Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund University, 221 85, Lund, Sweden.
Eur Radiol. 2012 Dec;22(12):2718-28. doi: 10.1007/s00330-012-2534-y. Epub 2012 Jun 30.
To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis.
A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system.
Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85).
The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity.
Tomosynthesis is more sensitive than conventional radiography for pulmonary cystic fibrosis changes. The radiation dose from chest tomosynthesis is low compared with computed tomography. Tomosynthesis may become useful in the regular follow-up of patients with cystic fibrosis.
设计并验证一种用于肺部囊性纤维化的断层合成（数字断层摄影）评分系统。
设计了一种专门用于肺部囊性纤维化断层合成的评分系统。三位放射科医生对 60 例囊性纤维化患者和 7 例肿瘤科患者的 88 对胸部 X 线片和断层合成检查进行了独立评分。X 线片根据 Brasfield 评分系统进行评分，断层合成检查根据新的评分系统进行评分。
断层合成总评分的观察者间一致性几乎为完美（加权平方 kapp >0.90），对于各亚评分，一致性通常为强至几乎完美。三位观察者的断层合成评分与 Brasfield 评分之间的相关性良好（Kendall 等级相关 tau 值为 0.68、0.77 和 0.78）。断层合成的评分通常以最大评分的百分比表示，得分更高。Brasfield 评分的总评分观察者间一致性几乎为完美（加权平方 kapp 值为 0.80、0.81 和 0.85）。
断层合成评分系统似乎很稳健，与 Brasfield 评分相关性良好。与 X 线摄影相比，断层合成对囊性纤维化的改变更敏感，尤其是支气管扩张和黏液栓形成，新的断层合成评分系统有可能对疾病严重程度进行更详细和准确的评分。
断层合成对肺部囊性纤维化的改变比常规 X 线摄影更敏感。与计算机断层扫描相比，胸部断层合成的辐射剂量较低。断层合成可能在囊性纤维化患者的常规随访中变得有用。
