title: Quantitative CT indexes in idiopathic pulmonary fibrosis: relationship with physiologic impairment.
abstract: OBJECTIVE
  To determine whether measurements of skewness, kurtosis, and mean lung attenuation on thin-section computed tomographic (CT) histograms in patients with idiopathic pulmonary fibrosis (IPF) correlate with pulmonary physiologic abnormality in a nonspirometrically controlled multicenter study.
  
  
  METHODS
  The authors analyzed baseline digital thin-section CT data from 144 patients with IPF who enrolled in a double-blind placebo-controlled clinical effectiveness trial of interferon beta 1a in the treatment of IPF. All patients underwent thin-section CT in the supine position at full inspiration. The lungs were isolated by using a semiautomated thresholding technique, with an upper threshold of -200 HU. An attenuation correction algorithm was used. Pulmonary function tests (PFTs) included forced vital capacity, total lung capacity, forced expiratory volume in 1 second, and diffusing lung capacity. Univariate and multiple correlation and regression statistical analyses were used to determine relationships between histogram features and results of PFTs.
  
  
  RESULTS
  Moderate correlations existed between histogram features and PFT results. Kurtosis showed the greatest degree of correlation with physiologic abnormality (r = 0.53, P <.01). Strength of correlation increased with exclusion of suboptimal scans but did not change significantly after application of an attenuation correction algorithm. Attenuations for lungs, gas, and soft tissue varied considerably between scanner manufacturers. Kurtosis alone provided predictions of pulmonary function that were virtually as good as those from all histogram features combined.
  
  
  CONCLUSIONS
  Thin-section CT histograms of the lungs were found to correlate with results of PFTs in patients with IPF, which supports the claim that histogram features can be used as valid indexes of IPF in a multiinstitutional nonspirometrically controlled study.
authors.affiliation: Department of Radiology, University of Colorado Health Sciences Center, 3025 E 11th Ave, Denver, CO 80262, USA. alan.best@uchsc.edu
authors.forename: Alan C
authors.initials: AC
authors.lastname: Best
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lynch
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Bozic
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.forename: Gary K
authors.initials: GK
authors.lastname: Grunwald
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
mesh_terms: D000465:Algorithms; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D012044:Regression Analysis; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D016899:Interferon-beta