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Repeatability of Quantitative CT Indexes of Emphysema in Patients Evaluated for Lung Volume Reduction Surgery¹

¹ From the Mallinckrodt Institute of Radiology (D.S.G., T.K.P., L.C., R.M.S., K.T.B.) and Divisions of Pulmonary and Critical Care Medicine (R.D.Y., S.S.L.), General Medical Sciences (R.D.Y.), and Cardiothoracic Surgery (J.D.C.), Washington University School of Medicine, Barnes-Jewish Hospital, 216 S Kingshighway Blvd, St Louis, MO 63110. From the 2000 RSNA scientific assembly. Received September 13, 2000; revision requested October 27; revision received February 23, 2001; accepted March 16. Supported in part by the American Lung Association of Eastern Missouri. R.D.Y. supported in part by the National Heart, Lung, and Blood Institute of the National Institutes of Health (1 K23 HL04236-01). Address correspondence to D.S.G. (e-mail: gieradad@mir.wustl.edu).

PURPOSE: To evaluate the repeatability of quantitative computed tomographic (CT) indexes of emphysema and the effect of spirometric gating of lung volume during CT in candidates for lung volume reduction surgery (LVRS).

MATERIALS AND METHODS: Initial and same-day repeat routine inspiratory spiral chest CT studies were performed in 29 LVRS candidates (group 1, routine study vs repeat study). In a separate cohort of 29 LVRS candidates, spiral chest CT studies were performed both without and with spirometric gating by using a spirometer to trigger scanning at 90% of vital capacity (group 2, spirometric gating study). In each study, Pearson and intraclass correlation coefficients were calculated to determine the agreement between multiple pairs of whole-lung quantitative CT indexes of emphysema, and mean values were compared with two-tailed paired t tests.

RESULTS: Pearson and intraclass correlation coefficients were high for all quantitative CT indexes (all 0.92). No significant differences were found between mean values of quantitative CT indexes in group 1. Variation in quantitative CT results was small but more prominent in group 2 than in group 1. The variation in quantitative CT results was primarily related to differences in lung volume (r² as great as 0.83).

CONCLUSION: Repeatability of quantitative CT test results in LVRS candidates is high and unlikely to improve by using spirometric gating.

Index terms: Emphysema, pulmonary, 60.751 • Lung, CT, 60.12115, 60.12119 • Lung, ventilation, 60.91

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