Repeatability of CT-based anthropomorphic measurements of frailty in patients with pulmonary fibrosis undergoing lung transplantation

Publication date: Available online 29 December 2016
Source:Current Problems in Diagnostic Radiology
Author(s): Taylor McClellan, Brian C. Allen, Matthew Kappus, Lubna Bhatti, Randa A. Dafalla, Laurie D. Snyder, Mustafa R. Bashir
PurposeTo determine inter- and intra-reader repeatability and correlations between measurements of CT based anthropomorphic measurements in patients with pulmonary fibrosis undergoing lung transplantation.MethodsThis was an IRB approved, HIPAA compliant retrospective study of 23 randomly selected subjects (19 male and 4 female; median age: 69 years, range: 66–77 years) with idiopathic pulmonary fibrosis undergoing pulmonary transplantation, who had also undergone preoperative thoraco-abdominal CT. Five readers of varying imaging experience independently performed the following cross-sectional area measurements at the inferior endplate of the L3 vertebral body: right and left psoas muscles, right and left paraspinal muscles, total abdominal musculature, visceral and subcutaneous fat. The following measurements were obtained at the inferior endplate of T6: right and left paraspinal muscles with and without including the trapezius muscles and subcutaneous fat. Three readers repeated all measurements to assess intra-reader repeatability.ResultsIntra-reader repeatability was nearly perfect (ICC=0.99, p<0.001). Inter-reader agreement was excellent across all five readers (ICC=0.71–0.99, p<0.001). Coefficients of variance between measures ranged from 3.2–6.8% for abdominal measurements, but were higher for thoracic measurements, up to 23.9%. Correlation between total paraspinal and total psoas muscle area was strong (r²=0.67, p<0.001). Thoracic and abdominal musculature had a weaker correlation (r²=0.35 to 0.38, p<0.001).ConclusionMeasures of thoracic and abdominal muscle and fat area are highly repeatable in patients with pulmonary fibrosis undergoing lung transplantation. Measures of muscle area are strongly correlated between abdominal locations but inversely correlated between abdominal and thoracic locations.



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