Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis

Micah M. Likness, John F. Pallanch, David A. Sherris, Hirohito Kita, Terry L. Mashtare, Jens U. Ponikau

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives. A truly objective method of measuring disease severity in chronic rhinosinusitis (CRS) has only recently existed. We evaluated computed tomography (CT) scans of CRS patients using this novel objective 3D computerized system and compared results with a novel 2D computerized analysis of a single coronal slice through the osteomeatal complex (OMC) and subjective methods including Lund-Mackay and Zinreich's modified Lund- Mackay. Study Design. Prospective multicenter study. Setting. Two academic tertiary referral centers. Subjects and Methods. Forty-six adults with a diagnosis of CRS underwent CT examination and received an intramuscular triamcinolone injection, dosage weight dependent, followed by CT scan 4 to 5 weeks later. Recruitment lasted 21 months. Scans were evaluated with all 4 scoring methods over 5 months. Results. The Lin's concordance class correlation (CCC) of the OMC method revealed the best correlation to the 3D volumetric computerized values (0.915), followed by the Zinreich (0.904) and Lund-Mackay methods (0.824). Posttreatment results demonstrated that both the OMC (0.824) and Zinreich's (0.778) methods had strong agreement with the 3D volumetric methods and were very sensitive to change, whereas the Lund-Mackay (0.545) had only moderate agreement. Conclusion. Computerized CT analysis provides the most comprehensive, objective, and reproducible method of measuring disease severity and is very sensitive to change induced by treatment intervention. A 2D coronal image through the OMC provides a valid, user-friendly method of assessing CRS and is representative of CRS severity in all sinuses. Zinreich's subjective method correlated well overall, but the Lund-Mackay method lagged behind in disease representation and sensitivity to change.

Original languageEnglish (US)
Pages (from-to)305-311
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume150
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Tomography
Triamcinolone
Intramuscular Injections
Tertiary Care Centers
Multicenter Studies
Research Design
Prospective Studies
Weights and Measures

Keywords

  • chronic rhinosinusitis
  • computed tomography
  • disease severity
  • objective
  • staging system
  • volumetric scoring

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis. / Likness, Micah M.; Pallanch, John F.; Sherris, David A.; Kita, Hirohito; Mashtare, Terry L.; Ponikau, Jens U.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 150, No. 2, 02.2014, p. 305-311.

Research output: Contribution to journalArticle

Likness, Micah M. ; Pallanch, John F. ; Sherris, David A. ; Kita, Hirohito ; Mashtare, Terry L. ; Ponikau, Jens U. / Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis. In: Otolaryngology - Head and Neck Surgery (United States). 2014 ; Vol. 150, No. 2. pp. 305-311.
@article{6d907ea73d224e43a67da19cb878c72b,
title = "Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis",
abstract = "Objectives. A truly objective method of measuring disease severity in chronic rhinosinusitis (CRS) has only recently existed. We evaluated computed tomography (CT) scans of CRS patients using this novel objective 3D computerized system and compared results with a novel 2D computerized analysis of a single coronal slice through the osteomeatal complex (OMC) and subjective methods including Lund-Mackay and Zinreich's modified Lund- Mackay. Study Design. Prospective multicenter study. Setting. Two academic tertiary referral centers. Subjects and Methods. Forty-six adults with a diagnosis of CRS underwent CT examination and received an intramuscular triamcinolone injection, dosage weight dependent, followed by CT scan 4 to 5 weeks later. Recruitment lasted 21 months. Scans were evaluated with all 4 scoring methods over 5 months. Results. The Lin's concordance class correlation (CCC) of the OMC method revealed the best correlation to the 3D volumetric computerized values (0.915), followed by the Zinreich (0.904) and Lund-Mackay methods (0.824). Posttreatment results demonstrated that both the OMC (0.824) and Zinreich's (0.778) methods had strong agreement with the 3D volumetric methods and were very sensitive to change, whereas the Lund-Mackay (0.545) had only moderate agreement. Conclusion. Computerized CT analysis provides the most comprehensive, objective, and reproducible method of measuring disease severity and is very sensitive to change induced by treatment intervention. A 2D coronal image through the OMC provides a valid, user-friendly method of assessing CRS and is representative of CRS severity in all sinuses. Zinreich's subjective method correlated well overall, but the Lund-Mackay method lagged behind in disease representation and sensitivity to change.",
keywords = "chronic rhinosinusitis, computed tomography, disease severity, objective, staging system, volumetric scoring",
author = "Likness, {Micah M.} and Pallanch, {John F.} and Sherris, {David A.} and Hirohito Kita and Mashtare, {Terry L.} and Ponikau, {Jens U.}",
year = "2014",
month = "2",
doi = "10.1177/0194599813513881",
language = "English (US)",
volume = "150",
pages = "305--311",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis

AU - Likness, Micah M.

