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Robust and Reproducible Quantification of the Extent of Chest Radiographic Abnormalities (And It's Free!).

Requena-Méndez A, Aldasoro E, Muñoz J, Moore DA - PLoS ONE (2015)

Bottom Line: The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE. 56 chest radiographs were included in the reading analysis.The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

View Article: PubMed Central - PubMed

Affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.

ABSTRACT

Rationale: Objective, reproducible quantification of the extent of abnormalities seen on a chest radiograph would improve the user-friendliness of a previously proposed severity scoring system for pulmonary tuberculosis and could be helpful in monitoring response to therapy, including in clinical trials.

Methods: In this study we report the development and evaluation of a simple tool using free image editing software (GIMP) to accurately and reproducibly quantify the area of affected lung on the chest radiograph of tuberculosis patients. As part of a pharmacokinetic study in Lima, Peru, a chest radiograph was performed on patients with pulmonary tuberculosis and this was subsequently photographed using a digital camera. The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE.

Results: 56 chest radiographs were included in the reading analysis. The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.

Conclusions: This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the followed methodology.A. Health worker taking a photo of a radiograph. B. Opening JPEG files with GIMP software. C. Selection of the area. D. Pixel quantification. E. Selected “affected area.”
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pone.0128044.g001: Flowchart of the followed methodology.A. Health worker taking a photo of a radiograph. B. Opening JPEG files with GIMP software. C. Selection of the area. D. Pixel quantification. E. Selected “affected area.”

Mentions: In a study of TB drug pharmacokinetics patients diagnosed with and treated for pulmonary TB in south Lima, under the DOTS programme of the Peruvian National TB programme, were invited to participate from July to December of 2009. As part of this study, a CXR was performed to all patients to assess cavitation and extent of the disease. All CXR films were digitalized into JPEG files by taking a photograph with conventional digital camera (See Fig 1). The digital image capture was performed by the same person, with the same camera and in the same place for all the CXRs. All CXR films were the same size and the distance from the digital camera to the films was established when the LCD monitor or the viewfinder of the camera framed the whole image. The zoom was not used in order to retain the maximum resolution of the image.


Robust and Reproducible Quantification of the Extent of Chest Radiographic Abnormalities (And It's Free!).

Requena-Méndez A, Aldasoro E, Muñoz J, Moore DA - PLoS ONE (2015)

Flowchart of the followed methodology.A. Health worker taking a photo of a radiograph. B. Opening JPEG files with GIMP software. C. Selection of the area. D. Pixel quantification. E. Selected “affected area.”
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440724&req=5

pone.0128044.g001: Flowchart of the followed methodology.A. Health worker taking a photo of a radiograph. B. Opening JPEG files with GIMP software. C. Selection of the area. D. Pixel quantification. E. Selected “affected area.”
Mentions: In a study of TB drug pharmacokinetics patients diagnosed with and treated for pulmonary TB in south Lima, under the DOTS programme of the Peruvian National TB programme, were invited to participate from July to December of 2009. As part of this study, a CXR was performed to all patients to assess cavitation and extent of the disease. All CXR films were digitalized into JPEG files by taking a photograph with conventional digital camera (See Fig 1). The digital image capture was performed by the same person, with the same camera and in the same place for all the CXRs. All CXR films were the same size and the distance from the digital camera to the films was established when the LCD monitor or the viewfinder of the camera framed the whole image. The zoom was not used in order to retain the maximum resolution of the image.

Bottom Line: The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE. 56 chest radiographs were included in the reading analysis.The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

View Article: PubMed Central - PubMed

Affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.

ABSTRACT

Rationale: Objective, reproducible quantification of the extent of abnormalities seen on a chest radiograph would improve the user-friendliness of a previously proposed severity scoring system for pulmonary tuberculosis and could be helpful in monitoring response to therapy, including in clinical trials.

Methods: In this study we report the development and evaluation of a simple tool using free image editing software (GIMP) to accurately and reproducibly quantify the area of affected lung on the chest radiograph of tuberculosis patients. As part of a pharmacokinetic study in Lima, Peru, a chest radiograph was performed on patients with pulmonary tuberculosis and this was subsequently photographed using a digital camera. The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE.

Results: 56 chest radiographs were included in the reading analysis. The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.

Conclusions: This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

No MeSH data available.


Related in: MedlinePlus