ArticleInternational journal of chronic obstructive pulmonary disease
Discordant Quantitative and Visual CT Assessments in the Diagnosis of Emphysema.
Article in International journal of chronic obstructive pulmonary disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Vascular-related proteomic signatures in COPD with suspected pulmonary hypertension as predictors of FEV₁ impairment.Respiratory research · 2026Article
- Quantitative CT Patterns and Functional Loss Related to Welding Fume Exposure, While Handling the Confounding Effect of Cigarette Smoking.Canadian respiratory journal · 2026Article
- The Prevalence of Emphysema in Patients Undergoing Lung Cancer Screening in a Middle-Income Country.Diseases (Basel, Switzerland) · 2025Article
- Article
- Differentiating Emphysema From Emphysema-Dominated COPD Patients with CT Imaging Feature and Machine Learning.International journal of chronic obstructive pulmonary disease · 2025Article
- Quantitative CT at Follow-Up of COVID-19 Pneumonia: Relationship with Pulmonary Function Tests.Diagnostics (Basel, Switzerland) · 2023Article
- Early Diagnosis of High-Risk Chronic Obstructive Pulmonary Disease Based on Quantitative High-Resolution Computed Tomography Measurements.International journal of chronic obstructive pulmonary disease · 2023Article
- Article
- AI-Driven Model for Automatic Emphysema Detection in Low-Dose Computed Tomography Using Disease-Specific Augmentation.Journal of digital imaging · 2022Article
- When Treatment of Pulmonary Emphysema with Endobronchial Valves Did Not Work: Evaluation of Quantitative CT Analysis and Pulmonary Function Tests Before and After Valve Explantation.International journal of chronic obstructive pulmonary disease · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
purposeVisual assessment of computed tomography (CT) of the lung is routinely employed in the diagnosis of emphysema. Quantitative CT (QCT) can complement visual CT but must be well validated. QCT emphysema is defined as ≥5% of lung volume occupied by low attenuation areas ≤-950 Hounsfield units (LAA-950). Discordant visual and QCT assessments are not uncommon. We examined the association between visual and quantitative chest CT evaluation within a large cohort of subjects to identify variables that may explain discordant visual and QCT findings. MATERIALS AND
methodsVolumetric inspiratory CT scans of 1221 subjects enrolled in phase 1 of the COPDGene study conducted at the University of Iowa were reviewed. Participants included never smokers, smokers with normal spirometry, preserved ratio impaired spirometry, and Global Initiative for Obstructive Lung Disease (GOLD) stages I-IV. CT scans were quantitatively scored and visually interpreted by both the COPDGene Imaging Center and the University of Iowa radiologists. Individual-level visual assessments were compared with QCT measurements. Agreement between the two sets of radiologists was calculated using kappa statistic. We assessed variables associated with discordant results using regression methods.
resultsThere was a fair agreement for the presence or absence of emphysema between our center's radiologists and QCT (61% concordance, kappa 0.22 [0.17-0.28]). Similar comparisons showed a slight agreement between the COPDGene Imaging Center and QCT (56% concordance, kappa 0.16 [0.11-0.21]), and a moderate agreement between both sets of visual assessments (80% concordance, kappa 0.60 [0.54-0.65]). Current smoking and female gender were significantly associated with QCT-negative but visually detectable emphysema.
conclusionThe slight-to-fair agreement between visual and quantitative CT assessment of emphysema highlights the need to utilize both modalities for a comprehensive radiologic evaluation. Discordant results may be attributable to one or more factors that warrant further exploration in larger studies. CLINICAL
trial registrationClinicalTrials.gov Identifier NCT000608764.
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