Quantitative assessment of change in regional disease patterns on serial HRCT of fibrotic interstitial pneumonia with texture-based automated quantification system.
OBJECTIVE
To evaluate the usefulness of a texture-based automated quantification system (AQS) for evaluating the extent and interval change of regional disease patterns on initial and follow-up high-resolution computed tomographies (HRCTs) of fibrotic interstitial pneumonia (FIP).


METHODS
Eighty-nine patients with clinically and/or biopsy confirmed usual interstitial pneumonia (UIP) (n = 71) and non-specific interstitial pneumonia (NSIP) (n = 18) were included. An AQS to quantify five disease patterns (ground-glass opacity [GGO], reticular opacity [RO], honeycombing [HC], emphysema [EMPH], consolidation [CONS]) and normal lung was developed. The extent and interval changes of each disease pattern, FS (fibrosis score), TA (total abnormal lung fraction) of entire lung on initial and 1-year follow-up HRCTs were quantified. The agreement between the results of AQS and two readers was assessed. Results of AQS were correlated with forced vital capacity (FVC) and carbon monoxide diffusing capacity (DLco).


RESULTS
The Intraclass correlation coefficient (ICC) study revealed acceptable agreement between visual assessment and AQS (r = 0.78, 0.66 for HC; 0.76, 0.61 for FS; 0.64, 0.68 for TA, initial and follow-up HRCTs, respectively). Linear regression analysis revealed the extent of HC, TA on initial CT, interval changes of FS contributed negatively to DLco, and interval changes of FS, TA contributed negatively to FVC.


CONCLUSIONS
Our AQS is comparable with visual assessment for evaluating the disease extent and the interval changes of FIP on HRCT.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736, South Korea. yoonrg@hanmail.net
Ra Gyoung
RG
Yoon
Joon Beom
JB
Seo
Namkug
N
Kim
Hyun Joo
HJ
Lee
Sang Min
SM
Lee
Young Kyung
YK
Lee
Jae Woo
JW
Song
Jin Woo
JW
Song
Dong Soon
DS
Kim
D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*