Jenny Vikgren1, Mohammad Khalil2, Kerstin Cederlund3, Karen Sörensen4, Marianne Boijsen2, John Brandberg2, Erik Lampa5, Magnus C Sköld6, Per Wollmer7, Eva Lindberg8, Jan E Engvall9, Göran Bergström10, Kjell Torén11, Åse A Johnsson2. 1. Department of Radiology, Sahlgrenska University Hospital and Institute of Clinical Sciences, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. Electronic address: jenny.vikgren@vgregion.se. 2. Department of Radiology, Sahlgrenska University Hospital and Institute of Clinical Sciences, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. 3. Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Södertälje Hospital, Södertälje, Sweden. 4. Department of Radiology, Umeå University Hospital, Umeå, Sweden. 5. Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. 6. Respiratory Medicine Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden. 7. Department of Translational Medicine, Lund University, Sweden. 8. Department of Medical Sciences, Respiratory, Allergy and Sleep Research, University Uppsala, Sweden. 9. Centre of Medical Image Science and Visualization, Linkoping University, Linkoping, Sweden; Department of Clinical Physiology, Linköping University, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 10. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden. 11. Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract
RATIONALE AND OBJECTIVES: Emphysema is a hallmark of chronic obstructive pulmonary disease. The primary aim of this study was to investigate inter- and intraobserver agreement of visual assessment of mild emphysema in low-dose multidetector computed tomography of subjects in the pilot SCAPIS in order to certify consistent detection of mild emphysema. The secondary aim was to investigate the performance of quantitative densitometric measurements in the cohort. MATERIALS AND METHODS: Participants with emphysema (n = 100, 56 males and 44 females) reported in the electronic case report form of pilot SCAPIS and 100 matched controls (gender, age, height, and weight) without emphysema were included. To assess interobserver variability the randomized examinations were evaluated by two thoracic radiologists. For intraobserver variability three radiologists re-evaluated randomized examinations which they originally evaluated. The results were evaluated statistically by Krippendorff's α. The dataset was also assessed quantitively for % lung attenuation value -950 HU (LAV950), mean lung density and total lung volume by commercially available software. RESULTS: Emphysema was visually scored as mild and Krippendorff's α was ≥0.8 for both the inter- and intraobserver agreement regarding presence of emphysema and approaching 0.8 regarding presence and extent of emphysema by location in the upper lobes. Mean LAV950 was not different between the emphysematous and the nonemphysematous participants; 8.3% and 8.4%, respectively. CONCLUSION: The inter- and intraobserver agreement for visual detection of mild emphysema in low-dose multidetector computed tomography was good. Surprisingly, quantitative analysis could not reliably identify participants with mild emphysema, which hampers the use of automatic evaluation.
RATIONALE AND OBJECTIVES:Emphysema is a hallmark of chronic obstructive pulmonary disease. The primary aim of this study was to investigate inter- and intraobserver agreement of visual assessment of mild emphysema in low-dose multidetector computed tomography of subjects in the pilot SCAPIS in order to certify consistent detection of mild emphysema. The secondary aim was to investigate the performance of quantitative densitometric measurements in the cohort. MATERIALS AND METHODS:Participants with emphysema (n = 100, 56 males and 44 females) reported in the electronic case report form of pilot SCAPIS and 100 matched controls (gender, age, height, and weight) without emphysema were included. To assess interobserver variability the randomized examinations were evaluated by two thoracic radiologists. For intraobserver variability three radiologists re-evaluated randomized examinations which they originally evaluated. The results were evaluated statistically by Krippendorff's α. The dataset was also assessed quantitively for % lung attenuation value -950 HU (LAV950), mean lung density and total lung volume by commercially available software. RESULTS:Emphysema was visually scored as mild and Krippendorff's α was ≥0.8 for both the inter- and intraobserver agreement regarding presence of emphysema and approaching 0.8 regarding presence and extent of emphysema by location in the upper lobes. Mean LAV950 was not different between the emphysematous and the nonemphysematous participants; 8.3% and 8.4%, respectively. CONCLUSION: The inter- and intraobserver agreement for visual detection of mild emphysema in low-dose multidetector computed tomography was good. Surprisingly, quantitative analysis could not reliably identify participants with mild emphysema, which hampers the use of automatic evaluation.