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Am. J. Respir. Crit. Care Med., Volume 161, Number 2, February 2000, 574-580

An Analysis Algorithm for Measuring Airway Lumen and Wall Areas from High-Resolution Computed Tomographic Data

GREGORY G. KING, NESTOR L. MÜLLER, KENNETH P. WHITTALL, QING-SAN XIANG, and PETER D. PARÉ

University of British Columbia Pulmonary Research Laboratory, and Department of Radiology, St. Paul's Hospital; Department of Radiology, Vancouver Hospital; and Department of Radiology, University of British Columbia Hospital, Vancouver, British Columbia, Canada

High-resolution computed tomography (HRCT) has been used to examine airway narrowing. We developed an automated computed tomographic image analysis algorithm (computed tomographic airway morphometry; CTAM) to measure airway lumen area (Ai ), airway wall area (Awa), and airway angle of orientation. Tubes of varying size were embedded in Styrofoam and then scanned at angles between 0° and 50° to assess the accuracy of measurements made with CTAM. Two excised pig lungs were fixed in inflation, sectioned, and scanned. Ai and Awa were measured planimetrically from the cut surfaces to optimize CTAM measurement parameters. In CTAM, Ai was defined according to an airway-size-dependent threshold value, and total Awa was determined through a score-guided erosion method. Results were compared with measurements made through a previously validated method (manual method). CTAM provided accurate measurements of the tubes' Ai values at all angles; Awa was overestimated in direct relation to airway size. The manual method underestimated Ai and overestimated Awa in a manner directly related to airway size as well as to airway angle of orientation. In the excised lung, the mean errors of Ai and Awa measurements made with CTAM were 0.52 ± 0.24 mm2 and 0.17 ± 0.32 mm2 (mean ± SEM), respectively. Ai errors with the manual method were similar, but Awa was overestimated to a greater degree (6.3 ± 0.38 mm2; p < 0.01) and the error was proportional to Awa (r = 0.64; p < 0.01). CTAM allows accurate measurements of airway dimensions and angle of orientation. King GG, Müller NL, Whittall KP, Xiang Q-S, Paré PD. An analysis algorithm for measuring airway lumen and wall areas from high-resolution computed tomographic data.




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