Thoracic Imaging Research Group, Los Angeles, Los Angeles, CA 90024, USA.
Acad Radiol. 2010 Mar;17(3):316-22. doi: 10.1016/j.acra.2009.10.005. Epub 2009 Dec 8.
Lung and lobar volume measurements from computed tomographic (CT) imaging are being used in clinical trials to assess new minimally invasive emphysema treatments aiming to reduce lung volumes. Establishing the reproducibility of lung volume measurements is important if they are to be accepted as treatment planning and outcome variables. The aims of this study were to (1) investigate the correlation between lung volumes assessed on CT imaging and on pulmonary function testing (PFT), (2) compare the two methods' reproducibility, and (3) assess the reproducibility of CT lobar volumes.
CT imaging and body plethysmography were performed at baseline and after a 9-month interval in multicenter emphysema treatment trials. Lung volumes were measured at total lung capacity (TLC) and at residual volume (RV). Lobar volumes were measured on CT imaging using a semiautomated technique. The correlations between CT and PFT volumes were computed for 486 subjects at baseline. Reproducibility was assessed in terms of the intraclass correlation coefficient (ICC) for 126 subjects from the control group at TLC and 120 subjects at RV.
Correlations between CT and PFT lung volumes were 0.86 at TLC and 0.67 at RV. At TLC, the ICCs were 0.943 for CT imaging and 0.814 for PFT. At RV, the ICCs were 0.886 for CT imaging and 0.683 for PFT. CT lobar volumes showed good reproducibility (all P values < .05).
CT lung and lobar volume measurements could be captured in a multicenter trial setting with high reproducibility and were highly correlated with those obtained on PFT. CT imaging showed significantly better reproducibility than PFT between interval lung volume measurements, offering the potential for designing emphysema treatment trials involving fewer subjects.
在临床试验中,使用计算机断层扫描(CT)成像来测量肺和肺叶体积,以评估旨在减少肺容积的新的微创肺气肿治疗方法。如果要将肺容积测量结果作为治疗计划和结果变量接受,那么建立肺容积测量的可重复性是很重要的。本研究的目的是:(1)研究 CT 成像上测量的肺容积与肺功能测试(PFT)之间的相关性;(2)比较两种方法的可重复性;(3)评估 CT 肺叶容积的可重复性。
在多中心肺气肿治疗试验中,在基线和 9 个月间隔时进行 CT 成像和体描仪检查。在总肺容量(TLC)和残气量(RV)时测量肺容积。使用半自动技术在 CT 成像上测量肺叶容积。在 486 例患者的基线时计算 CT 和 PFT 容积之间的相关性。在 TLC 时,对来自对照组的 126 例患者和在 RV 时,对 120 例患者,评估了重复性,用组内相关系数(ICC)来表示。
TLC 时 CT 和 PFT 肺容积之间的相关性为 0.86,RV 时为 0.67。TLC 时,CT 成像的 ICC 为 0.943,PFT 为 0.814。在 RV 时,CT 成像的 ICC 为 0.886,PFT 为 0.683。CT 肺叶容积具有很好的可重复性(所有 P 值均<0.05)。
在多中心试验环境中,CT 肺和肺叶容积测量具有较高的可重复性,与 PFT 获得的结果高度相关。在两次间隔的肺容积测量中,CT 成像的可重复性明显优于 PFT,为设计涉及较少患者的肺气肿治疗试验提供了潜力。