Intra- and interoperator variability of lobar pulmonary volumes and emphysema scores in patients with chronic obstructive pulmonary disease and emphysema: comparison of manual and semi-automated segmentation techniques
Intra- and interoperator varia...
Francesco Molinari 1 , Tommaso Pirronti 2 , Nicola Sverzellati 3 , Stefano Diciotti 4 , Michele Amato 2 , Guglielmo Paolantonio 5 , Luigia Gentile 6 , George K. Parapatt 2 , Francesco D’Argento 2 , Jan-Martin Kuhnigk 7
C. H. R. U. Lille , Hôpital Calmette, Lille, France
Department of Bioimaging and Radiological Sciences, Catholic University of Rome, Rome, Italy
Section of Radiology, Department of Surgery, University Hospital of Parma, Italy.
Computational Biomedical Imaging Laboratory, Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Florence, Italy
Vascular and Interventional Radiology Unit, Pediatric Hospital Bambino Gesù, Rome, Italy
Department of Radiology, Hospital San Maurizio, Bozen, Italy
Fraunhofer MEVIS , Bremen, Germany
We aimed to compare the intra- and interoperator variability of lobar volumetry and emphysema scores obtained by semi-automated and manual segmentation techniques in lung emphysema patients.
In two sessions held three months apart, two operators performed lobar volumetry of unenhanced chest computed tomography examinations of 47 consecutive patients with chronic obstructive pulmonary disease and lung emphysema. Both operators used the manual and semi-automated segmentation techniques. The intra- and interoperator variability of the volumes and emphysema scores obtained by semi-automated segmentation was compared with the variability obtained by manual segmentation of the five pulmonary lobes.
The intra- and interoperator variability of the lobar volumes decreased when using semi-automated lobe segmentation (coefficients of repeatability for the first operator: right upper lobe, 147 vs. 96.3; right middle lobe, 137.7 vs. 73.4; right lower lobe, 89.2 vs. 42.4; left upper lobe, 262.2 vs. 54.8; and left lower lobe, 260.5 vs. 56.5; coefficients of repeatability for the second operator: right upper lobe, 61.4 vs. 48.1; right middle lobe, 56 vs. 46.4; right lower lobe, 26.9 vs. 16.7; left upper lobe, 61.4 vs. 27; and left lower lobe, 63.6 vs. 27.5; coefficients of reproducibility in the interoperator analysis: right upper lobe, 191.3 vs. 102.9; right middle lobe, 219.8 vs. 126.5; right lower lobe, 122.6 vs. 90.1; left upper lobe, 166.9 vs. 68.7; and left lower lobe, 168.7 vs. 71.6). The coefficients of repeatability and reproducibility of emphysema scores also decreased when using semi-automated segmentation and had ranges that varied depending on the target lobe and selected threshold of emphysema.
Semi-automated segmentation reduces the intra- and interoperator variability of lobar volumetry and provides a more objective tool than manual technique for quantifying lung volumes and severity of emphysema.