Ventilation/perfusion SPECT/CT in patients with pulmonary emphysema^[*]

Summary

The purpose of this study was to evaluate the reproducibility of a new software based analysing system for ventilation/perfusion single-photon emission computed tomography/ computed tomography (V/P SPECT/CT) in patients with pulmonary emphysema and to compare it to the visual interpretation. Patients, material and methods: 19 patients (mean age: 68.1 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. Data were analysed by two independent observers in visual interpretation (VI) and by software based analysis system (SBAS). SBAS PMOD version 3.4 (Technologies Ltd, Zurich, Switzerland) was used to assess counts and volume per lung lobe/per lung and to calculate the count density per lung, lobe ratio of counts and ratio of count density. VI was performed using a visual scale to assess the mean counts per lung lobe. Interobserver variability and association for SBAS and VI were analysed using Spearman's rho correlation coefficient. Results: Interobserver agreement correlated highly in perfusion (rho: 0.982, 0.957, 0.90, 0.979) and ventilation (rho: 0.972, 0.924, 0.941, 0.936) for count/count density per lobe and ratio of counts/count density in SBAS. Interobserver agreement correlated clearly for perfusion (rho: 0.655) and weakly for ventilation (rho: 0.458) in VI. Conclusions: SBAS provides more reproducible measures than VI for the relative tracer uptake in V/P SPECT/CTs in patients with pulmonary emphysema. However, SBAS has to be improved for routine clinical use.

Zusammenfassung

Ziel dieser Studie ist die Evaluation der Reproduzierbarkeit Software basierter Analyse von Ventilations-/Perfusions SPECT/CT Untersuchungen in Patienten mit Lungenemphysem und deren Vergleich mit der visuellen Bildinterpretation. Patienten, Material und Methode: 19 Patienten (Durchschnittsalter: 68,1 Jahre) mit Lungenemphysem, die sich einer V/P SPECT/CT unterzogen wurden eingeschlossen. Die Datenanlyse erfolgte durch zwei unabhängige Observer mittels visueller Interpretation (VI) und Software basierten Analyse Systems (SBAS). SBAS PMOD Version 3.4 (Technologies Ltd, Zurich, Switzerland) wurde genutzt, um die Counts und das Volumen pro Lungenlappen/Lunge zu erheben und die Countdichte pro Lunge, die Countratio pro Lungenlappen und die Ratio der Countdichte zu kalkulieren. VI der Counts pro Lungenlappen erfolgte mithilfe einer visuellen Skala. Interobserver-Variabilität und Assoziation für SBAS und VI wurde mittels Spearman- Korrelation berechnet. Ergebnisse: Die übereinstimmung der Interobserver korrelierte hoch in der Perfusion (rho: 0,982; 0,957; 0,90; 0,979) und Ventilation (rho: 0,972; 0,942; 0,941; 0,936) für Counts/Countdichte pro Lungenlappen und Ratio der Counts/ Countdichte unter Verwendung des SBAS. Die übereinstimmung der Interobserver korrelierte klar für die Perfusion (rho: 0,655) und schwach für die Ventilation (rho: 0,458) in der VI. Schlussfolgerung: SBAS für V/P SPECT/ CT erzielt -im Vgl. zur VI-reproduzierbarere Messungen des relativen Traceruptakes in Patienten mit Lungenemphysem. Dennoch sollte die SBAS vor ihrem routinemäßigen Einsatz in der Klinik verbessert werden.

Keywords

V/P SPECT/CT - pulmonary emphysema - software-based analysing

Schlüsselwörter

V/P SPECT/CT - Software basierte Analyse - Lungenemphysem

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