue":"10","key":"pone.0299366.ref007","doi-asserted-by":"crossref","first-page":"E1015","DOI":"10.1097\/CCM.0000000000005071","article-title":"Diminishing Efficacy of Prone Positioning With Late Application in Evolving Lung Injury.","volume":"49","author":"Y Xin","year":"2021","journal-title":"Critical Care Medicine"},{"issue":"10","key":"pone.0299366.ref008","doi-asserted-by":"crossref","first-page":"E1001","DOI":"10.1097\/CCM.0000000000005086","article-title":"Prone Positioning of Nonintubated Patients With Coronavirus Disease 2019-A Systematic Review and Meta-Analysis.","volume":"49","author":"MP Reddy","year":"2021","journal-title":"Critical Care Medicine."},{"issue":"1","key":"pone.0299366.ref009","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1148\/radiol.2341030992","article-title":"Acute lung injury: Effects of prone positioning on cephalocaudal distribution of lung inflation\u2014CT assessment in dogs","volume":"234","author":"HJ Lee","year":"2005","journal-title":"Radiology"},{"issue":"1","key":"pone.0299366.ref010","article-title":"Quantitative CT-based image registration metrics provide different ventilation and lung motion patterns in prone and supine positions in healthy subjects","volume":"21","author":"KM Shin","year":"2020","journal-title":"Respiratory Research"},{"key":"pone.0299366.ref011","first-page":"807982","article-title":"Computed Tomography Predictors of Mortality or Disease Progression in Systemic Sclerosis-Interstitial Lung Disease: A Systematic Review.","volume":"8","author":"N Landini","year":"2022","journal-title":"Front Med (Lausanne). Frontiers in Medicine (Lausanne)."},{"issue":"9","key":"pone.0299366.ref012","doi-asserted-by":"crossref","first-page":"E18","DOI":"10.1164\/rccm.202202-0399ST","article-title":"Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline.","volume":"205","author":"G Raghu","year":"2022","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"issue":"3","key":"pone.0299366.ref013","doi-asserted-by":"crossref","first-page":"476","DOI":"10.3348\/kjr.2020.0318","article-title":"Automated Lung Segmentation on Chest Computed Tomography Images with Extensive Lung Parenchymal Abnormalities Using a Deep Neural Network.","volume":"22","author":"SJ Yoo","year":"2021","journal-title":"Korean Journal of Radiology"},{"issue":"5","key":"pone.0299366.ref014","first-page":"1093","article-title":"Positional Therapy and Regional Pulmonary Ventilation High-resolution Alignment of Prone and Supine Computed Tomography Images in a Large Animal Model","volume":"133","author":"Y Xin","year":"2020","journal-title":"Anesthesiology"},{"issue":"12","key":"pone.0299366.ref015","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1164\/rccm.201105-0840OC","article-title":"Forced Vital Capacity in Patients with Idiopathic Pulmonary Fibrosis Test Properties and Minimal Clinically Important Difference","volume":"184","author":"RM du Bois","year":"2011","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"key":"pone.0299366.ref016","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-015-0161-5","article-title":"Change in forced vital capacity and associated subsequent outcomes in patients with newly diagnosed idiopathic pulmonary fibrosis.","volume":"15","author":"WM Reichmann","year":"2015","journal-title":"Bmc Pulmonary Medicine."},{"key":"pone.0299366.ref017","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.rmed.2017.06.013","article-title":"Correlation of pulmonary function and usual interstitial pneumonia computed tomography patterns in idiopathic pulmonary fibrosis.","volume":"129","author":"A Arcadu","year":"2017","journal-title":"Respiratory Medicine."},{"key":"pone.0299366.ref018","article-title":"Lung cancer screening with low-dose CT: Simulating the effect of starting screening at a younger age in women.","volume":"148","author":"YH Du","year":"2022","journal-title":"European Journal of Radiology"},{"issue":"8","key":"pone.0299366.ref019","doi-asserted-by":"crossref","first-page":"3290","DOI":"10.1007\/s00330-017-4739-6","article-title":"Ultralow dose CT for pulmonary nodule detection with chest x-ray equivalent dose\u2014a prospective intra-individual comparative study.","volume":"27","author":"M Messerli","year":"2017","journal-title":"European Radiology."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0299366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T18:43:52Z","timestamp":1709232232000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0299366"}},"subtitle":[],"editor":[{"given":"Vincenzo","family":"Lionetti","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,2,29]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,29]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0299366","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,29]]}}}