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Original Research: Diffuse Lung Disease |

Quantitative Computerized Two-Point Correlation Analysis of Lung CT Scans Correlates With Pulmonary Function in Pulmonary SarcoidosisComputer Analysis of Chest CT Scan for Sarcoidosis

Barbaros Selnur Erdal, DDS, PhD; Elliott D. Crouser, MD; Vedat Yildiz, MS; Mark A. King, MD; Andrew T. Patterson, BS; Michael V. Knopp, MD, PhD; Bradley D. Clymer, PhD
Author and Funding Information

From the Department of Electrical and Computer Engineering (Drs Erdal and Clymer), The Ohio State University College of Engineering; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine (Dr Crouser), The Ohio State University College of Medicine; Center for Biostatistics (Mr Yildiz), The Ohio State University Office of Health Sciences; and Department of Radiology (Drs Erdal, King, Knopp and Mr Patterson), The Ohio State University College of Medicine, Columbus, OH.

Correspondence to: Elliott D. Crouser, MD, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Medical Center, Dorothy M. Davis Heart & Lung Research Institute, Room 201, 473 W 12th Ave, Columbus, OH 43210; e-mail: elliott.crouser@osumc.edu


Drs Erdal and Crouser contributed equally to the content of this article.

Funding/Support: This work was supported in part by a joint grant from the Foundation for Sarcoidosis Research and American Thoracic Society awarded to Dr Crouser.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1589-1597. doi:10.1378/chest.11-2027
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Background:  Chest CT scans are commonly used to clinically assess disease severity in patients presenting with pulmonary sarcoidosis. Despite their ability to reliably detect subtle changes in lung disease, the utility of chest CT scans for guiding therapy is limited by the fact that image interpretation by radiologists is qualitative and highly variable. We sought to create a computerized CT image analysis tool that would provide quantitative and clinically relevant information.

Methods:  We established that a two-point correlation analysis approach reduced the background signal attendant to normal lung structures, such as blood vessels, airways, and lymphatics while highlighting diseased tissue. This approach was applied to multiple lung fields to generate an overall lung texture score (LTS) representing the quantity of diseased lung parenchyma. Using deidentified lung CT scan and pulmonary function test (PFT) data from The Ohio State University Medical Center’s Information Warehouse, we analyzed 71 consecutive CT scans from patients with sarcoidosis for whom simultaneous matching PFTs were available to determine whether the LTS correlated with standard PFT results.

Results:  We found a high correlation between LTS and FVC, total lung capacity, and diffusing capacity of the lung for carbon monoxide (P < .0001 for all comparisons). Moreover, LTS was equivalent to PFTs for the detection of active lung disease. The image analysis protocol was conducted quickly (< 1 min per study) on a standard laptop computer connected to a publicly available National Institutes of Health ImageJ toolkit.

Conclusions:  The two-point image analysis tool is highly practical and appears to reliably assess lung disease severity. We predict that this tool will be useful for clinical and research applications.

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