Abstract
Objectives
The reproducibilities of CT lung volume and densitometric measures of emphysema were assessed over 1 week. The influence of breathhold on reproducibility was assessed.
Methods
HRCT was performed on 44 subjects at inspiration on two visits with a 7-day interval. CT lung volume, relative area below -950HU (RA950-raw), and 15th percentile density (PD15-raw) were computed. Volume correction was used to obtain RA950-adj and PD15-adj. Reproducibilities between visits were assessed using concordance correlation coefficient (CCC) and repeatability coefficient (RC). Reproducibilities were compared between raw and adjusted measures. Differences between visits were computed for volume and density measures. Correlations were computed for density differences versus volume difference. Subgroup analysis was performed using a 0.25 L volume difference threshold.
Results
High CCC were observed for all measures in full group (CCC > 0.97). Reproducibilities of volume (RC = 0.67 L), RA950-raw (RC = 2.3%), and PD15-raw (RC = 10.6HU) were observed. Volume correction significantly improved PD15 (RC = 3.6HU) but not RA950 (RC = 1.7%). RA950-raw and PD15-raw had significantly better RC in <0.25 L subgroup than ≥0.25 L. Significant correlations with volume were observed for RA950-raw and PD15-raw (R 2 > 0.71), but not RA950-adj or PD15-adj (R 2 < 0.11).
Conclusions
Good breathhold and RA950 reproducibilities were achieved. PD15 was less reproducible but improved with volume correction or superior breathhold reproduction.
Key Points
• Good breath-hold reproducibility is achievable between multiple CT examinations.
• Reproducibility of densitometric measures may be improved by statistical volume correction.
• Volume correction may result in decreased signal.
• Densitometric reproducibility may also be improved by achieving good breath-hold reproduction.
• Careful consideration of signal and noise is necessary in reproducibility assessment.
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References
Gold. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Executive summary, updated 2009. http://www.goldcopd.org. Accessed September 7, 2011
Hurd S (1984) The impact of COPD on lung health worldwide: epidemiology and incidence. Chest 117(2 Suppl):1S–4S
Hayhurst MD, Flenley DC, McLean A, Wightman AJA, MacNec W, Wright D et al (1984) Diagnosis of pulmonary emphysema by computerised tomography. Lancet 2:320–322
Muller NL, Staples CA, Miller RR, Abboud RT (1988) Density mask. An objective method to quantitate emphysema using computed tomography. Chest 94:782–787
Dirksen A, Friis M, Olesen KP, Skovgaard LT, Sorensen K (1997) Progress of emphysema in severe α1-antitrypsin deficiency as assessed by annual CT. Acta Radiol 38:826–832
Goldin JG (2004) Quantitative CT of emphysema and the airways. J Thorac Imaging 19(4):235–240
Spouge D, Mayo JR, Cardoso W, Muller NL (1993) Panacinar emphysema: CT and pathologic findings. J Comput Assist Tomogr 17(5):710–713
Gevenois PA, De Vuyst P, de Maertelaer V, Zanen J, Jacobovitz D, Cosio MG, Yernault JC (1996) Comparison of computed density and microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med 154(1):187–192
Pauls S, Gulkin D, Feuerlein S, Muche R, Kruger S, Schmidt SA, Dharaiya E, Brambs HJ, Hetzel M (2010) Assessment of COPD severity by computed tomography: correlation with lung functional testing. Clin Imaging 34:172–178
Robinson PJ, Kreel L (1979) Pulmonary tissue attenuation with computed tomography: comparison of inspiration and expiration scans. J Comput Assist Tomogr 3(6):740–748
Shaker SB, Dirksen A, Laursen LC, Skovgaard LT, Holstein-Rathlou NH (2004) Volume adjustment of lung density by computed tomography scans in patients with emphysema. Acta Radiol 45:417–423
Brown MS, McNitt-Gray MF, Pais R, Shah SK, Qing D, Da Costa I, Aberle DR, Goldin JG (2007) CAD in clinical trials: current role and architectural requirements. J Comput Med Imaging Graph 31:332–337
Brown MS, McNitt-Gray MF, Mankovich NJ, Hiller J, Wilson LS, Goldin JG, Aberle DR (1997) Method for segmenting chest CT image data using an anatomical model: preliminary results. IEEE Trans Med Imaging 16(6):828–839
Gould GA, MacNee W, McLean A, Warren PM, Redpath A, Best JJ et al (1988) CT measurements of lung density in life can quantitate distal airspace enlargement: an essential defining feature of human emphysema. Am Rev Respir Dis 137:380–392
Stoel BC, Putter H, Bakker ME, Dirksen A, Stockley RA, Piitulainen E, Russi EW, Parr D, Shaker SB, Reiber JH, Stolk J (2008) Volume correction in computed tomography densitometry for follow-up studies on pulmonary emphysema. Proc Am Thorac Soc 5(9):919–924
Dirksen A, Dijkman JH, Madsen F, Stoel B, Hutchison DCS, Ulrik CS, Skovgaard LT, Kok-Jensen A, Rudolphus A, Seersholm N, Vrooman HA, Reiber JH, Hansen NC, Heckscher T, Viskum K, Stolk J (1999) A randomized clinical trial of alpha 1-antitrypsin augmentation therapy. Am J Respir Crit Care Med 160:1468–1472
Parr DG, Stoel BC, Stolk J, Stockley RA (2006) Validation of computed tomographic lung densitometry for monitoring emphysema in alpha 1-antitrypsin deficiency. Thorax 61(6):485–490
Lin LI (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics 45(1):255–268
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CPM, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J (2005) Standardization of spirometry. Eur Respir J 26(2):319–338
Sciurba FC, Ernst A, Herth FJ, Strange C, Criner GJ, Marquette CH, Kovitz KL, Chiacchierini RP, Goldin J, McLennan G, for the VENT Study Group (2010) A Randomized study of endobronchial valves for advanced emphysema. N Engl J Med 363:1233–1244
Coxson HO, Nasute Fauerbach PV, Storness-Bliss C, Muller NL, Cogswell S, Dillard DH, Finger CL, Springmeyer SC (2008) Computed tomography assessment of lung volume changes after bronchial valve treatment. Eur Respir J 32(6):1443–1450
Parr DG, Sevenoaks M, Deng CQ, Stoel BC, Stockley RA (2008) Detection of emphysema progression in alpha 1-antytrpsin deficiency using CT densitometry; Methodological advances. Respir Res 9:21
Brown MS, Kim HJ, Abtin F, Da Costa I, Pais R, Ahmad S, Angel E, Ni C, Kleerup EC, Gjertson DW, McNitt-Gray MF, Goldin JG (2010) Reproducibility of lung and lobar volume measurements using computed tomography. Acad Radiol 17(3):316–322
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Chong, D., Brown, M.S., Kim, H.J. et al. Reproducibility of volume and densitometric measures of emphysema on repeat computed tomography with an interval of 1 week. Eur Radiol 22, 287–294 (2012). https://doi.org/10.1007/s00330-011-2277-1
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DOI: https://doi.org/10.1007/s00330-011-2277-1