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Erschienen in: European Radiology 12/2012

01.12.2012 | Chest

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

verfasst von: Kristina Vult von Steyern, Isabella M. Björkman-Burtscher, Peter Höglund, Gracijela Bozovic, Marie Wiklund, Mats Geijer

Erschienen in: European Radiology | Ausgabe 12/2012

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Abstract

Objectives

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis.

Methods

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.

Results

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).

Conclusions

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.

Key Points

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.
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Literatur
1.
Zurück zum Zitat Vikgren J, Zachrisson S, Svalkvist A et al (2008) Comparison of chest tomosynthesis and chest radiography for detection of pulmonary nodules: human observer study of clinical cases. Radiology 249:1034–1041PubMedCrossRef Vikgren J, Zachrisson S, Svalkvist A et al (2008) Comparison of chest tomosynthesis and chest radiography for detection of pulmonary nodules: human observer study of clinical cases. Radiology 249:1034–1041PubMedCrossRef
2.
Zurück zum Zitat Vult von Steyern K, Bjorkman-Burtscher I, Geijer M (2011) Tomosynthesis in pulmonary cystic fibrosis with comparison to radiography and computed tomography: a pictorial review. Insights Imaging. doi:10.1007/s13244-011-0137-9 Vult von Steyern K, Bjorkman-Burtscher I, Geijer M (2011) Tomosynthesis in pulmonary cystic fibrosis with comparison to radiography and computed tomography: a pictorial review. Insights Imaging. doi:10.​1007/​s13244-011-0137-9
3.
Zurück zum Zitat Shwachman H, Kulczycki L (1958) Long-term study of one hundred five patients with cystic fibrosis: studies made over a five- to fourteen-year period. AMA J Dis Child 96:6–15PubMed Shwachman H, Kulczycki L (1958) Long-term study of one hundred five patients with cystic fibrosis: studies made over a five- to fourteen-year period. AMA J Dis Child 96:6–15PubMed
4.
Zurück zum Zitat Taussig L, Kattwinkel J, Friedewald W et al (1973) A new prognostic score and clinical evaluation system for cystic fibrosis. J Pediatr 82:380–390PubMedCrossRef Taussig L, Kattwinkel J, Friedewald W et al (1973) A new prognostic score and clinical evaluation system for cystic fibrosis. J Pediatr 82:380–390PubMedCrossRef
5.
Zurück zum Zitat Chrispin A, Norman A (1974) The systematic evaluation of the chest radiograph in cystic fibrosis. Pediatr Radiol 2:101–105PubMedCrossRef Chrispin A, Norman A (1974) The systematic evaluation of the chest radiograph in cystic fibrosis. Pediatr Radiol 2:101–105PubMedCrossRef
6.
Zurück zum Zitat Brasfield D, Hicks G, Soong S et al (1979) The chest roentgenogram in cystic fibrosis: a new scoring system. Pediatrics 63:24–29PubMed Brasfield D, Hicks G, Soong S et al (1979) The chest roentgenogram in cystic fibrosis: a new scoring system. Pediatrics 63:24–29PubMed
7.
Zurück zum Zitat Van der Put J, Meradji M, Danoesastro D et al (1982) Chest radiographs in cystic fibrosis. A follow-up study with application of a quantitative system. Pediatr Radiol 12:57–61PubMedCrossRef Van der Put J, Meradji M, Danoesastro D et al (1982) Chest radiographs in cystic fibrosis. A follow-up study with application of a quantitative system. Pediatr Radiol 12:57–61PubMedCrossRef
8.
Zurück zum Zitat Carty H (1987) The chest radiograph in cystic fibrosis in children and the role of other radiological techniques. J R Soc Med 80:38–46PubMed Carty H (1987) The chest radiograph in cystic fibrosis in children and the role of other radiological techniques. J R Soc Med 80:38–46PubMed
9.
Zurück zum Zitat Weatherly M, Palmer C, Peters M et al (1993) Wisconsin cystic fibrosis chest radiograph scoring system. Pediatrics 91:488–495PubMed Weatherly M, Palmer C, Peters M et al (1993) Wisconsin cystic fibrosis chest radiograph scoring system. Pediatrics 91:488–495PubMed
10.
Zurück zum Zitat Conway S, Pond M, Bowler I et al (1994) The chest radiograph in cystic fibrosis: a new scoring system compared with the Chrispin-Norman and Brasfield scores. Thorax 49:860–862PubMedCrossRef Conway S, Pond M, Bowler I et al (1994) The chest radiograph in cystic fibrosis: a new scoring system compared with the Chrispin-Norman and Brasfield scores. Thorax 49:860–862PubMedCrossRef
11.
Zurück zum Zitat Cleveland R, Neish A, Zurakowski D et al (1998) Cystic fibrosis: a system for assessing and predicting progression. AJR Am J Roentgenol 170:1067–1072PubMed Cleveland R, Neish A, Zurakowski D et al (1998) Cystic fibrosis: a system for assessing and predicting progression. AJR Am J Roentgenol 170:1067–1072PubMed
