Comparison of 2D and 3D lung lobe quantification with Ventilation/Perfusion Ratio

Abstract

Aim

In this study, standard 2D lung lobe quantification is compared with two 3D lung lobe quantification software tools to investigate the clinical benefit of a 3D approach. The accuracy of 2D versus 3D lung lobe quantification is evaluated based on the calculated numerical ventilation-perfusion ratio (VQR) using a receiver operating curve (ROC) analysis.

Methods

A study group of 50 consecutive patients underwent a planar lung scintigraphy (anterior/posterior) as well as ventilation/perfusion single photon emission computed tomography (SPECT/CT) to exclude acute pulmonary embolism. All data were acquired with SPECT OPTIMA NM/CT 640 (GE Healthcare). 2D analysis was performed for all ventilation/perfusion scans using a lung analysis tool (Syngo Workstation, Siemens Healthineers). 3D quantification analysis was performed using QLUNG (Q. Lung, Xeleris 4.0, GE Healthcare) and LLQ (Hermes Hybrid 3D Lung Lobar Quantification, Hermes Medical Solutions). The area under the ROC curve (AUC) served as a decision criterion to find the best agreement between clinical PE findings and calculated PE candidates of the 2D and 3D methods. The significance of the ROC curves was evaluated using the DeLong comparison.

Results

A significant difference between 2D/3D could be determined. Both 3D approaches showed robust and comparable results. The AUC range of [0.10, 0.67] was given for 2D lobar analysis, QLUNG AUC range revealed in [0.39,0.74] and LLQ AUC range was [0.42,0.72]. Averaged over all lung lobes an AUC=0.39 was given for 2D analysis and AUC=0.58 was given for LLQ/QLUNG.

Conclusion

We could demonstrate the better performance of 3D analysis compared to 2D analysis. Consequently, is recommended to use a 3D approach in clinical practice.

Zusammenfassung

Ziel

In dieser Studie wird die standardmäßige 2D-Lungenlappenquantifizierung mit 2 3D-Lungenlappenquantifizierungs-Softwaretools verglichen, um den klinischen Nutzen eines 3D-Ansatzes zu untersuchen. Die Genauigkeit der 2D- gegenüber der 3D-Lungenlappenquantifizierung wird anhand des berechneten numerischen Ventilations-Perfusions-Verhältnisses (VQR) unter Verwendung einer Receiver-Operating-Curve (ROC) -Analyse bewertet.

Methoden

Eine Studiengruppe von 50 konsekutiven Patienten unterzog sich zum Ausschluss einer akuten Lungenembolie einer planaren Lungenszintigrafie (anterior/posterior) sowie einer Ventilations-Perfusions-Einzelphotonen-Emissions-Computertomografie (SPECT/CT). Alle Daten wurden mit SPECT OPTIMA NM/CT 640 (GE Healthcare) aufgenommen. Die 2D-Analyse wurde für alle Ventilations-Perfusions-Scans mit einem Lungenanalyse-Tool (Syngo Workstation, Siemens Healthineers) durchgeführt. Die 3D-Quantifizierungsanalyse wurde mit QLUNG (Q. Lung, Xeleris 4.0, GE Healthcare) und LLQ (Hermes Hybrid 3D Lung Lobar Quantification, Hermes Medical Solutions) durchgeführt. Die Fläche unter der ROC-Kurve (AUC) diente als Entscheidungskriterium, um die beste Übereinstimmung zwischen klinischen PE-Befunden und berechneten PE-Kandidaten der 2D- und 3D-Methoden zu finden. Die Signifikanz der ROC-Kurven wurde mittels DeLong-Algorithmus überprüft.

Ergebnisse

Es konnte ein signifikanter Unterschied zwischen 2D und 3D festgestellt werden. Beide 3D-Ansätze zeigten robuste und vergleichbare Ergebnisse. Es ergab sich ein AUC-Bereich von 0,10–0,67 für die Lungenlappen-basierte 2D-Analyse. Für QLUNG ergab sich ein AUC-Bereich von 0,39–0,74 und für LLQ ein AUC-Bereich von 0,42–0,72. Für alle Lungenlappen ergab sich gemittelt für die 2D-Analyse ein AUC-Wert von 0,39 und für LLQ/QLUNG ein AUC-Wert von 0,58.

Schlussfolgerung

Wir konnten die bessere Leistung der 3D-Analyse im Vergleich zur 2D-Analyse nachweisen. Daher wird empfohlen, in der klinischen Praxis einen 3D-Ansatz zu verwenden.

Keywords

V/P SPECT/CT - Planar - Ventilation/Perfusion Ratio - 3D Lung Lobe Quantification - Pulmonary Embolism - Lung Scintigraphy

Publication History

Received: 14 November 2023

Accepted after revision: 31 October 2024

Article published online:
04 December 2024

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