Original investigationReproducibility of Lung and Lobar Volume Measurements Using Computed Tomography
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.
References (28)
- et al.
Density mask: an objective method to quantitate emphysema using computed tomography
Chest
(1988) - et al.
Automatic segmentation and recognition of anatomical lung structures from high-resolution chest CT images
Comput Med Imaging Graph
(2006) - et al.
Automated lung segmentation in x-ray computed tomography development and evaluation of a heuristic threshold-based scheme
Acad Radiol
(2003) - et al.
Quantification of pulmonary emphysema from lung computed tomography images
Am J Respir Crit Care Med
(1997) - et al.
The diagnosis of mild centrilobular emphysema: correlation of computed tomography and pathology scores
Am Rev Respir Dis
(1990) - et al.
Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema
Eur Respir J
(2001) - et al.
CT of pulmonary emphysema-current status, challenges, and future directions
Eur Radiol
(2009) - et al.
Regional distribution of emphysema: correlation of high-resolution CT with pulmonary function tests in unselected smokers
Radiology
(1992) - et al.
Automated measurement of single and total lung volume from CT
J Comput Assist Tomogr
(1999) - et al.
Atlas-driven lung lobe segmentation in volumetric x-ray CT images
Proc SPIE
(2003)
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
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This study was supported by Emphasys Medical, Inc (Redwood City, CA), and University of California Discovery Grant It106-10158.