Pulmonary Vascular Disease: Cystic Fibrosis |

A New CT Scoring System for Sinus Disease in Children With Cystic Fibrosis FREE TO VIEW

Shahid Sheikh, MD; Brian Handly, MD; Nancy Ryan-Wenger, PhD; Don Hayes, Jr., MD; Chandar Ramanathan, 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):1133A. doi:10.1016/j.chest.2016.08.1243
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SESSION TITLE: Cystic Fibrosis

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 computed tomography (CT) scans of the sinuses specific to children with cystic fibrosis (CF). We propose a simple and easily implemented scoring system to quantify severity of sinus disease in pediatric CF patients.

METHODS: We validated a scoring system in 128 children with CF and 90 age-matched controls. CT scans were blindly interpreted by 3 physicians (pulmonologist, otolaryngologist, and a neuro radiologist) on two separate occasions. Intra-rater and inter-rater reliability were measured by intraclass correlations (ICC). CT scoring system: The following parameters were included in the score: Maxillary opacification (MO), Nasal cavity obstruction (NCO), Lateral nasal wall displacement (LNWD), Uncinate process (UP) absence or demineralization, and Mucocele (MU). The right and left sides were scored separately. Maxillary opacification and nasal cavity obstruction were scored in a graded fashion (0 to 3) with 0 = normal, 1 = mild (<33%), 2 = moderate (33-66%) and 3=severe (>66%). Lateral nasal wall displacement, Uncinate process absence/ demineralization, and Mucocele were scored as 1=present, 0=absent.

RESULTS:Intra-Rater Reliability: in the CF cohort (n=128), ICC reliability for the 10 CT categories across the three raters ranged from .67 to .98. Twenty-five (83%) were in the excellent range, 4 (13%) were good, and remaining 1 (3%) was moderate. In the non-CF cohort (n=90), reliabilities ranged from .11 to 1.00. Inter-Rater Reliability: in the CF cohort, 10 CT categories across the three raters ranged from ICC = .34 to .97. Excellent reliability was achieved in 20 (67%) of the observations, 3 (10%) were good, 2 (7%) were moderate, 3 (10%) were fair, and remaining 2 (7%) were poor. In the non-CF cohort, reliabilities ranged from .11 to .99.

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

CLINICAL IMPLICATIONS: As our scoring system is CF-specific, it has a potential to be able to correlate better with therapies, symptom scores, and quality of life measures.

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

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