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      Comparison of computed density and macroscopic morphometry in pulmonary emphysema.

      American journal of respiratory and critical care medicine

      Tomography, X-Ray Computed, methods, Humans, Image Processing, Computer-Assisted, Lung, pathology, Female, radiography, Lung Neoplasms, surgery, Lung Transplantation, Male, Middle Aged, Pattern Recognition, Automated, Pneumonectomy, Prospective Studies, Pulmonary Emphysema, Radiographic Image Enhancement, Adult, Aged

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          High-resolution computed tomography (HRCT) scans were obtained at 1 cm intervals in 63 subjects referred for surgical resection of a cancer or for transplantation to find out whether the relative area of lung occupied by attenuation values lower than a threshold would be a measurement of macroscopic emphysema. Using a semiautomatic procedure, the relative areas occupied by attenuation values lower than eight thresholds ranging from -900 to -970 HU were calculated on the set of scans obtained through the lobe or the lung to be resected. The extent of emphysema was quantified by a computer-assisted method on horizontal paper-mounted lung sections obtained every 1 to 2 cm. The only level for which no statistically significant difference was found between the HRCT and the morphometric data was -950 HU. To determine the number of scans sufficient for an accurate quantification, we recalculated the relative area occupied by attenuation values lower than -950 HU on progressively fewer numbers of scans and investigated the departure from the results obtained with 1 cm intervals. Because of wide variations in this departure from patient to patient, a standard cannot be recommended as the optimal distance between scans.

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