Automated Algorithm for Quantifying the Extent of Cystic Change on Volumetric Chest CT: Initial Results in Lymphangioleiomyomatosis

OBJECTIVE. The purpose of our study was to develop a new method for quantifying the severity of cystic lung disease using chest CT and to evaluate this method in patients with lymphangioleiomyomatosis (LAM).SUBJECTS AND METHODS. Eighteen patients with LAM (all women; mean age, 43.6 years) underwent chest CT and pulmonary function testing including diffusing capacity for carbon monoxide (DLCO). All patients were at their clinical baseline on the day of imaging. Standard quantitative CT metrics including the percentage of the lung volume < –910 HU and the 15th percentile of Hounsfield units were computed from the histogram of lung voxels. A new histogram analysis method was developed to compute the cyst volume and the volume of the remaining lung by segmenting the entire lung attenuation histogram into two underlying distributions, one from the cysts and the other from the remaining lung tissue.RESULTS. The mean ± SD for quantitative lung metrics was 21% ± 16% for percentage < –910 HU, –915 ± 47 HU for 15th...