12.
Zurück zum Zitat Koscik R, Kosorok M, Farrell P et al (2000) Wisconsin cystic fibrosis chest radiograph scoring system: validation and standardization for application to longitudinal studies. Pediatr Pulmonol 29:457–467PubMedCrossRef Koscik R, Kosorok M, Farrell P et al (2000) Wisconsin cystic fibrosis chest radiograph scoring system: validation and standardization for application to longitudinal studies. Pediatr Pulmonol 29:457–467PubMedCrossRef
13.
Zurück zum Zitat Benden C, Wallis C, Owens C et al (2005) The Chrispin-Norman score in cystic fibrosis: doing away with the lateral view. Eur Respir J 26:894–897PubMedCrossRef Benden C, Wallis C, Owens C et al (2005) The Chrispin-Norman score in cystic fibrosis: doing away with the lateral view. Eur Respir J 26:894–897PubMedCrossRef
14.
Zurück zum Zitat Bhalla M, Turcios N, Aponte V et al (1991) Cystic fibrosis: scoring system with thin-section CT. Radiology 179:783–788PubMed Bhalla M, Turcios N, Aponte V et al (1991) Cystic fibrosis: scoring system with thin-section CT. Radiology 179:783–788PubMed
15.
Zurück zum Zitat Nathanson I, Conboy K, Murphy S et al (1991) Ultrafast computerized tomography of the chest in cystic fibrosis: a new scoring system. Pediatr Pulmonol 11:81–86PubMedCrossRef Nathanson I, Conboy K, Murphy S et al (1991) Ultrafast computerized tomography of the chest in cystic fibrosis: a new scoring system. Pediatr Pulmonol 11:81–86PubMedCrossRef
16.
Zurück zum Zitat Maffessanti M, Candusso M, Brizzi F et al (1996) Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging 11:27–38PubMedCrossRef Maffessanti M, Candusso M, Brizzi F et al (1996) Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging 11:27–38PubMedCrossRef
17.
Zurück zum Zitat Santamaria F, Grillo G, Guidi G et al (1998) Cystic fibrosis: when should high-resolution computed tomography of the chest be obtained? Pediatrics 101:908–913PubMedCrossRef Santamaria F, Grillo G, Guidi G et al (1998) Cystic fibrosis: when should high-resolution computed tomography of the chest be obtained? Pediatrics 101:908–913PubMedCrossRef
18.
Zurück zum Zitat Brody A, Molina P, Klein J et al (1999) High-resolution computed tomography of the chest in children with cystic fibrosis: support for use as an outcome surrogate. Pediatr Radiol 29:731–735PubMedCrossRef Brody A, Molina P, Klein J et al (1999) High-resolution computed tomography of the chest in children with cystic fibrosis: support for use as an outcome surrogate. Pediatr Radiol 29:731–735PubMedCrossRef
19.
Zurück zum Zitat Helbich T, Heinz-Peer G, Eichler I et al (1999) Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology 213:537–544PubMed Helbich T, Heinz-Peer G, Eichler I et al (1999) Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology 213:537–544PubMed
20.
Zurück zum Zitat Robinson T, Leung A, Northway W et al (2001) Spirometer-triggered high-resolution computed tomography and pulmonary function measurements during an acute exacerbation in patients with cystic fibrosis. J Pediatr 138:553–559PubMedCrossRef Robinson T, Leung A, Northway W et al (2001) Spirometer-triggered high-resolution computed tomography and pulmonary function measurements during an acute exacerbation in patients with cystic fibrosis. J Pediatr 138:553–559PubMedCrossRef
21.
Zurück zum Zitat Oikonomou A, Tsanakas J, Hatziagorou E et al (2008) High resolution computed tomography of the chest in cystic fibrosis (CF): is simplification of scoring systems feasible? Eur Radiol 18:538–547PubMedCrossRef Oikonomou A, Tsanakas J, Hatziagorou E et al (2008) High resolution computed tomography of the chest in cystic fibrosis (CF): is simplification of scoring systems feasible? Eur Radiol 18:538–547PubMedCrossRef
22.
Zurück zum Zitat Brody A, Klein J, Molina P et al (2004) High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. J Pediatr 145:32–38PubMedCrossRef Brody A, Klein J, Molina P et al (2004) High-resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. J Pediatr 145:32–38PubMedCrossRef
23.
Zurück zum Zitat Dobbins J, Godfrey D (2003) Digital x-ray tomosynthesis: current state of the art and clinical potential. Phys Med Biol 48:R65–R106PubMedCrossRef Dobbins J, Godfrey D (2003) Digital x-ray tomosynthesis: current state of the art and clinical potential. Phys Med Biol 48:R65–R106PubMedCrossRef
24.
Zurück zum Zitat Bath M, Svalkvist A, von Wrangel A et al (2010) Effective dose to patients from chest examinations with tomosynthesis. Radiat Prot Dosim 139:153–158CrossRef Bath M, Svalkvist A, von Wrangel A et al (2010) Effective dose to patients from chest examinations with tomosynthesis. Radiat Prot Dosim 139:153–158CrossRef
25.
Zurück zum Zitat Sabol JM (2009) A Monte Carlo estimation of effective dose in chest tomosynthesis. Med Phys 36:5480–5487PubMedCrossRef Sabol JM (2009) A Monte Carlo estimation of effective dose in chest tomosynthesis. Med Phys 36:5480–5487PubMedCrossRef
26.
27.
Zurück zum Zitat Lynch D, Newell J, Hale V et al (1999) Correlation of CT findings with clinical evaluations in 261 patients with symptomatic bronchiectasis. AJR Am J Roentgenol 173:53–58PubMed Lynch D, Newell J, Hale V et al (1999) Correlation of CT findings with clinical evaluations in 261 patients with symptomatic bronchiectasis. AJR Am J Roentgenol 173:53–58PubMed
29.
Zurück zum Zitat Rossi S, Franquet T, Volpacchio M et al (2005) Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview1. Radiographics 25:789–801PubMedCrossRef Rossi S, Franquet T, Volpacchio M et al (2005) Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview1. Radiographics 25:789–801PubMedCrossRef
31.
Zurück zum Zitat Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRef
32.
Zurück zum Zitat Svensson E, Holm S (1994) Separation of systematic and random differences in ordinal rating scales. Stat Med 13:2437–2453PubMedCrossRef Svensson E, Holm S (1994) Separation of systematic and random differences in ordinal rating scales. Stat Med 13:2437–2453PubMedCrossRef
33.
Zurück zum Zitat Svensson E, Starmark JE, Ekholm S et al (1996) Analysis of interobserver disagreement in the assessment of subarachnoid blood and acute hydrocephalus on CT scans. Neurol Res 18:487–494PubMed Svensson E, Starmark JE, Ekholm S et al (1996) Analysis of interobserver disagreement in the assessment of subarachnoid blood and acute hydrocephalus on CT scans. Neurol Res 18:487–494PubMed
34.
Zurück zum Zitat de Jong P, Lindblad A, Rubin L et al (2006) Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis. Thorax 61:80–85PubMedCrossRef de Jong P, Lindblad A, Rubin L et al (2006) Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis. Thorax 61:80–85PubMedCrossRef
35.
Zurück zum Zitat de Jong P, Tiddens H (2007) Cystic fibrosis specific computed tomography scoring. Proc Am Thorac Soc 4:338–342PubMedCrossRef de Jong P, Tiddens H (2007) Cystic fibrosis specific computed tomography scoring. Proc Am Thorac Soc 4:338–342PubMedCrossRef
37.
Zurück zum Zitat Aziz Z, Davies J, Alton E et al (2007) Computed tomography and cystic fibrosis: promises and problems. Thorax 62:181–186PubMedCrossRef Aziz Z, Davies J, Alton E et al (2007) Computed tomography and cystic fibrosis: promises and problems. Thorax 62:181–186PubMedCrossRef
38.
Zurück zum Zitat Cooper P, MacLean J (2006) High-resolution computed tomography (HRCT) should not be considered as a routine assessment method in cystic fibrosis lung disease. Paediatr Respir Rev 7:197–201PubMedCrossRef Cooper P, MacLean J (2006) High-resolution computed tomography (HRCT) should not be considered as a routine assessment method in cystic fibrosis lung disease. Paediatr Respir Rev 7:197–201PubMedCrossRef
39.
Zurück zum Zitat Tiddens H (2006) Chest computed tomography scans should be considered as a routine investigation in cystic fibrosis. Paediatr Respir Rev 7:202–208PubMedCrossRef Tiddens H (2006) Chest computed tomography scans should be considered as a routine investigation in cystic fibrosis. Paediatr Respir Rev 7:202–208PubMedCrossRef
40.
Zurück zum Zitat de Jong P, Nakano Y, Lequin M et al (2004) Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis. Eur Respir J 23:93–97PubMedCrossRef de Jong P, Nakano Y, Lequin M et al (2004) Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis. Eur Respir J 23:93–97PubMedCrossRef
41.
Zurück zum Zitat Lucaya J, Piqueras J, Garcia-Pena P et al (2000) Low-dose high-resolution CT of the chest in children and young adults: dose, cooperation, artifact incidence, and image quality. AJR Am J Roentgenol 175:985–992PubMed Lucaya J, Piqueras J, Garcia-Pena P et al (2000) Low-dose high-resolution CT of the chest in children and young adults: dose, cooperation, artifact incidence, and image quality. AJR Am J Roentgenol 175:985–992PubMed
Metadaten
Titel
Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis
verfasst von
Kristina Vult von Steyern
Isabella M. Björkman-Burtscher
Peter Höglund
Gracijela Bozovic
Marie Wiklund
Mats Geijer
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 12/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2534-y

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