Comparison of human lung tissue mass measurements from Ex Vivo lungs and high resolution CT software analysis

ABSTRACT: BACKGROUND: Quantification of lung tissue via analysis of computed tomography (CT) scans is increasingly common for monitoring disease progression and for planning of therapeutic interventions. The current study evaluates the quantification of human lung tissue mass by software analysis of a CT to physical tissue mass measurements. METHODS: Twenty-two ex vivo lungs were scanned by CT and analyzed by commercially available software. The lungs were then dissected into lobes and sublobar segments and weighed. Because sublobar boundaries are not visually apparent, a novel technique of defining sublobar segments in ex vivo tissue was developed. The tissue masses were then compared to measurements by the software analysis. RESULTS: Both emphysematous (n = 14) and non-emphysematous (n = 8) bilateral lungs were evaluated. Masses (Mean +/- SD) as measured by dissection were 651 +/- 171 g for en bloc lungs, 126 +/- 60 g for lobar segments, and 46 +/- 23 g for sublobar segments. Masses as measured by software analysis were 598 +/- 159 g for en bloc lungs, 120 +/- 58 g for lobar segments, and 45 +/- 23 g for sublobar segments. Correlations between measurement methods was above 0.9 for each segmentation level. The Bland-Altman analysis found limits of agreement at the lung, lobe and sublobar levels to be 13.11% to 4.22%, -13.59% to 4.24%, and -45.85% to 44.56%. CONCLUSION: The degree of concordance between the software mass quantification to physical mass measurements provides substantial evidence that the software method represents an appropriate non-invasive means to determine lung tissue mass.