TY - JOUR
T1 - HRCT characteristics of severe emphysema patients
T2 - Interobserver variability among expert readers and comparison with quantitative software
AU - Hartman, Jorine E.
AU - Criner, Gerard J.
AU - Moore, William H.
AU - van Rikxoort, Eva M.
AU - Sciurba, Frank C.
AU - Shah, Pallav L.
AU - Vliegenthart, Rozemarijn
AU - Welling, Jorrit B. A.
AU - Slebos, Dirk-Jan
N1 - Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Purpose: For a successful bronchoscopic lung volume reduction coil treatment it is important to place the coils in the most emphysematous lobes. Therefore assessment of the lobe with greatest destruction is essential. Our aims were to investigate the level of agreement among expert reviewers of HRCT-scans in emphysema patients and the comparison with QCT (quantitative computed tomography) software.Method: Five experienced CT-assessors, conducted a visual assessment of the baseline HRCT-scans of emphysema patients who participated in the RENEW bronchoscopic lung volume reduction coil study. On the same HRCT-scans, a QCT analysis was performed.Results: In total 134 HRCT-scans were rated by all 5 experts. All 5 CT-assessors agreed on which was the most destructed lobe in 61 % of the left lungs (kappa:0.459) and 60 % of the right lungs (kappa:0.370). The consensus of the 5 assessors matched the QCT in the left lung for 77 % of the patients (kappa:0.425) and in the right lung for 82 % (kappa:0.524).Conclusions: Our results show that the interobserver agreement between five expert CT-assessors was only fair to moderate when evaluating the most destructed lobe. CT-assessor consensus improved matching with QCT determination of lobar destruction compared to individual assessor determinations. Because some CT-features are associated with treatment outcomes and important for optimal patient selection of bronchoscopic lung volume reduction treatment, we recommend including more than one CT-reviewer and supported by QCT measurements.
AB - Purpose: For a successful bronchoscopic lung volume reduction coil treatment it is important to place the coils in the most emphysematous lobes. Therefore assessment of the lobe with greatest destruction is essential. Our aims were to investigate the level of agreement among expert reviewers of HRCT-scans in emphysema patients and the comparison with QCT (quantitative computed tomography) software.Method: Five experienced CT-assessors, conducted a visual assessment of the baseline HRCT-scans of emphysema patients who participated in the RENEW bronchoscopic lung volume reduction coil study. On the same HRCT-scans, a QCT analysis was performed.Results: In total 134 HRCT-scans were rated by all 5 experts. All 5 CT-assessors agreed on which was the most destructed lobe in 61 % of the left lungs (kappa:0.459) and 60 % of the right lungs (kappa:0.370). The consensus of the 5 assessors matched the QCT in the left lung for 77 % of the patients (kappa:0.425) and in the right lung for 82 % (kappa:0.524).Conclusions: Our results show that the interobserver agreement between five expert CT-assessors was only fair to moderate when evaluating the most destructed lobe. CT-assessor consensus improved matching with QCT determination of lobar destruction compared to individual assessor determinations. Because some CT-features are associated with treatment outcomes and important for optimal patient selection of bronchoscopic lung volume reduction treatment, we recommend including more than one CT-reviewer and supported by QCT measurements.
KW - Bronchoscopic lung volume reduction
KW - Chest Computed Tomography
KW - Emphysema
KW - Interobserver agreement
KW - Quantified Computed Tomography
U2 - 10.1016/j.ejrad.2021.109561
DO - 10.1016/j.ejrad.2021.109561
M3 - Article
C2 - 33516140
SN - 0720-048X
VL - 136
JO - European Journal of Radiology
JF - European Journal of Radiology
M1 - 109561
ER -