title: Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques.
abstract: OBJECTIVE
  We aimed to compare the intra- and interoperator variability of lobar volumetry and emphysema scores obtained by semi-automated and manual segmentation techniques in lung emphysema patients.
  
  
  METHODS
  In two sessions held three months apart, two operators performed lobar volumetry of unenhanced chest computed tomography examinations of 47 consecutive patients with chronic obstructive pulmonary disease and lung emphysema. Both operators used the manual and semi-automated segmentation techniques. The intra- and interoperator variability of the volumes and emphysema scores obtained by semi-automated segmentation was compared with the variability obtained by manual segmentation of the five pulmonary lobes.
  
  
  RESULTS
  The intra- and interoperator variability of the lobar volumes decreased when using semi-automated lobe segmentation (coefficients of repeatability for the first operator: right upper lobe, 147 vs. 96.3; right middle lobe, 137.7 vs. 73.4; right lower lobe, 89.2 vs. 42.4; left upper lobe, 262.2 vs. 54.8; and left lower lobe, 260.5 vs. 56.5; coefficients of repeatability for the second operator: right upper lobe, 61.4 vs. 48.1; right middle lobe, 56 vs. 46.4; right lower lobe, 26.9 vs. 16.7; left upper lobe, 61.4 vs. 27; and left lower lobe, 63.6 vs. 27.5; coefficients of reproducibility in the interoperator analysis: right upper lobe, 191.3 vs. 102.9; right middle lobe, 219.8 vs. 126.5; right lower lobe, 122.6 vs. 90.1; left upper lobe, 166.9 vs. 68.7; and left lower lobe, 168.7 vs. 71.6). The coefficients of repeatability and reproducibility of emphysema scores also decreased when using semi-automated segmentation and had ranges that varied depending on the target lobe and selected threshold of emphysema.
  
  
  CONCLUSIONS
  Semi-automated segmentation reduces the intra- and interoperator variability of lobar volumetry and provides a more objective tool than manual technique for quantifying lung volumes and severity of emphysema.
authors: Department of Radiology, CHRU. Lille, France. francescomolinari.dr@gmail.com
authors: Francesco
authors: F
authors: Molinari
authors: Tommaso
authors: T
authors: Pirronti
authors: Nicola
authors: N
authors: Sverzellati
authors: Stefano
authors: S
authors: Diciotti
authors: Michele
authors: M
authors: Amato
authors: Guglielmo
authors: G
authors: Paolantonio
authors: Luigia
authors: L
authors: Gentile
authors: George K
authors: GK
authors: Parapatt
authors: Francesco
authors: F
authors: D'Argento
authors: Jan-Martin
authors: JM
authors: Kuhnigk
mesh_terms: D000368:Aged; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods