CHEST Guidelines-Visual-vs-Automated-Assessment-of-Emphysema

Visual-vs-Automated-Assessment-of-Emphysema_chest

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The correspondence to the editor in CHEST journal discusses the assessment of COPD using CT scanning, specifically comparing visual and automated methods for evaluating pulmonary emphysema. The authors commend Bafadhel et al. for their article on the role of CT scanning in multidimensional COPD phenotyping but emphasize the need to consider certain technical aspects.<br /><br />The authors note that high-resolution CT scanning and visual assessment were used in the study. However, past studies suggest limitations in visual evaluation due to the histopathological nature of emphysema. Bankier et al. used nonspiral CT scans with visual assessments conducted by operators with differing expertise levels, revealing varied interoperator agreement. Their findings indicated that the anatomic extent of emphysema correlated more closely with automated assessments using RA950, a densitometric measure, rather than visual scores.<br /><br />Further, Cavigli et al. demonstrated that densitometry allowed for a more reproducible and comprehensive evaluation of emphysema through volumetric acquisitions. Automated assessments generally showed stronger correlations with histopathological findings and consistency in results compared to visual assessments. As automated methods also facilitate the evaluation of lung volumes, the authors advocate for their use in emphysema assessment, especially for evolving criteria in COPD phenotyping.<br /><br />The authors, all radiology experts, conclude by stressing the enhanced reliability and reproducibility of automated CT assessment over visual techniques in the context of emphysema evaluation. The correspondence also acknowledges the availability of several free software programs developed based on these findings for widespread use in clinical practice.

Keywords

COPD

CT scanning

pulmonary emphysema

visual assessment

automated methods

densitometry

RA950

multidimensional phenotyping

lung volumes

radiology