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Gallardo Estrella L, Pompe E, Kuhnigk JM, Lynch D, Bhatt S, van Ginneken B, van Rikxoort E. Erratum: “Computed tomography quantification of tracheal abnormalities in COPD and their influence on airflow limitation.” [Med. Phys., 44: 3594-3603 (2017)]. Med Phys 2018. [DOI: 10.1002/mp.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dettmer S, Suhling H, Klingenberg I, Otten O, Kaireit T, Fuge J, Kuhnigk JM, Gottlieb J, Haverich A, Welte T, Wacker F, Vogel-Claussen J, Shin HO. Lobe-wise assessment of lung volume and density distribution in lung transplant patients and value for early detection of bronchiolitis obliterans syndrome. Eur J Radiol 2018; 106:137-144. [PMID: 30150035 DOI: 10.1016/j.ejrad.2018.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/04/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate quantitative computed tomography (CT) measurements of the lung parenchyma in lung transplant (LTx) patients for early detection of the bronchiolitis obliterans syndrome (BOS). MATERIALS AND METHODS 359 CT scans of 122 lung transplant patients were evaluated. Measurements of lung volume and density were performed for the whole lung and separately for each lobe. For longitudinal analysis the difference between the baseline at 6 months after LTx and follow-up examinations was calculated. Patients with and without BOS (matched 1:2) were compared at two different time points, the last examination before the BOS onset and the first examination within one year after BOS onset. RESULTS 30 patients developed BOS during the follow-up period. Longitudinal changes in the lung volume and lung density measured on CT differed significantly between those patients with and without early BOS, in particular the difference of the inspiratory and expiratory lung volume (p < 0.001), the ratio of the expiratory and inspiratory lung volume (p < 0.001-p = 0.001) and MLD (p < 0.001-p = 0.001), the volume on expiration (p < 0.001-p = 0.007), the MLD on expiration (p < 0.001-p = 0.007), and the percentiles on expiration (p < 0.001-p = 0.002) with an increase of lung volume and a decrease of lung density. Changes were pronounced in the lower lobes. Before BOS onset, patients with and without future development of BOS showed no significant differences. CONCLUSION Longitudinal changes of lung volume and lung density measured on CT start markedly at BOS onset with increased lung volume and decreased lung density indicating increased inflation levels. Even though this method may help to diagnose BOS at onset it is not useful as a predictor for BOS before disease onset.
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Affiliation(s)
- S Dettmer
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - H Suhling
- Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - I Klingenberg
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - O Otten
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - T Kaireit
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - J Fuge
- Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - J M Kuhnigk
- Fraunhofer Institute for Medical Image Computing MEVIS, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - J Gottlieb
- Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - A Haverich
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany; Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - T Welte
- Department of Respiratory Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany.
| | - F Wacker
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany; Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - J Vogel-Claussen
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany; Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - H O Shin
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Germany; Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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Doellinger F, Huebner RH, Kuhnigk JM, Poellinger A. Lung Volume Reduction in Pulmonary Emphysema from the Radiologist's Perspective. ROFO-FORTSCHR RONTG 2015; 187:662-75. [PMID: 26062174 DOI: 10.1055/s-0034-1399540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED Pulmonary emphysema causes decrease in lung function due to irreversible dilatation of intrapulmonary air spaces, which is linked to high morbidity and mortality. Lung volume reduction (LVR) is an invasive therapeutical option for pulmonary emphysema in order to improve ventilation mechanics. LVR can be carried out by lung resection surgery or different minimally invasive endoscopical procedures. All LVR-options require mandatory preinterventional evaluation to detect hyperinflated dysfunctional lung areas as target structures for treatment. Quantitative computed tomography can determine the volume percentage of emphysematous lung and its topographical distribution based on the lung's radiodensity. Modern techniques allow for lobebased quantification that facilitates treatment planning. Clinical tests still play the most important role in post-interventional therapy monitoring, but CT is crucial in the detection of postoperative complications and foreshadows the method's high potential in sophisticated experimental studies. Within the last ten years, LVR with endobronchial valves has become an extensively researched minimally-invasive treatment option. However, this therapy is considerably complicated by the frequent occurrence of functional interlobar shunts. The presence of "collateral ventilation" has to be ruled out prior to valve implantations, as the presence of these extraanatomical connections between different lobes may jeopardize the success of therapy. Recent experimental studies evaluated the automatic detection of incomplete lobar fissures from CT scans, because they are considered to be a predictor for the existence of shunts. To date, these methods are yet to show acceptable results. KEY POINTS Today, surgical and various minimal invasive methods of lung volume reduction are in use. Radiological and nuclear medical examinations are helpful in the evaluation of an appropriate lung area. Imaging can detect periinterventional complications. Reduction of lung volume has not yet been conclusively proven to be effective and is a therapeutical option with little scientific evidence.
