A method for the automatic quantification of the completeness of pulmonary fissures: evaluation in a database of subjects with severe emphysema
To propose and evaluate a technique for automatic quantification of fissural completeness from chest computed tomography (CT) in a database of subjects with severe emphysema.
Ninety-six CT studies of patients with severe emphysema were included. The lungs, fissures and lobes were automatically segmented. The completeness of the fissures was calculated as the percentage of the lobar border defined by a fissure. The completeness score of the automatic method was compared with a visual consensus read by three radiologists using boxplots, rank sum tests and ROC analysis.
The consensus read found 49% (47/96), 15% (14/96) and 67% (64/96) of the right major, right minor and left major fissures to be complete. For all fissures visually assessed as being complete the automatic method resulted in significantly higher completeness scores (mean 92.78%) than for those assessed as being partial or absent (mean 77.16%; all p values <0.001). The areas under the curves for the automatic fissural completeness were 0.88, 0.91 and 0.83 for the right major, right minor and left major fissures respectively.
An automatic method is able to quantify fissural completeness in a cohort of subjects with severe emphysema consistent with a visual consensus read of three radiologists.
• Lobar fissures are important for assessing the extent and distribution of lung disease
• Modern CT allows automatic lobar segmentation and assessment of the fissures
• This segmentation can also assess the completeness of the fissures.
• Such assessment is important for decisions about novel therapies (eg for emphysema).
- Aziz, A, Ashizawa, K, Nagaoki, K, Hayashi, K (2004) High resolution CT anatomy of the pulmonary fissures. J Thorac Imaging 19: pp. 189-191 CrossRef
- Gülsün, M, Ariyürek, OM, Cömert, RB, Karabulut, N (2006) Variability of the pulmonary oblique fissures presented by high-resolution computed tomography. Surg Radiol Anat 28: pp. 293-299 CrossRef
- Cronin, P, Gross, BH, Kelly, AM, Patel, S, Kazerooni, EA, Carlos, RC (2010) Normal and accessory fissures of the lung: evaluation with contiguous volumetric thin-section multidetector CT. Eur J Radiol 75: pp. 1-8 CrossRef
- Sciurba, FC, Ernst, A, Herth, FJF (2010) A randomized study of endobronchial valves for advanced emphysema. N Engl J Med 363: pp. 1233-1244 CrossRef
- Medlar, EM (1947) Variations in interlobar fissures. Am J Roentgenol Radium Ther 57: pp. 723-725
- Mahmut, M, Nishitani, H (2007) Evaluation of pulmonary lobe variations using multidetector row computed tomography. J Comput Assist Tomogr 31: pp. 956-960 CrossRef
- Ozmen, CA, Nazaroglu, H, Bayrak, AH, Senturk, S, Akay, HO (2010) Evaluation of interlobar and accessory pulmonary fissures on 64-row MDCT. Clin Anat 23: pp. 552-558 CrossRef
- Rikxoort, EM, Hoop, B, Viergever, MA, Prokop, M, Ginneken, B (2009) Automatic lung segmentation from thoracic computed tomography scans using a hybrid approach with error detection. Med Phys 36: pp. 2934-2947 CrossRef
- Rikxoort, EM, Ginneken, B, Klik, M, Prokop, M (2008) Supervised enhancement filters: application to fissure detection in chest CT scans. IEEE Trans Med Imaging 27: pp. 1-10 CrossRef
- Rikxoort, EM, Prokop, M, Hoop, B, Viergever, MA, Pluim, JPW, Ginneken, B (2010) Automatic segmentation of pulmonary lobes robust against incomplete fissures. IEEE Trans Med Imaging 29: pp. 1286-1296 CrossRef
- Kuhnigk, JM, Dicken, V, Zidowitz, S (2005) New tools for computer assistance in thoracic CT part 1. Functional analysis of lungs, lung lobes and bronchopulmonary segments. Radiographics 25: pp. 525-536 CrossRef
- Ukil, S, Reinhardt, JM (2009) Anatomy-guided lung lobe segmentation in x-ray CT images. IEEE Trans Med Imaging 28: pp. 202-214 CrossRef
- A method for the automatic quantification of the completeness of pulmonary fissures: evaluation in a database of subjects with severe emphysema
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Volume 22, Issue 2 , pp 302-309
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- X-ray computed tomography
- Computer-assisted radiographic image interpretation
- Chronic obstructive pulmonary disease
- Industry Sectors
- Author Affiliations
- 1. Center for Computer Vision and Imaging Biomarkers and Thoracic Imaging Research Group, Department of Radiological Sciences, David Geffen School of Medicine, University of California-Los Angeles, 924 Westwood Blvd, suite 650, Los Angeles, CA, 90024, USA
- 2. Diagnostic Image Analysis Group, Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- 3. Image Sciences Institute, Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands