Intensive Care Medicine

, Volume 36, Issue 11, pp 1836–1844 | Cite as

Extrapolation from ten sections can make CT-based quantification of lung aeration more practicable

  • A. W. ReskeEmail author
  • A. P. Reske
  • H. A. Gast
  • M. Seiwerts
  • A. Beda
  • U. Gottschaldt
  • C. Josten
  • D. Schreiter
  • N. Heller
  • H. Wrigge
  • M. B. Amato



Clinical applications of quantitative computed tomography (qCT) in patients with pulmonary opacifications are hindered by the radiation exposure and by the arduous manual image processing. We hypothesized that extrapolation from only ten thoracic CT sections will provide reliable information on the aeration of the entire lung.


CTs of 72 patients with normal and 85 patients with opacified lungs were studied retrospectively. Volumes and masses of the lung and its differently aerated compartments were obtained from all CT sections. Then only the most cranial and caudal sections and a further eight evenly spaced sections between them were selected. The results from these ten sections were extrapolated to the entire lung. The agreement between both methods was assessed with Bland–Altman plots.


Median (range) total lung volume and mass were 3,738 (1,311–6,768) ml and 957 (545–3,019) g, the corresponding bias (limits of agreement) were 26 (−42 to 95) ml and 8 (−21 to 38) g, respectively. The median volumes (range) of differently aerated compartments (percentage of total lung volume) were 1 (0–54)% for the nonaerated, 5 (1–44)% for the poorly aerated, 85 (28–98)% for the normally aerated, and 4 (0–48)% for the hyperaerated subvolume. The agreement between the extrapolated results and those from all CT sections was excellent. All bias values were below 1% of the total lung volume or mass, the limits of agreement never exceeded ±2%.


The extrapolation method can reduce radiation exposure and shorten the time required for qCT analysis of lung aeration.


Computed tomography Quantitative imaging Lung volume measurements Acute respiratory failure Pulmonary atelectasis 



This work was supported by institutional funding.

Supplementary material

134_2010_2014_MOESM1_ESM.doc (44 kb)
Supplementary material 1 (DOC 43.5 kb)


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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • A. W. Reske
    • 1
    Email author
  • A. P. Reske
    • 1
  • H. A. Gast
    • 2
  • M. Seiwerts
    • 2
  • A. Beda
    • 1
  • U. Gottschaldt
    • 3
  • C. Josten
    • 4
  • D. Schreiter
    • 5
  • N. Heller
    • 6
  • H. Wrigge
    • 7
  • M. B. Amato
    • 8
  1. 1.Department of Anesthesiology and Intensive Care MedicineUniversity Hospital Carl Gustav CarusDresdenGermany
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity Hospital LeipzigLeipzigGermany
  3. 3.Department of Anesthesiology and Intensive Care MedicineUniversity Hospital LeipzigLeipzigGermany
  4. 4.Department of Trauma and Reconstructive SurgeryUniversity Hospital LeipzigLeipzigGermany
  5. 5.Department of Surgery, Surgical Intensive Care UnitUniversity Hospital Carl Gustav CarusDresdenGermany
  6. 6.Institute of InformaticsUniversity of LeipzigLeipzigGermany
  7. 7.Department of Anesthesiology and Intensive Care MedicineUniversity of BonnBonnGermany
  8. 8.Pulmonary Divison, Cardio-Pulmonary DepartmentHospital das Clinicas, University of Sao PauloSao PauloBrazil

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