Related Experiment Video
Updated: Dec 1, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Simple quantitative chest CT for pulmonary edema
Maria Barile1,2, Tomoyuki Hida1,3, Mark Hammer3
1Departments of Radiology, Brigham and Women's Hospital, Boston, MA, United States.
Insights
Quantitative CT accurately diagnoses pulmonary edema, showing higher sensitivity than qualitative CT. A threshold of -825 Hounsfield Units (HU) in the left upper lobe is highly effective for detecting this condition.
Area of Science:
- Radiology
- Medical Imaging
- Pulmonary Medicine
Background:
- Pulmonary edema is a critical condition often associated with heart failure.
- Accurate diagnosis of pulmonary edema is essential for timely and effective patient management.
- Traditional methods like Chest X-ray (CXR) have limitations in sensitivity and specificity.
Purpose of the Study:
- To evaluate the diagnostic accuracy of quantitative computed tomography (CT) for pulmonary edema.
- To compare quantitative CT with qualitative CT and CXR in diagnosing pulmonary edema.
- To establish a Hounsfield Unit (HU) threshold for identifying pulmonary edema on CT scans.
Main Methods:
- Retrospective analysis of 100 patients with heart failure undergoing both CT and CXR within three hours.
- Qualitative scoring of edema severity (0-5 scale) and quantitative CT HU measurements in each lung lobe.
- Correlation analysis and Receiver Operating Characteristic (ROC) curve analysis to determine accuracy and optimal HU cutoff values.
Main Results:
- Quantitative CT showed moderate to strong correlation with CXR scores (r=0.585-0.685).
- Quantitative CT demonstrated excellent accuracy (AUCs 0.869-0.995) in differentiating edema severity across all lobes.
- A cutoff of -825 HU in the left upper lobe achieved 100% sensitivity and 95.1% specificity for pulmonary edema.
Conclusions:
- Quantitative CT is a highly accurate method for diagnosing pulmonary edema.
- Quantitative CT offers superior sensitivity compared to qualitative CT in assessing pulmonary edema.
- The established HU threshold provides a reliable quantitative measure for pulmonary edema detection.
Purpose:
To determine the accuracy of quantitative CT to diagnose pulmonary edema compared to qualitative CT and CXR and to determine a threshold Hounsfield unit (HU) measurement for pulmonary edema on CT examinations.
Method:
Electronic medical records were searched for patients with a billing diagnosis of heart failure and a Chest CT and CXR performed within three hours between 1/1/2016 to 10/1/2016, yielding 100 patients. CXR and CT examinations were scored for the presence and severity of edema, using a 0-5 scale, and CT HU measurements were obtained in each lobe. Polyserial correlation coefficients evaluated the association between CT HUs and CXR scores, and receiver operating characteristic (ROC) curve analysis determined a cutoff CT HU value for identification of pulmonary edema.
Results:
Correlation between CT HU and CXR score was moderately strong (r = 0.585-0.685) with CT HU measurements demonstrating good to excellent accuracy in differentiating between no edema (grade 0) and mild to severe edema (grades 1-5) in every lobe, with AUCs ranging between 0.869 and 0.995. The left upper lobe demonstrated the highest accuracy, using a cutoff value of -825 HU (AUC of 0.995, sensitivity = 100 % and specificity = 95.1 %). Additionally, qualitative CT evaluation was less sensitive (84 %) than portable CXR in identifying pulmonary edema. However, quantitative CT evaluation was as sensitive as portable CXR (100 %) and highly specific (95 %).
Conclusions:
Quantitative CT enables the identification of pulmonary edema with high accuracy and demonstrates a greater sensitivity than qualitative CT in assessment of pulmonary edema.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:28Imaging Studies for Cardiovascular System V: CT
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:30Radiological Investigation I: X-ray and CT
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT