UMMS Affiliation
Department of Radiology
Publication Date
2020-10-30
Document Type
Article
Disciplines
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology | Respiratory Tract Diseases
Abstract
Purpose: To determine the accuracy of quantitative CT to diagnose pulmonary edema compared to qualitative CT and CXR and to determine a threshold Hounsfield unit (HU) measurement for pulmonary edema on CT examinations.
Method: Electronic medical records were searched for patients with a billing diagnosis of heart failure and a Chest CT and CXR performed within three hours between 1/1/2016 to 10/1/2016, yielding 100 patients. CXR and CT examinations were scored for the presence and severity of edema, using a 0-5 scale, and CT HU measurements were obtained in each lobe. Polyserial correlation coefficients evaluated the association between CT HUs and CXR scores, and receiver operating characteristic (ROC) curve analysis determined a cutoff CT HU value for identification of pulmonary edema.
Results: Correlation between CT HU and CXR score was moderately strong (r=0.585-0.685) with CT HU measurements demonstrating good to excellent accuracy in differentiating between no edema (grade 0) and mild to severe edema (grades 1-5) in every lobe, with AUCs ranging between 0.869 and 0.995. The left upper lobe demonstrated the highest accuracy, using a cutoff value of -825 HU (AUC of 0.995, sensitivity=100 % and specificity=95.1 %). Additionally, qualitative CT evaluation was less sensitive (84 %) than portable CXR in identifying pulmonary edema. However, quantitative CT evaluation was as sensitive as portable CXR (100 %) and highly specific (95 %).
Conclusions: Quantitative CT enables the identification of pulmonary edema with high accuracy and demonstrates a greater sensitivity than qualitative CT in assessment of pulmonary edema.
Keywords
AUC, area under the curve, CT, CT, computed tomography, CXR, chest X-ray, Chest radiograph, HU, hounsfield unit, Pulmonary edema, Quantitative CT, R, correlation coefficient, ROC, receiver operating characteristic, ROI, region of interest
Rights and Permissions
© 2020 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
DOI of Published Version
10.1016/j.ejro.2020.100273
Source
Barile M, Hida T, Hammer M, Hatabu H. Simple quantitative chest CT for pulmonary edema. Eur J Radiol Open. 2020 Oct 30;7:100273. doi: 10.1016/j.ejro.2020.100273. PMID: 33163584; PMCID: PMC7607389. Link to article on publisher's site
Journal/Book/Conference Title
European journal of radiology open
Related Resources
PubMed ID
33163584
Repository Citation
Barile M, Hida T, Hammer M, Hatabu H. (2020). Simple quantitative chest CT for pulmonary edema. Radiology Publications. https://doi.org/10.1016/j.ejro.2020.100273. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/571
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Included in
Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons, Radiology Commons, Respiratory Tract Diseases Commons