Quantitative and Qualitative Assessments of Lung Destruction and Pulmonary Functional Loss from Reduced-Dose Thin-Section CT in Pulmonary Emphysema Patients

Koyama, Hisanobu; Ohno, Yoshiharu; Yamazaki, Youichi; Nogami, Munenobu; Murase, Kenya; Onishi, Yumiko; Matsumoto, Keiko; Takenaka, Daisuke; Sugimura, Kazuro

doi:10.1016/j.acra.2009.08.009

« Previous Next »Academic Radiology
Volume 17, Issue 2 , Pages 163-168, February 2010

Quantitative and Qualitative Assessments of Lung Destruction and Pulmonary Functional Loss from Reduced-Dose Thin-Section CT in Pulmonary Emphysema Patients

Hisanobu Koyama, MD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Address correspondence to: H.K.
Yoshiharu Ohno, MD, PhD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
Youichi Yamazaki, PhD
- Department of Medical Physics and Engineering, Faculty of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
Munenobu Nogami, MD, PhD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
Kenya Murase, PhD
- Department of Medical Physics and Engineering, Faculty of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
Yumiko Onishi, MD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
Keiko Matsumoto, MD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
Daisuke Takenaka, MD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
Kazuro Sugimura, MD
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan

Received 8 June 2008; accepted 27 July 2009. published online 12 November 2009.

Rationale and Objectives

Academic and clinical interest in reducing radiation from computed tomography (CT) examinations has increased, and the purpose of this study was to determine the capabilities of reduced-dose multidetector-row CT (MDCT) in assessing lung destruction and pulmonary functional loss in pulmonary emphysema patients.

Materials and Methods

Twenty-five consecutive smokers (15 men and 10 women; mean age 67.9 years; age range 49–86 years) underwent MDCT examinations using two different effective tube currents (standard-dose protocol [150 mAs] and reduced-dose protocol [50 mAs]). For quantitative and qualitative assessments of lung destruction in each subject, percentage of low attenuation emphysematous destruction areas (%LAAs) were computationally calculated, and visual emphysema scores (ESs) were determined for both protocols. To determine the capabilities for quantitative and qualitative assessments of lung destruction by using reduced-dose protocol, %LAAs and ESs of both protocols were compared statistically. To compare the capabilities for quantitative and qualitative assessments of pulmonary functional loss, %LAAs and ESs of both protocols were correlated with forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC).

Results

%LAAs and ESs had significant correlations between both protocols (%LAAs: r = 0.95, P < .001; ESs: r = 0.97, P < .001). The limits of agreement of %LAAs were −1.8 ± 9.2%. The agreement of ESs between both protocols was substantial (κ = 0.70). %LAAs and ESs of both protocols had significant correlations with FEV1/FVC (%LAAs of 150 mAs: r = −0.49, P < .05; %LAAs of 50 mAs: r = −0.44, P < .05; ESs of 150 mAs: r = −0.67, P < .001; ESs of 50 mAs: r = −0.66, P < .001).