Reproducibility of Lung and Lobar Volume Measurements Using Computed Tomography

doi:10.1016/j.acra.2009.10.005

Academic Radiology

Volume 17, Issue 3, March 2010, Pages 316-322

https://doi.org/10.1016/j.acra.2009.10.005 Get rights and content

Rationale and Objectives

Lung and lobar volume measurements from computed tomographic (CT) imaging are being used in clinical trials to assess new minimally invasive emphysema treatments aiming to reduce lung volumes. Establishing the reproducibility of lung volume measurements is important if they are to be accepted as treatment planning and outcome variables. The aims of this study were to (1) investigate the correlation between lung volumes assessed on CT imaging and on pulmonary function testing (PFT), (2) compare the two methods' reproducibility, and (3) assess the reproducibility of CT lobar volumes.

Materials and Methods

CT imaging and body plethysmography were performed at baseline and after a 9-month interval in multicenter emphysema treatment trials. Lung volumes were measured at total lung capacity (TLC) and at residual volume (RV). Lobar volumes were measured on CT imaging using a semiautomated technique. The correlations between CT and PFT volumes were computed for 486 subjects at baseline. Reproducibility was assessed in terms of the intraclass correlation coefficient (ICC) for 126 subjects from the control group at TLC and 120 subjects at RV.

Results

Correlations between CT and PFT lung volumes were 0.86 at TLC and 0.67 at RV. At TLC, the ICCs were 0.943 for CT imaging and 0.814 for PFT. At RV, the ICCs were 0.886 for CT imaging and 0.683 for PFT. CT lobar volumes showed good reproducibility (all P values < .05).

Conclusion

CT lung and lobar volume measurements could be captured in a multicenter trial setting with high reproducibility and were highly correlated with those obtained on PFT. CT imaging showed significantly better reproducibility than PFT between interval lung volume measurements, offering the potential for designing emphysema treatment trials involving fewer subjects.

Section snippets

Subject Recruitment

Data have been collected from the Endobronchial Valve for Emphysema Palliation Trial (VENT) and International VENT, two parallel clinical trials designed to assess the efficacy of bronchoscopically placed endobronchial valves in reducing lung volumes in subjects with emphysema. These multicenter studies involved 31 sites in the United States and 25 sites in Europe. Patient inclusion and exclusion criteria, CT collection methodology, and lung function testing protocols were identical across the

Baseline Characteristics

Baseline descriptive statistics are shown in Table 1 for the 486 treatment and control subjects with both CT and PFT lung volumes obtained at TLC and 473 at RV. At TLC the percentage of the total lung volume contributed by the right and left lungs had a mean of 52.6% for the right lung and 47.4% for the left lung with 3% standard derivatives. At RV the means were 53.2% for the right lung and 46.8% for the left lung with 4% standard derivatives.

Lung Volume Correlations

For 486 subjects, the correlation between lung

Discussion

This study makes contributions in three main areas of lung volume quantitation. First, we investigated the correlation between lung volumes on CT imaging and those on body plethysmography at TLC and RV, which has not been reported in a large emphysema cohort. Second, we compared the reproducibility of lung volumes on CT imaging and on body plethysmography in the setting of large multicenter clinical trials. Third, this was the first study of the reproducibility of lobar lung volumes computed

Conclusion

CT lung and lobar volume measurements can be captured in a multicenter trial setting with high reproducibility when careful attention is paid to breathing instructions and consistency in image acquisition parameters. PFT and CT lung volumes were highly correlated. Although both showed high reproducibility, CT imaging showed better reproducibility than PFT between interval lung volume measurements. This offers the potential for designing emphysema treatment trials involving fewer subjects.

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: This study was supported by Emphasys Medical, Inc (Redwood City, CA), and University of California Discovery Grant It106-10158.

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Original investigationReproducibility of Lung and Lobar Volume Measurements Using Computed Tomography

Rationale and Objectives

Materials and Methods

Results

Conclusion

Section snippets

Subject Recruitment

Baseline Characteristics

Lung Volume Correlations

Discussion

Conclusion

Chest

Comput Med Imaging Graph

Acad Radiol

Quantification of pulmonary emphysema from lung computed tomography images

Am J Respir Crit Care Med

The diagnosis of mild centrilobular emphysema: correlation of computed tomography and pathology scores

Am Rev Respir Dis

Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema

Eur Respir J

CT of pulmonary emphysema-current status, challenges, and future directions

Eur Radiol

Regional distribution of emphysema: correlation of high-resolution CT with pulmonary function tests in unselected smokers

Radiology

Automated measurement of single and total lung volume from CT

J Comput Assist Tomogr

Atlas-driven lung lobe segmentation in volumetric x-ray CT images

Proc SPIE

Patients with emphysema: quantitative CT analysis before and after lung volume reduction surgery

Radiology

Design of the Endobronchial Valve for Emphysema Palliation Trial (VENT): a non-surgical method of lung volume reduction

BMC Pulm Med

Computed tomography assessment of lung volume changes after bronchial valve treatment

Eur Respir J

The measurement of lung expansion with computed tomography and comparison with quantitative histology

J Appl Physiol

Original investigation
Reproducibility of Lung and Lobar Volume Measurements Using Computed Tomography