Density-based MDCT quantification of lobar lung volumes: a study of inter- and intraobserver reproducibility

Molinari, Francesco; Amato, Michele; Stefanetti, Mariangela; Parapatt, George Koshy; Macagnino, Alberto; Serricchio, Grazia; Pirronti, Tommaso; Bonomo, Lorenzo

doi:10.1007/s11547-010-0536-x

Cited by 9 publications

(12 citation statements)

References 26 publications

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“…A trend of high variability was also noted for the right middle lobe in the interoperator analysis. As reported previously, the smaller absolute volume of the right middle lobe leads to considerable relative differences, which are also expected because the minor fissure is typically less pronounced and therefore more difficult to delineate (10).…”

Section: Coefficient Of Reproducibility (Ml)supporting

confidence: 68%

“…Quantitative CT techniques for emphysema scoring are objective and therefore preferable to visual analysis (7). Recent studies have also demonstrated that CT lobar volumetry has good inter scan reproducibility (8)(9)(10). Among the different sources of variability of CT lung volumetry and emphysema scoring, those depending on the method used for lobar segmentation have received little attention (5).…”

mentioning

confidence: 99%

“…If the segmentation error extends over the entire interlobar boundary, the miscategorized volume can alter the proportions among the measured lobar volumes. Repeated segmentations also indicate that the variability of the measured lobar volumes increases when the interlobar landmark is uncertain (10). Particularly in diseased lungs, where pathologic changes deform the fissures, the accuracy of the segmentation is critical for correctly measuring the lobar volumes (12).…”

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confidence: 99%

“…However, when applied recursively to a whole chest multidetector CT (MDCT) dataset containing hundreds of images, the manual segmentation is time-consuming and overall clinically impractical (11). In this setting, the manual technique is subject to substantial error sources, which yield variability in the lobar volumes (10). Conversely, computer-based techniques that use mathematical algorithms such as thresholding, pattern recognition, and deformable models facilitate the segmentation (11).…”

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confidence: 99%

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Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques

Molinari¹,

Pirronti²,

Sverzellati³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to compare the intra-and interoperator variability of lobar volumetry and emphysema scores obtained by semi-automated and manual segmentation techniques in lung emphysema patients. MATERIALS AND METHODSIn two sessions held three months apart, two operators performed lobar volumetry of unenhanced chest computed tomography examinations of 47 consecutive patients with chronic obstructive pulmonary disease and lung emphysema. Both operators used the manual and semi-automated segmentation techniques. The intra-and interoperator variability of the volumes and emphysema scores obtained by semi-automated segmentation was compared with the variability obtained by manual segmentation of the five pulmonary lobes. RESULTSThe intra-and interoperator variability of the lobar volumes decreased when using semi-automated lobe segmentation 166.9 vs. 68.7; and left lower lobe, 168.7 vs. 71.6). The coefficients of repeatability and reproducibility of emphysema scores also decreased when using semi-automated segmentation and had ranges that varied depending on the target lobe and selected threshold of emphysema. CONCLUSION Semi-automated segmentation reduces the intra-and interoperator variability of lobar volumetry and provides a more objective tool than manual technique for quantifying lung volumes and severity of emphysema.

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Section: Coefficient Of Reproducibility (Ml)supporting

confidence: 68%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques

Molinari¹,

Pirronti²,

Sverzellati³

et al. 2013

Diagn Interv Radiol

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“…Lobe-specific measurements may provide insight into both underlying disease mechanisms and the spectrum of disease phenotypes (particularly in chronic obstructive lung disease), as well as help to refine therapeutic strategies (4)(5)(6). Prior studies also evaluated the reliability of the corresponding measurements by testing the inherent interoperator variability or comparing software results with the visual score (7,8). However, the accuracies of CT-based lobe segmentation and measurements have yet to be proven in comparison with a gold standard, such as pathological measurements.…”

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confidence: 99%

CT-based weight assessment of lung lobes: comparison with ex vivo measurements

Sverzellati

Kuhnigk

Furia

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the validity of lung lobe weight assessment via computed tomography (CT) by comparing CT-derived and ex vivo measurements. MATERIALS AND METHODSUnenhanced CT scanning was performed in 30 consecutive patients before lobectomy for lung cancer. The CT images were analyzed using research software after allowing for lobar weight quantitation. The lobar weight estimated by CT was then compared with that measured after surgery using a precision scale (ex vivo measurement). Comparisons as well as assessment of intra-and interoperator variability were conducted using the Bland-Altman method and the coefficient of repeatability (CR). Correlations were examined using Pearson's correlation analysis. RESULTSComparison analyses were feasible for 28 cases. The ex vivo lobe weight was 186.2±57.3 g, whereas the weights measured by the two operators by CT were 190.0±55 and 182.4±58.2 g, respectively. As compared with ex vivo weights, the CR was 36.4 for operator 1 and 50.4 for operator 2; the mean differences were 3.8 and -3.8 for operators 1 and 2, respectively. The intraoperator and interoperator CR were 20.9 and 36.6, respectively. The mean differences for the intra-and interoperator analysis were -1.5 and -7.5, respectively. The correlation was very high between CT-based and ex vivo measurements (r=0.95 and r=0.90 for operators 1 and 2, respectively; P < 0.001). CONCLUSIONEstimation of lung lobe weight by semi-automated CT analysis is sufficiently reproducible and in agreement with ex vivo measurements. C omputed tomography (CT) is the most widely used imaging modality for the evaluation of lung disease at the lobar level. Several methods for the automatic and semi-automatic segmentation of the lung lobes have been developed (1-5).This advance in postprocessing CT technique also allows lobar assessment of several CT parameters, such as volume, mean density, and emphysema extent. Lobe-specific measurements may provide insight into both underlying disease mechanisms and the spectrum of disease phenotypes (particularly in chronic obstructive lung disease), as well as help to refine therapeutic strategies (4-6). Prior studies also evaluated the reliability of the corresponding measurements by testing the inherent interoperator variability or comparing software results with the visual score (7,8). However, the accuracies of CT-based lobe segmentation and measurements have yet to be proven in comparison with a gold standard, such as pathological measurements.The combination of lung volume and density allows the estimation of other volumetric parameters such as lung weight (9, 10). The lobe weight when assessed by automated CT analysis may be suitable for pathological correlations. Lobe weight measurement, as outlined in the present study, is based on the calculation of lobe density and volume. Lobe volume variation (e.g., due to different levels of inspiration) may be attenuated using the density of the corresponding lung. Therefore, weighing the lungs by CT may be important because suc...

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Comparison of four software packages for CT lung volumetry in healthy individuals

et al. 2015

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• Volumetric differences, assessed by different CTLV software, are small but statistically significant. • Volumetric differences are smaller at TLC than at MIC and FRC. • Volumetric differences rarely exceed spirometric repeatability thresholds at MIC and FRC. • Differences between CTLV measurements should be interpreted based on comparison of absolute differences. • MLD increases with decreasing volumes, and is larger in lower compared to upper lobes.

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Density-based MDCT quantification of lobar lung volumes: a study of inter- and intraobserver reproducibility

Cited by 9 publications

References 26 publications

Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques

Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques

CT-based weight assessment of lung lobes: comparison with ex vivo measurements

Comparison of four software packages for CT lung volumetry in healthy individuals

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