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Sources of Variation in Quantitative Computed Tomography of the Lung

Coxson, Harvey O. PhD*,†

doi: 10.1097/RTI.0b013e31829efbe9
Symposium Review Articles

The goal of quantitative analysis of computed tomography (CT) scans is to understand the anatomic structure that is responsible for the physiological function of the lung. The gold standard for structural analysis requires the examination of tissue, which is not practical in most studies. Quantitative CT allows valuable information on lung structure to be obtained without removal of tissue from the body, thereby aiding longitudinal studies on chronic lung diseases. This review briefly discusses CT analysis of the lung and some of the sources of variation that can cause differences in the CT metrics used for analysis of lung disease. Although there are many sources of variation, this review will show that, if the study is properly designed to take into account these variations and if the CT scanner is properly calibrated, valuable information can be obtained from CT scans that should allow us to study the pathogenesis of lung disease and the effect of treatment.

*Department of Radiology, Vancouver General Hospital

James Hogg Research Centre, Providence Heart+Lung Institute, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada

Harvey O. Coxson received $4800 in the years 2008 to 2012 for serving on the steering committee for the ECLIPSE project for GSK. In addition, Harvey O. Coxson was the coinvestigator on 2 multicenter studies sponsored by GSK and has received travel expenses to attend meetings related to the project. He has 3 contract service agreements with GSK (including the ECLIPSE study) to quantify the computed tomography scans in subjects with chronic obstructive pulmonary disorder and a service agreement with Spiration Inc. to measure changes in lung volume in subjects with severe emphysema. He was the recipient of a GSK Clinical Scientist Award in 2010. Dr Coxson is supported by a Roberta R. Miller Fellowship in Thoracic Imaging from the British Columbia Lung Association and was also supported, in part, by the University of Pittsburgh COPD SCCOR NIH 1P50 HL084948 and R01 HL085096 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD to the University of Pittsburgh. He has ongoing research funding from CIHR Team Grant CIF# 97687.

Reprints: Harvey O. Coxson, PhD, Department of Radiology, Vancouver General Hospital, University of British Columbia, 855 West 12th Ave, Room CP G22A, Vancouver, BC, Canada V5Z 1M9 (e-mail:

© 2013 by Lippincott Williams & Wilkins