European Radiology

, Volume 22, Issue 2, pp 287–294

Reproducibility of volume and densitometric measures of emphysema on repeat computed tomography with an interval of 1 week

  • Daniel Chong
  • Matthew S. Brown
  • Hyun J. Kim
  • Eva M. van Rikxoort
  • Laura Guzman
  • Michael F. McNitt-Gray
  • Maryam Khatonabadi
  • Maya Galperin-Aizenberg
  • Heidi Coy
  • Katherine Yang
  • Yongha Jung
  • Jonathan G. Goldin
Computed Tomography

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 (R2 > 0.71), but not RA950-adj or PD15-adj (R2 < 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.

Keywords

Chronic obstructive pulmonary disease Pulmonary emphysema X-ray computed tomography Densitometry Reproducibility 

References

  1. 1.
    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
  2. 2.
    Hurd S (1984) The impact of COPD on lung health worldwide: epidemiology and incidence. Chest 117(2 Suppl):1S–4SGoogle Scholar
  3. 3.
    Hayhurst MD, Flenley DC, McLean A, Wightman AJA, MacNec W, Wright D et al (1984) Diagnosis of pulmonary emphysema by computerised tomography. Lancet 2:320–322PubMedCrossRefGoogle Scholar
  4. 4.
    Muller NL, Staples CA, Miller RR, Abboud RT (1988) Density mask. An objective method to quantitate emphysema using computed tomography. Chest 94:782–787PubMedCrossRefGoogle Scholar
  5. 5.
    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 38:826–832PubMedGoogle Scholar
  6. 6.
    Goldin JG (2004) Quantitative CT of emphysema and the airways. J Thorac Imaging 19(4):235–240PubMedCrossRefGoogle Scholar
  7. 7.
    Spouge D, Mayo JR, Cardoso W, Muller NL (1993) Panacinar emphysema: CT and pathologic findings. J Comput Assist Tomogr 17(5):710–713PubMedCrossRefGoogle Scholar
  8. 8.
    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):187–192PubMedGoogle Scholar
  9. 9.
    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 34:172–178PubMedCrossRefGoogle Scholar
  10. 10.
    Robinson PJ, Kreel L (1979) Pulmonary tissue attenuation with computed tomography: comparison of inspiration and expiration scans. J Comput Assist Tomogr 3(6):740–748PubMedGoogle Scholar
  11. 11.
    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 45:417–423PubMedCrossRefGoogle Scholar
  12. 12.
    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 31:332–337CrossRefGoogle Scholar
  13. 13.
    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):828–839PubMedCrossRefGoogle Scholar
  14. 14.
    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 137:380–392PubMedGoogle Scholar
  15. 15.
    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):919–924PubMedCrossRefGoogle Scholar
  16. 16.
    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 160:1468–1472PubMedGoogle Scholar
  17. 17.
    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):485–490PubMedCrossRefGoogle Scholar
  18. 18.
    Lin LI (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics 45(1):255–268PubMedCrossRefGoogle Scholar
  19. 19.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310PubMedCrossRefGoogle Scholar
  20. 20.
    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):319–338PubMedCrossRefGoogle Scholar
  21. 21.
    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 363:1233–1244PubMedCrossRefGoogle Scholar
  22. 22.
    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):1443–1450PubMedCrossRefGoogle Scholar
  23. 23.
    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 9:21PubMedCrossRefGoogle Scholar
  24. 24.
    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):316–322PubMedCrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Daniel Chong
    • 1
  • Matthew S. Brown
    • 2
  • Hyun J. Kim
    • 2
  • Eva M. van Rikxoort
    • 1
  • Laura Guzman
    • 1
  • Michael F. McNitt-Gray
    • 2
  • Maryam Khatonabadi
    • 1
  • Maya Galperin-Aizenberg
    • 1
  • Heidi Coy
    • 1
  • Katherine Yang
    • 1
  • Yongha Jung
    • 1
  • Jonathan G. Goldin
    • 2
  1. 1.Center for Computer Vision and Imaging BiomarkersDavid Geffen School of Medicine, UCLALos AngelesUSA
  2. 2.Center for Computer Vision and Imaging Biomarkers, Department of Radiological SciencesDavid Geffen School of Medicine, UCLALos AngelesUSA

Personalised recommendations