Faculty Collaboration Database

Reproducibility of a scoring system for computed tomography scanning in cystic fibrosis. J Thorac Imaging 2006 Mar;21(1):14-21

Date

03/16/2006

Pubmed ID

16538150

DOI

10.1097/01.rti.0000203937.82276.ce

Scopus ID

2-s2.0-33645096073 (requires institutional sign-in at Scopus site)   173 Citations

Abstract

INTRODUCTION: Computerized tomography (CT) scanning shows promise as an outcome surrogate for cystic fibrosis (CF) lung disease progression. The scoring system used to convert the CT image to numeric data is an essential determinant of the performance of CT scanning.

METHODS: Three radiologists independently scored 16 high-resolution CT scans performed on children in the Wisconsin CF Neonatal Screening Project. The test scans were selected to provide a broad range of disease severity. The scoring system provided subscores for the presence and severity of 5 findings of CF lung disease. The sum of the subscores provided a total score. The CT scans were then read again by each of the radiologists at least 11 months later. Using Mixed Effects Linear Model Analysis, the sources of error (scan-to-scan variation, interrater variance, and intrarater variance) were calculated.

RESULTS: For the total score, the scan-to-scan variation was 14.48, interrater variance was 0.28, and intrarater variance was 0.45, with an overall reproducibility of 95%. The square root of scan-to-scan variance, a measure of sensitivity, was 3.81. Evaluation of the subscores showed higher reproducibility for bronchiectasis and hyperinflation (95% and 88%, respectively). The bronchiectasis score was more sensitive than the air-trapping score (1.46 vs. 0.89).

DISCUSSION: This system was developed to provide a reproducible method that could be used to evaluate the lobar location, severity, and extent of a broad spectrum of CT features of CF lung disease, especially in children. This study demonstrates that the overall score is both sensitive to variation in the severity of lung disease and reproducible.

Author List

Brody AS, Kosorok MR, Li Z, Broderick LS, Foster JL, Laxova A, Bandla H, Farrell PM

Author

Hari Bandla MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Cystic Fibrosis
Disease Progression
Humans
Lung
Observer Variation
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Tomography, X-Ray Computed