title: Automated lobar quantification of emphysema in patients with severe COPD.
abstract: Automated lobar quantification of emphysema has not yet been evaluated. Unenhanced 64-slice MDCT was performed in 47 patients evaluated before bronchoscopic lung-volume reduction. CT images reconstructed with a standard (B20) and high-frequency (B50) kernel were analyzed using a dedicated prototype software (MevisPULMO) allowing lobar quantification of emphysema extent. Lobar quantification was obtained following (a) a fully automatic delineation of the lobar limits by the software and (b) a semiautomatic delineation with manual correction of the lobar limits when necessary and was compared with the visual scoring of emphysema severity per lobe. No statistically significant difference existed between automated and semiautomated lobar quantification (p > 0.05 in the five lobes), with differences ranging from 0.4 to 3.9%. The agreement between the two methods (intraclass correlation coefficient, ICC) was excellent for left upper lobe (ICC = 0.94), left lower lobe (ICC = 0.98), and right lower lobe (ICC = 0.80). The agreement was good for right upper lobe (ICC = 0.68) and moderate for middle lobe (IC = 0.53). The Bland and Altman plots confirmed these results. A good agreement was observed between the software and visually assessed lobar predominance of emphysema (kappa 0.78; 95% CI 0.64-0.92). Automated and semiautomated lobar quantifications of emphysema are concordant and show good agreement with visual scoring.
authors.affiliation: Department of Radiology, Calmette Hospital, University of Lille 2, Boulevard Jules Leclerc, 59037, Lille, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Revel
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Faivre
authors.forename: Martine
authors.initials: M
authors.lastname: Remy-Jardin
authors.forename: Valérie
authors.initials: V
authors.lastname: Deken
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Charles-Hugo
authors.initials: CH
authors.lastname: Marquette
authors.forename: Nunzia
authors.initials: N
authors.lastname: Tacelli
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bakai
authors.forename: Jacques
authors.initials: J
authors.lastname: Remy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001185:Artificial Intelligence; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*