AU - Pallanch, John F.

AU - Sherris, David A.

AU - Kita, Hirohito

AU - Mashtare, Terry L.

AU - Ponikau, Jens U.

PY - 2014/2

Y1 - 2014/2

N2 - Objectives. A truly objective method of measuring disease severity in chronic rhinosinusitis (CRS) has only recently existed. We evaluated computed tomography (CT) scans of CRS patients using this novel objective 3D computerized system and compared results with a novel 2D computerized analysis of a single coronal slice through the osteomeatal complex (OMC) and subjective methods including Lund-Mackay and Zinreich's modified Lund- Mackay. Study Design. Prospective multicenter study. Setting. Two academic tertiary referral centers. Subjects and Methods. Forty-six adults with a diagnosis of CRS underwent CT examination and received an intramuscular triamcinolone injection, dosage weight dependent, followed by CT scan 4 to 5 weeks later. Recruitment lasted 21 months. Scans were evaluated with all 4 scoring methods over 5 months. Results. The Lin's concordance class correlation (CCC) of the OMC method revealed the best correlation to the 3D volumetric computerized values (0.915), followed by the Zinreich (0.904) and Lund-Mackay methods (0.824). Posttreatment results demonstrated that both the OMC (0.824) and Zinreich's (0.778) methods had strong agreement with the 3D volumetric methods and were very sensitive to change, whereas the Lund-Mackay (0.545) had only moderate agreement. Conclusion. Computerized CT analysis provides the most comprehensive, objective, and reproducible method of measuring disease severity and is very sensitive to change induced by treatment intervention. A 2D coronal image through the OMC provides a valid, user-friendly method of assessing CRS and is representative of CRS severity in all sinuses. Zinreich's subjective method correlated well overall, but the Lund-Mackay method lagged behind in disease representation and sensitivity to change.

AB - Objectives. A truly objective method of measuring disease severity in chronic rhinosinusitis (CRS) has only recently existed. We evaluated computed tomography (CT) scans of CRS patients using this novel objective 3D computerized system and compared results with a novel 2D computerized analysis of a single coronal slice through the osteomeatal complex (OMC) and subjective methods including Lund-Mackay and Zinreich's modified Lund- Mackay. Study Design. Prospective multicenter study. Setting. Two academic tertiary referral centers. Subjects and Methods. Forty-six adults with a diagnosis of CRS underwent CT examination and received an intramuscular triamcinolone injection, dosage weight dependent, followed by CT scan 4 to 5 weeks later. Recruitment lasted 21 months. Scans were evaluated with all 4 scoring methods over 5 months. Results. The Lin's concordance class correlation (CCC) of the OMC method revealed the best correlation to the 3D volumetric computerized values (0.915), followed by the Zinreich (0.904) and Lund-Mackay methods (0.824). Posttreatment results demonstrated that both the OMC (0.824) and Zinreich's (0.778) methods had strong agreement with the 3D volumetric methods and were very sensitive to change, whereas the Lund-Mackay (0.545) had only moderate agreement. Conclusion. Computerized CT analysis provides the most comprehensive, objective, and reproducible method of measuring disease severity and is very sensitive to change induced by treatment intervention. A 2D coronal image through the OMC provides a valid, user-friendly method of assessing CRS and is representative of CRS severity in all sinuses. Zinreich's subjective method correlated well overall, but the Lund-Mackay method lagged behind in disease representation and sensitivity to change.

KW - chronic rhinosinusitis

KW - computed tomography

KW - disease severity

KW - objective

KW - staging system

KW - volumetric scoring

UR - http://www.scopus.com/inward/record.url?scp=84893607288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893607288&partnerID=8YFLogxK

U2 - 10.1177/0194599813513881

DO - 10.1177/0194599813513881

M3 - Article

C2 - 24301090

AN - SCOPUS:84893607288

VL - 150

SP - 305

EP - 311

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 2

ER -