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Affiliation(s)
- F Doellinger
- Department of Radiology, Charité Universitätsmedizin Berlin, Germany
| | - R H Huebner
- Department of Internal Medicine/Infectious and Respiratory Diseases, Charité Universitätsmedizin Berlin, Germany
| | - J M Kuhnigk
- Institute for Medical Image Computing, Fraunhofer MEVIS, Bremen, Germany
| | - A Poellinger
- Department of Radiology, Charité Universitätsmedizin Berlin, Germany
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Theilig D, Doellinger F, Kuhnigk JM, Temmesfeld-Wollbrueck B, Huebner RH, Schreiter N, Poellinger A. Pulmonary lymphangioleiomyomatosis: analysis of disease manifestation by region-based quantification of lung parenchyma. Eur J Radiol 2015; 84:732-7. [PMID: 25604910 DOI: 10.1016/j.ejrad.2014.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 12/18/2014] [Accepted: 12/24/2014] [Indexed: 01/10/2023]
Abstract
PURPOSE Lymphangioleiomyomatosis (LAM) is characterized by proliferation of smooth muscle tissue that causes bronchial obstruction and secondary cystic destruction of lung parenchyma. The aim of this study was to evaluate the typical distribution of cystic defects in LAM with quantitative volumetric chest computed tomography (CT). MATERIALS AND METHODS CT examinations of 20 patients with confirmed LAM were evaluated with region-based quantification of lung parenchyma. Additionally, 10 consecutive patients were identified who had recently undergone CT imaging of the lung at our institution, in which no pathologies of the lung were found, to serve as a control group. Each lung was divided into three regions (upper, middle and lower thirds) with identical number of slices. In addition, we defined a "peel" and "core" of the lung comprising the 2 cm subpleural space and the remaining inner lung area. Computerized detection of lung volume and relative emphysema was performed with the PULMO 3D software (v3.42, Fraunhofer MEVIS, Bremen, Germany). This software package enables the quantification of emphysematous lung parenchyma by calculating the pixel index, which is defined as the ratio of lung voxels with a density <-950HU to the total number of voxels in the lung. RESULTS Cystic changes accounted for 0.1-39.1% of the total lung volume in patients with LAM. Disease manifestation in the central lung was significantly higher than in peripheral areas (peel median: 15.1%, core median: 20.5%; p=0.001). Lower thirds of lung parenchyma showed significantly less cystic changes than upper and middle lung areas combined (lower third: median 13.4, upper and middle thirds: median 19.0, p=0.001). CONCLUSION The distribution of cystic lesions in LAM is significantly more pronounced in the central lung compared to peripheral areas. There is a significant predominance of cystic changes in apical and intermediate lung zones compared to the lung bases.
