{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T12:58:29Z","timestamp":1787403509070,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Treatment monitoring in pulmonary tuberculosis increasingly requires assessment of residual inflammatory burden and structural lung damage beyond microbiologic response alone. High-resolution computed tomography (HRCT) can provide this information, but interpretation of serial examinations is time-consuming and partly subjective. This study did not aim to evaluate AI for the diagnosis of pulmonary tuberculosis. Instead, it explored whether artificial intelligence (AI)-assisted quantitative HRCT analysis could support longitudinal assessment of treatment-related imaging changes in patients with microbiologically confirmed pulmonary tuberculosis. Methods: We conducted a retrospective, single-center, exploratory longitudinal study of patients receiving treatment for pulmonary tuberculosis. HRCT examinations acquired at diagnosis and during follow-up were anonymized, reviewed by an expert thoracic radiologist, and processed using AVIEW Lung Texture (Coreline Soft v2.0). The software quantified total lung volume and six predefined parenchymal categories: normal lung, ground-glass opacity, consolidation, reticulation, honeycombing, and emphysema. Results: Ninety-six patients contributed 256 HRCT examinations. The most frequent software-detected abnormalities were ground-glass opacity, consolidation, and emphysema-labeled low-attenuation areas. Ground-glass opacity and consolidation showed the clearest decline across serial examinations, consistent with regression of active inflammatory disease during treatment. Reticulation showed a heterogeneous course, likely reflecting both inflammatory resolution and residual structural remodeling. Honeycombing was infrequent and quantitatively limited. Lung volume changed variably and did not consistently parallel visual improvement. A key methodological limitation was the absence of a dedicated cavity class. As a result, emphysema-labeled low-attenuation areas should not be interpreted as conventional emphysema alone, because tuberculous cavities and post-destructive abnormalities were frequently included in this category. Conclusions: AI-assisted HRCT quantification may support longitudinal assessment of pulmonary tuberculosis by providing structured and reproducible measures of interval change. However, tuberculosis-specific interpretation remains dependent on expert radiologic oversight, particularly in cavitary disease.<\/jats:p>","DOI":"10.3390\/diagnostics16121822","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:44:58Z","timestamp":1781484298000},"page":"1822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Artificial Intelligence-Assisted Quantification of Longitudinal HRCT Changes During Treatment of Pulmonary Tuberculosis: An Exploratory Proof-of-Concept Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Anna","family":"Russo","sequence":"first","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Patan\u00e8","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1654-0685","authenticated-orcid":false,"given":"Francesco","family":"Ruotolo","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Brunese","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariateresa","family":"Del Canto","sequence":"additional","affiliation":[{"name":"Radiology Department, San Leonardo Hospital, 80053 Castellamare di Stabia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"Alessio","sequence":"additional","affiliation":[{"name":"Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, UOC Malattie Infettive, Universit\u00e0 Degli Studi Della Campania \u2018Luigi Vanvitelli\u2019, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Monari","sequence":"additional","affiliation":[{"name":"Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, UOC Malattie Infettive, Universit\u00e0 Degli Studi Della Campania \u2018Luigi Vanvitelli\u2019, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-4949","authenticated-orcid":false,"given":"Nicola","family":"Coppola","sequence":"additional","affiliation":[{"name":"Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, UOC Malattie Infettive, Universit\u00e0 Degli Studi Della Campania \u2018Luigi Vanvitelli\u2019, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4809-6235","authenticated-orcid":false,"given":"Alfonso","family":"Reginelli","sequence":"additional","affiliation":[{"name":"Precision Medicine Department, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100510","DOI":"10.1016\/j.jctube.2025.100510","article-title":"The persistent threat of tuberculosis\u2014Why ending TB remains elusive?","volume":"38","author":"Suvvari","year":"2025","journal-title":"J. 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