Gianna Camiciottoli1, Ilaria Orlandi2, Maurizio Bartolucci2, Eleonora Meoni3, Francesca Nacci3, Stefano Diciotti4, Chiara Barcaroli2, Maria Letizia Conforti5, Massimo Pistolesi3, Marco Matucci-Cerinic5, Mario Mascalchi2. 1. Respiratory Medicine Unit, Department of Critical Care, University of Florence, Florence, Italy. Electronic address: g.camiciottoli@dac.unifi.it. 2. Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Florence, Italy. 3. Respiratory Medicine Unit, Department of Critical Care, University of Florence, Florence, Italy. 4. Department of Electronics and Telecommunications, University of Florence, Florence, Italy. 5. Rheumatology Unit, Department of Internal Medicine, University of Florence, Florence, Italy.
Abstract
BACKGROUND: To ascertain if analysis of lung density histograms in thin-section CT was more reproducible than visual assessment of lung changes in systemic sclerosis (SSc), and if such density histogram parameters as mean lung attenuation (MLA), skewness, and kurtosis could more closely reflect pulmonary function as well as exercise and quality of life impairment. METHODS: The intraoperator and interoperator reproducibility of visual and densitometric lung CT analysis in 48 SSc patients examined with CT were evaluated by means of weighted kappa statistics. Univariate and multivariate regression analyses were applied to evaluate the relationship of visual and densitometric CT measurements with functional parameters including functional residual capacity (FRC), FVC, FEV(1), diffusion capacity of the lung for carbon monoxide (Dlco), 6-min walking testing (6MWT), and health-related quality of life questionnaire (QLQ) parameters. RESULTS: The intraoperator and interoperator reproducibility of MLA (intraobserver weighted kappa = 0.97; interobserver weighted kappa = 0.96), skewness (intraobserver weighted kappa = 0.89; interobserver weighted kappa = 0.88), and kurtosis (intraobserver weighted kappa = 0.89; interobserver weighted kappa = 0.88) were higher than those of visual assessment (intraobserver weighted kappa = 0.71; interobserver weighted kappa = 0.69). In univariate analysis, only densitometric measurements were correlated with some exercise and QLQ parameters. In multivariate analysis, MLA (square regression coefficient corrected [R(2)c] = 0.70), skewness (R(2)c = 0.78), and kurtosis (R(2)c = 0.77) were predicted by FRC, FVC, Dlco, 6MWT, and QLQ parameters, while visual assessment was associated only with FRC and FVC (R(2)c = 0.40). CONCLUSIONS: In SSc, densitometric analysis is more reproducible than visual assessment of lung changes in thin-section CT and more closely correlated to pulmonary function testing, 6MWT, and QLQ. Density histogram parameters may be useful for cross-sectional and longitudinal studies of lung involvement in SSc.
BACKGROUND: To ascertain if analysis of lung density histograms in thin-section CT was more reproducible than visual assessment of lung changes in systemic sclerosis (SSc), and if such density histogram parameters as mean lung attenuation (MLA), skewness, and kurtosis could more closely reflect pulmonary function as well as exercise and quality of life impairment. METHODS: The intraoperator and interoperator reproducibility of visual and densitometric lung CT analysis in 48 SSc patients examined with CT were evaluated by means of weighted kappa statistics. Univariate and multivariate regression analyses were applied to evaluate the relationship of visual and densitometric CT measurements with functional parameters including functional residual capacity (FRC), FVC, FEV(1), diffusion capacity of the lung for carbon monoxide (Dlco), 6-min walking testing (6MWT), and health-related quality of life questionnaire (QLQ) parameters. RESULTS: The intraoperator and interoperator reproducibility of MLA (intraobserver weighted kappa = 0.97; interobserver weighted kappa = 0.96), skewness (intraobserver weighted kappa = 0.89; interobserver weighted kappa = 0.88), and kurtosis (intraobserver weighted kappa = 0.89; interobserver weighted kappa = 0.88) were higher than those of visual assessment (intraobserver weighted kappa = 0.71; interobserver weighted kappa = 0.69). In univariate analysis, only densitometric measurements were correlated with some exercise and QLQ parameters. In multivariate analysis, MLA (square regression coefficient corrected [R(2)c] = 0.70), skewness (R(2)c = 0.78), and kurtosis (R(2)c = 0.77) were predicted by FRC, FVC, Dlco, 6MWT, and QLQ parameters, while visual assessment was associated only with FRC and FVC (R(2)c = 0.40). CONCLUSIONS: In SSc, densitometric analysis is more reproducible than visual assessment of lung changes in thin-section CT and more closely correlated to pulmonary function testing, 6MWT, and QLQ. Density histogram parameters may be useful for cross-sectional and longitudinal studies of lung involvement in SSc.
Authors: H G Kim; D P Tashkin; P J Clements; G Li; M S Brown; R Elashoff; D W Gjertson; F Abtin; D A Lynch; D C Strollo; J G Goldin Journal: Clin Exp Rheumatol Date: 2010-11-03 Impact factor: 4.473
Authors: Hyun J Kim; Matthew S Brown; Robert Elashoff; Gang Li; David W Gjertson; David A Lynch; Diane C Strollo; Eric Kleerup; Daniel Chong; Sumit K Shah; Shama Ahmad; Fereidoun Abtin; Donald P Tashkin; Jonathan G Goldin Journal: Eur Radiol Date: 2011-09-17 Impact factor: 5.315
Authors: Lauren A Henderson; Stephen H Loring; Ritu R Gill; Katherine P Liao; Rumey Ishizawar; Susan Kim; Robin Perlmutter-Goldenson; Deborah Rothman; Mary Beth F Son; Matthew L Stoll; Lawrence S Zemel; Christy Sandborg; Paul F Dellaripa; Peter A Nigrovic Journal: J Rheumatol Date: 2013-02-01 Impact factor: 4.666