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Affiliation(s)
- D Theilig
- Charité, Universitätsmedizin Berlin, Department of Radiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - F Doellinger
- Charité, Universitätsmedizin Berlin, Department of Radiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - J M Kuhnigk
- Fraunhofer MEVIS, Universitaetsallee 29, 28359 Bremen, Germany
| | | | - R H Huebner
- Charité, Department of Pneumology, Augustenburger Platz 1, 13353 Berlin, Germany
| | - N Schreiter
- Charité, Universitätsmedizin Berlin, Department of Radiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - A Poellinger
- Charité, Universitätsmedizin Berlin, Department of Radiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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Wiederhold A, Litzlbauer D, Kuhnigk JM, Kraß S, Krombach GA. Quantifizierung der Mosaikperfusion bei chronisch thromboembolischer Hypertension im Vergleich zur akuten Lungenembolie und der gesunden Lunge anhand eines objektiven Messwertes in der CT. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Litzlbauer HD, Weber A, Harth S, Moritz R, Eichner G, Kuhnigk JM, Krass S, Peitgen HO, Krombach GA. Einfluß der Bildrekonstruktion auf die softwarebasierte automatisierte CT- Densitometrie und die Lappensegmentation der Lunge. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Stöcker C, Welter S, Moltz J, Lassen B, Kuhnigk JM, Kraß S. Bestimmung der Lungensegmente anhand des Abstands zur Pulmonalarterie im Lungen-CT. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kuhnigk JM, Schmidt M, Lassen B, Kraß S, Peitgen HO. Integrierte, quantitative Beurteilung der Luftwege und des Lungenparenchyms in der COPD Diagnostik, Therapieplanung und -kontrolle. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bolte H, Jahnke T, Schäfer FKW, Wenke R, Hoffmann B, Freitag-Wolf S, Dicken V, Kuhnigk JM, Lohmann J, Voss S, Knöss N, Heller M, Biederer J. Interobserver-variability of lung nodule volumetry considering different segmentation algorithms and observer training levels. Eur J Radiol 2007; 64:285-95. [PMID: 17433595 DOI: 10.1016/j.ejrad.2007.02.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Revised: 02/22/2007] [Accepted: 02/23/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the interobserver variability of CT based diameter and volumetric measurements of artificial pulmonary nodules. A special interest was the consideration of different measurement methods, observer experience and training levels. MATERIALS AND METHODS For this purpose 46 artificial small solid nodules were examined in a dedicated ex-vivo chest phantom with multislice-spiral CT (20 mAs, 120 kV, collimation 16 mm x 0.75 mm, table feed 15 mm, reconstructed slice thickness 1mm, reconstruction increment 0.7 mm, intermediate reconstruction kernel). Two observer groups of different radiologic experience (0 and more than 5 years of training, 3 observers each) analysed all lesions with digital callipers and 2 volumetry software packages (click-point depending and robust volumetry) in a semi-automatic and manually corrected mode. For data analysis the variation coefficient (VC) was calculated in per cent for each group and a Wilcoxon test was used for analytic statistics. RESULTS Click-point robust volumetry showed with a VC of <0.01% in both groups the smallest interobserver variability. Between experienced and un-experienced observers interobserver variability was significantly different for diameter measurements (p=0.023) but not for semi-automatic and manual corrected volumetry. A significant training effect was revealed for diameter measurements (p=0.003) and semi-automatic measurements of click-point depending volumetry (p=0.007) in the un-experienced observer group. CONCLUSIONS Compared to diameter measurements volumetry achieves a significantly smaller interobserver variance and advanced volumetry algorithms are independent of observer experience.
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Affiliation(s)
- H Bolte
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Arnold-Heller Strasse 9, 24105 Kiel, Germany.
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Kraß S, Bornemann L, Dicken V, Kuhnigk JM, Peitgen HO. Bildgestützte volumetrische Therapiekontrolle in der Onkologie. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wormanns DW, Beyer F, Hoffknecht P, Dicken V, Kuhnigk JM, Lange T, Thomas M, Heindel W. Klinische Bedeutung eines CT-basierten Ansatzes zur softwaregestützten Vorhersage der postoperativen Lungenfunktion nach Lungenteilresektion. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kuhnigk JM, Yuval S, Schwarze B, Jend HH, Kraß S, Peitgen HO. Computerassistierte CT-basierte Lungenfunktionsprognostik bei Lungenresektionen. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schubert H, Bornemann L, Dicken V, Kuhnigk JM, Wein B. „PulmoMon“: Automatische 3D-Volumetrie von Lungentumoren zur Beurteilung der Tumormasse und Verlaufskontrolle – ein VICORA Teilprojekt. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bornemann LB, Dicken V, Kuhnigk JM, Kümmerlen B, Zidowitz S, Krass S, Peitgen HO. Ein Werkzeug zur Verlaufskontrolle der Tumortherapie durch volumetrische Quantifizierung der Tumorlast und Registrierung im zeitlichen Verlauf in der Lunge. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dicken V, Wormanns D, Bornemann L, Kuhnigk JM, Heindel WL, Peitgen HO. Quantifizierung von Tumorwachstum: Prinzipielle Überlegungen zur erzielbaren Genauigkeit bei Anwendung von RECIST Methodik und Softwarevolumetrie. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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