TY - JOUR
T1 - A Combined Pulmonary-Radiology Workshop for Visual Evaluation of COPD
T2 - Study Design, Chest CT Findings and Concordance with Quantitative Evaluation
AU - COPDGene CT Workshop Group
AU - Barr, R Graham
AU - Berkowitz, Eugene A
AU - Bigazzi, Francesca
AU - Bode, Frederick
AU - Bon, Jessica
AU - Bowler, Russell P
AU - Chiles, Caroline
AU - Crapo, James D
AU - Criner, Gerard J
AU - Curtis, Jeffrey L
AU - Dass, Chandra
AU - Dirksen, Asger
AU - Dransfield, Mark T
AU - Edula, Goutham
AU - Erikkson, Leif
AU - Friedlander, Adam
AU - Galperin-Aizenberg, Maya
AU - Gefter, Warren B
AU - Gierada, David S
AU - Grenier, Philippe A
AU - Goldin, Jonathan
AU - Han, MeiLan K
AU - Hanania, Nicola A
AU - Hansel, Nadia N
AU - Jacobson, Francine L
AU - Kauczor, Hans-Ulrich
AU - Kinnula, Vuokko L
AU - Lipson, David A
AU - Lynch, David A
AU - MacNee, William
AU - Make, Barry J
AU - Mamary, A James
AU - Mann, Howard
AU - Marchetti, Nathaniel
AU - Mascalchi, Mario
AU - McLennan, Geoffrey
AU - Murphy, James R
AU - Naidich, David
AU - Nath, Hrudaya
AU - Newell, John D
AU - Pistolesi, Massimo
AU - Regan, Elizabeth A
AU - Reilly, John J
AU - Sandhaus, Robert
AU - Schroeder, Joyce D
AU - Sciurba, Frank
AU - Shaker, Saher
AU - Sharafkhaneh, Amir
AU - Silverman, Edwin K
AU - van Beek, Edwin J R
PY - 2012/4
Y1 - 2012/4
N2 - The purposes of this study were: to describe chest CT findings in normal non-smoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring. Methods: Volumetric inspiratory and expiratory CT scans of 294 subjects, including normal non-smokers, smokers without COPD, and smokers with GOLD Stage I-IV COPD, were scored at a multi-reader workshop using a standardized worksheet. There were 58 observers (33 pulmonologists, 25 radiologists); each scan was scored by 9–11 observers. Interobserver agreement was calculated using kappa statistic. Median score of visual observations was compared with QCT measurements. Results: Interobserver agreement was moderate for the presence or absence of emphysema and for the presence of panlobular emphysema; fair for the presence of centrilobular, paraseptal, and bullous emphysema subtypes and for the presence of bronchial wall thickening; and poor for gas trapping, centrilobular nodularity, mosaic attenuation, and bronchial dilation. Agreement was similar for radiologists and pulmonologists. The prevalence on CT readings of most abnormalities (e.g. emphysema, bronchial wall thickening, mosaic attenuation, expiratory gas trapping) increased significantly with greater COPD severity, while the prevalence of centrilobular nodularity decreased. Concordances between visual scoring and quantitative scoring of emphysema, gas trapping and airway wall thickening were 75%, 87% and 65%, respectively. Conclusions: Despite substantial inter-observer variation, visual assessment of chest CT scans in cigarette smokers provides information regarding lung disease severity; visual scoring may be complementary to quantitative evaluation.
AB - The purposes of this study were: to describe chest CT findings in normal non-smoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring. Methods: Volumetric inspiratory and expiratory CT scans of 294 subjects, including normal non-smokers, smokers without COPD, and smokers with GOLD Stage I-IV COPD, were scored at a multi-reader workshop using a standardized worksheet. There were 58 observers (33 pulmonologists, 25 radiologists); each scan was scored by 9–11 observers. Interobserver agreement was calculated using kappa statistic. Median score of visual observations was compared with QCT measurements. Results: Interobserver agreement was moderate for the presence or absence of emphysema and for the presence of panlobular emphysema; fair for the presence of centrilobular, paraseptal, and bullous emphysema subtypes and for the presence of bronchial wall thickening; and poor for gas trapping, centrilobular nodularity, mosaic attenuation, and bronchial dilation. Agreement was similar for radiologists and pulmonologists. The prevalence on CT readings of most abnormalities (e.g. emphysema, bronchial wall thickening, mosaic attenuation, expiratory gas trapping) increased significantly with greater COPD severity, while the prevalence of centrilobular nodularity decreased. Concordances between visual scoring and quantitative scoring of emphysema, gas trapping and airway wall thickening were 75%, 87% and 65%, respectively. Conclusions: Despite substantial inter-observer variation, visual assessment of chest CT scans in cigarette smokers provides information regarding lung disease severity; visual scoring may be complementary to quantitative evaluation.
U2 - 10.3109/15412555.2012.654923
DO - 10.3109/15412555.2012.654923
M3 - Article
C2 - 22429093
SN - 1541-2563
VL - 9
SP - 151
EP - 159
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
IS - 2
ER -