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    Original Research

    Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

    Published Online:Feb 1 2013https://doi.org/10.1148/radiol.12120385

    Abstract

    With standard reference images, lobe-based visual assessment of volumetric CT in chronic obstructive pulmonary disease correlated well with quantitative CT findings and physiologic parameters and provided additional direct information on emphysema type and current morphologic abnormality in small and large airways.

    Purpose

    To provide a new detailed visual assessment scheme of computed tomography (CT) for chronic obstructive pulmonary disease (COPD) by using standard reference images and to compare this visual assessment method with quantitative CT and several physiologic parameters.

    Materials and Methods

    This research was approved by the institutional review board of each institution. CT images of 200 participants in the COPDGene study were evaluated. Four thoracic radiologists performed independent, lobar analysis of volumetric CT images for type (centrilobular, panlobular, and mixed) and extent (on a six-point scale) of emphysema, the presence of bronchiectasis, airway wall thickening, and tracheal abnormalities. Standard images for each finding, generated by two radiologists, were used for reference. The extent of emphysema, airway wall thickening, and luminal area were quantified at the lobar level by using commercial software. Spearman rank test and simple and multiple regression analyses were performed to compare the results of visual assessment with physiologic and quantitative parameters.

    Results

    The type of emphysema, determined by four readers, showed good agreement (κ = 0.63). The extent of the emphysema in each lobe showed good agreement (mean weighted κ = 0.70) and correlated with findings at quantitative CT (r = 0.75), forced expiratory volume in 1 second (FEV1) (r = −0.68), FEV1/forced vital capacity (FVC) ratio (r = −0.74) (P < .001). Agreement for airway wall thickening was fair (mean κ = 0.41), and the number of lobes with thickened bronchial walls correlated with FEV1 (r = −0.60) and FEV1/FVC ratio (r = −0.60) (P < .001).

    Conclusion

    Visual assessment of emphysema and airways disease in individuals with COPD can provide reproducible, physiologically substantial information that may complement that provided by quantitative CT assessment.

    © RSNA, 2012

    Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120385/-/DC1

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    Article History

    Received February 17, 2012; revision requested April 25; final revision received June 28; accepted July 24; final version accepted August 14.
    Published online: Feb 2013
    Published in print: Feb 2013