Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Eur J Radiol. 2021 Mar;136:109561. doi: 10.1016/j.ejrad.2021.109561. Epub 2021 Jan 23.
For a successful bronchoscopic lung volume reduction coil treatment it is important to place the coils in the most emphysematous lobes. Therefore assessment of the lobe with greatest destruction is essential. Our aims were to investigate the level of agreement among expert reviewers of HRCT-scans in emphysema patients and the comparison with QCT (quantitative computed tomography) software.
Five experienced CT-assessors, conducted a visual assessment of the baseline HRCT-scans of emphysema patients who participated in the RENEW bronchoscopic lung volume reduction coil study. On the same HRCT-scans, a QCT analysis was performed.
In total 134 HRCT-scans were rated by all 5 experts. All 5 CT-assessors agreed on which was the most destructed lobe in 61 % of the left lungs (ƙ:0.459) and 60 % of the right lungs (ƙ:0.370). The consensus of the 5 assessors matched the QCT in the left lung for 77 % of the patients (ƙ:0.425) and in the right lung for 82 % (ƙ:0.524).
Our results show that the interobserver agreement between five expert CT-assessors was only fair to moderate when evaluating the most destructed lobe. CT-assessor consensus improved matching with QCT determination of lobar destruction compared to individual assessor determinations. Because some CT-features are associated with treatment outcomes and important for optimal patient selection of bronchoscopic lung volume reduction treatment, we recommend including more than one CT-reviewer and supported by QCT measurements.
为了成功进行支气管镜肺减容线圈治疗，将线圈放置在最肺气肿的肺叶中非常重要。因此，评估具有最大破坏的肺叶至关重要。我们的目的是研究肺气肿患者的 HRCT 扫描中专家评审员之间的一致性水平，并与 QCT（定量计算机断层扫描）软件进行比较。
5 名有经验的 CT 评估员对参与 RENEW 支气管镜肺减容线圈研究的肺气肿患者的基线 HRCT 扫描进行了视觉评估。在相同的 HRCT 扫描上进行了 QCT 分析。
总共对 134 例 HRCT 扫描进行了 5 位专家的评估。所有 5 位 CT 评估员在 61%的左肺（ƙ：0.459）和 60%的右肺（ƙ：0.370）中对最破坏的肺叶达成一致。5 位评估员的共识与 QCT 在左肺的匹配率为 77%（ƙ：0.425），在右肺的匹配率为 82%（ƙ：0.524）。
我们的结果表明，当评估最破坏的肺叶时，五位专家 CT 评估员之间的观察者间一致性仅为中等至良好。与个别评估员的评估相比，CT 评估员的共识改善了与 QCT 确定的肺叶破坏的匹配。由于一些 CT 特征与治疗结果相关，对于支气管镜肺减容治疗的最佳患者选择很重要，因此我们建议包括一位以上的 CT 审阅者，并支持 QCT 测量。
