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La radiologia medica
Published in: La radiologia medica 4/2021

Open Access 01-04-2021 | Idiopathic Pulmonary Fibrosis | Computed Tomography

Comparative analysis of density histograms and visual scores in incremental and volumetric high-resolution computed tomography of the chest in idiopathic pulmonary fibrosis patients

Authors: Gaetano Rea, Marina De Martino, Annalisa Capaccio, Pasquale Dolce, Tullio Valente, Sabrina Castaldo, Angelo Canora, Francesco Lassandro, Marialuisa Bocchino

Published in: La radiologia medica | Issue 4/2021

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Abstract

Background

Volumetric high-resolution computed tomography (HRCT) of the chest has recently replaced incremental CT in the diagnostic workup of idiopathic pulmonary fibrosis (IPF). Concomitantly, visual and quantitative scores have been proposed for disease extent assessment to ameliorate disease management.

Purpose

To compare the performance of density histograms (mean lung attenuation, skewness, and kurtosis) and visual scores, along with lung function correlations, in IPF patients submitted to incremental or volumetric thorax HRCT.

Material and methods

Clinical data and CT scans of 89 newly diagnosed and therapy-naive IPF patients were retrospectively evaluated.

Results

Forty-six incremental and 43 volumetric CT scans were reviewed. No differences of density histograms and visual scores estimates were found by comparing two HRCT techniques, with an optimal inter-operator agreement (concordance correlation coefficient >0.90 in all instances). Single-breath diffusing lung capacity for carbon monoxide (DLCOsb) was inversely related with the Best score (r = −00.416; p = 0.014), the Kazerooni fibrosis extent (r = −0.481; p = 0.004) and the mean lung attenuation (r = −0.382; p = 0.026), while a positive correlation was observed with skewness (r = 0.583; p = 0.001) and kurtosis (r = 0.543; p = 0.001) in the incremental HRCT sub-group. Similarly, in the volumetric CT sub-cohort, DLCOsb was significantly associated with skewness (r = 0.581; p = 0.007) and kurtosis (r = 0.549; p = 0.018). Correlations with visual scores were not confirmed. Forced vital capacity significantly related to all density indices independently on HRCT technique.

Conclusions

Density histograms and visual scores similarly perform in incremental and volumetric HRCT. Density quantification displays an optimal reproducibility and proves to be superior to visual scoring as more strongly correlated with lung function.
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Metadata
Title
Comparative analysis of density histograms and visual scores in incremental and volumetric high-resolution computed tomography of the chest in idiopathic pulmonary fibrosis patients
Authors
Gaetano Rea
Marina De Martino
Annalisa Capaccio
Pasquale Dolce
Tullio Valente
Sabrina Castaldo
Angelo Canora
Francesco Lassandro
Marialuisa Bocchino
Publication date
01-04-2021
Publisher
Springer Milan
Published in
La radiologia medica / Issue 4/2021
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI
https://doi.org/10.1007/s11547-020-01307-7

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