Imaging: Imaging |

Novel CT Scoring System for Sinus Disease in Adults With Cystic Fibrosis FREE TO VIEW

Shahid Sheikh, MD; Brian Handly, MD; Nancy Ryan-Wenger, PhD; Don Hayes, Jr., MD; Steven Kirkby, MD; Karen McCoy, MD; Meredith Lind, MD
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Ohio State University/Nationwide Children's Hospital, Columbus, OH

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):655A. doi:10.1016/j.chest.2016.08.749
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: There is no easy-to-use scoring system for CT Scans of the sinuses that is specific to cystic fibrosis (CF). We propose a simple and easily implemented scoring system to quantify severity of sinus disease in adults with CF.

METHODS: After IRB approval, we validated a scoring system in 69 adults with CF and 50 age-matched controls. CT scans were interpreted by three physicians (pulmonologist, ENT surgeon and a neuro radiologist) on two separate sittings. Parameters include maxillary opacification and nasal obstruction scored in a graded fashion (0 to 3) with 0 = normal, 1 = mild (<33%), 2 = moderate (33-66%) and 3=severe (>66%), while lateral nasal wall displacement, uncinate process absence/demineralization, and mucocele were scored as 1=present, 0=absent. Intra-rater and inter-rater reliability were measured by intraclass correlations (ICC).

RESULTS: CF patients aged 21-30 years (mean=24.7 ± SD 2.49). Intra-Rater Reliability: in CF cohort (n=69), reliability for the 10 CT categories ranged from .70 to 1.00. Twenty six (87%) were in the excellent range, and remaining 4 (13%) were evaluated as good. In the non-CF cohort (n=50), reliabilities ranged from .44 to 1.00. Twenty seven (90%) were in the excellent range. Inter-Rater Reliability: in CF cohort, 10 CT categories across the three raters ranged from .35 to 1.00. Excellent reliability was achieved in 15 (50%) of the observations. In the non-CF cohort, reliabilities ranged from .44 to 1.00.

CONCLUSIONS: A novel and easy-to-use CT scoring system for CF sinus disease in adults was validated with acceptable inter- and intra-rater reliability.

CLINICAL IMPLICATIONS: This new CF sinus disease specific scoring system can quantify disease severity and can be used with acceptable reliabilities by clinicians, surgeons and radiologists.

DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Brian Handly, Nancy Ryan-Wenger, Don Hayes, Jr., Steven Kirkby, Karen McCoy, Meredith Lind

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