Top

Published in:

01-11-2014 | Chest

Emphysema progression is visually detectable in low-dose CT in continuous but not in former smokers

Authors: Mathilde Marie Winkler Wille, Laura H. Thomsen, Asger Dirksen, Jens Petersen, Jesper Holst Pedersen, Saher B. Shaker

Published in: European Radiology | Issue 11/2014

Abstract

Objectives

To evaluate interobserver agreement and time-trend in chest CT assessment of emphysema, airways, and interstitial abnormalities in a lung cancer screening cohort.

Methods

Visual assessment of baseline and fifth-year examination of 1990 participants was performed independently by two observers. Results were standardised by means of an electronic score sheet; kappa and time-trend analyses were performed.

Results

Interobserver agreement was substantial in early emphysema diagnosis; highly significant (p < 0.001) time-trends in both emphysema presence and grading were found (higher prevalence and grade of emphysema in late CT examinations). Significant progression in emphysema was seen in continuous smokers, but not in former smokers. Agreement on centrilobular emphysema subtype was substantial; agreement on paraseptal subtype, moderate. Agreement on panlobular and mixed subtypes was only fair. Agreement was fair regarding airway analysis. Interstitial abnormalities were infrequent in the cohort, and agreement on these was fair to moderate. A highly significant time-trend was found regarding interstitial abnormalities, which were more frequent in late examinations.

Conclusions

Visual scoring of chest CT is able to characterise the presence, pattern, and progression of early emphysema. Continuous smokers progress; former smokers do not.

Key Points

• Substantial interobserver consistency in determining early-stage emphysema in low-dose CT.

• Longitudinal analyses show clear time-trends for emphysema presence and grading.

• For continuous smokers, progression of emphysema was seen in all lung zones.

• For former smokers, progression of emphysema was undetectable by visual assessment.

• Onset and progression of interstitial abnormalities are visually detectable.

Lynch DA, Godwin JD, Safrin S et al (2005) High-resolution computed tomography in idiopathic pulmonary fibrosis: diagnosis and prognosis. Am J Respir Crit Care Med 4:488–493CrossRef

Gietema HA, Muller NL, Fauerbach PV et al (2011) Quantifying the extent of emphysema: factors associated with radiologists’ estimations and quantitative indices of emphysema severity using the ECLIPSE cohort. Acad Radiol 6:661–671CrossRef

Sverzellati N, Devaraj A, Desai SR et al (2011) Method for minimizing observer variation for the quantitation of high-resolution computed tomographic signs of lung disease. J Comput Assist Tomogr 5:596–601CrossRef

Hansell DM (2001) Computed tomography of diffuse lung disease: functional correlates. Eur Radiol 9:1666–1680CrossRef

Mets OM, Smit EJ, Mohamed Hoesein FA et al (2012) Visual versus automated evaluation of chest computed tomography for the presence of chronic obstructive pulmonary disease. PLoS One 7:e42227PubMedCrossRefPubMedCentral

Rabe KF, Hurd S, Anzueto A et al (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 6:532–555CrossRef

Gurney JW, Jones KK, Robbins RA et al (1992) Regional distribution of emphysema: correlation of high-resolution CT with pulmonary function tests in unselected smokers. Radiology 2:457–463CrossRef

Kakinuma R, Ashizawa K, Kuriyama K et al (2012) Measurement of focal ground-glass opacity diameters on CT images: interobserver agreement in regard to identifying increases in the size of ground-glass opacities. Acad Radiol 4:389–394CrossRef

Watadani T, Sakai F, Johkoh T et al (2013) Interobserver variability in the CT assessment of honeycombing in the lungs. Radiology 3:936–944CrossRef

10.

Barr RG, Berkowitz EA, Bigazzi F et al (2012) A combined pulmonary-radiology workshop for visual evaluation of COPD: study design, chest CT findings and concordance with quantitative evaluation. COPD 2:151–159CrossRef

11.

Grenier P, Mourey-Gerosa I, Benali K et al (1996) Abnormalities of the airways and lung parenchyma in asthmatics: CT observations in 50 patients and inter- and intraobserver variability. Eur Radiol 2:199–206

12.

Ng CS, Desai SR, Rubens MB et al (1999) Visual quantitation and observer variation of signs of small airways disease at inspiratory and expiratory CT. J Thorac Imaging 4:279–285CrossRef

13.

Thomsen LH, Dirksen A, Shaker SB et al (2014) Analysis of FEV decline in relatively healthy heavy smokers: implications of expressing changes in FEV in relative terms. COPD 11:96–104

14.

Shaker SB, Dirksen A, Lo P et al (2012) Factors influencing the decline in lung density in a Danish lung cancer screening cohort. Eur Respir J 5:1142–1148CrossRef

15.

Pedersen JH, Ashraf H, Dirksen A et al (2009) The Danish randomized lung cancer CT screening trial–overall design and results of the prevalence round. J Thorac Oncol 5:608–614CrossRef

16.

Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 3:697–722CrossRef

17.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 1:159–174CrossRef

18.

Lo P, Sporring J, Ashraf H, Pedersen JJ, de Bruijne M (2010) Vessel-guided airway tree segmentation: a voxel classification approach. Med Image Anal 4:527–538CrossRef

19.

Dijkstra AE, Postma DS, ten Hacken N et al (2013) Low-dose CT measurements of airway dimensions and emphysema associated with airflow limitation in heavy smokers: a cross sectional study. Respir Res 14:11PubMedCrossRefPubMedCentral

20.

Wille MMW, Petersen J, Dirksen A, Pedersen JH, De Bruijne M (2013) Airway distensibility in chronic obstructive pulmonary disease – evaluation by CT airway segmentation and lung density measurement based on the Danish Lung Cancer Screening Trial. AJRCCM:A2871

21.

Hasegawa M, Nasuhara Y, Onodera Y et al (2006) Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 12:1309–1315CrossRef

22.

Kazantzi A, Costaridou L, Skiadopoulos S et al (2014) Automated 3D iotanterstitial lung disease epsilonxtent quantification: performance evaluation and correlation to PFTs. J Digit Imaging 27(3):380–391

Title: Emphysema progression is visually detectable in low-dose CT in continuous but not in former smokers
Authors: Mathilde Marie Winkler Wille
Laura H. Thomsen
Asger Dirksen
Jens Petersen
Jesper Holst Pedersen
Saher B. Shaker
Publication date: 01-11-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3294-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Emphysema progression is visually detectable in low-dose CT in continuous but not in former smokers

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 11/2014

Embolization of post-biliary sphincterotomy bleeding refractory to medical and endoscopic therapy: technical results, clinical efficacy and predictors of outcome

Diagnostic accuracy of post-mortem MRI for thoracic abnormalities in fetuses and children

Single-source dual-energy CT angiography with reduced iodine load in patients referred for aortoiliofemoral evaluation before transcatheter aortic valve implantation: impact on image quality and radiation dose

Diffusion-weighted imaging for the detection of mesenteric small bowel tumours with Magnetic Resonance--enterography

Comparison of dual-biomarker PIB-PET and dual-tracer PET in AD diagnosis

Ultrafast cone-beam computed tomography imaging and postprocessing data during image-guided therapeutic practice