Digital DiagnosticsDigital DiagnosticsDigital DiagnosticsDigital Diagnostics2712-84902712-8962Eco-Vector10435810.17816/DD104358Original Study ArticlesОригинальные исследования原创性科研成果Research ArticleImpact of body mass index on the reliability of the CT0–4 grading system: a comparison of computed tomography protocolsВлияние индекса массы тела на надёжность шкалы КТ 0–4: сравнение протоколов компьютерной томографии体重指数对CT 0-4量表可靠性的影响： 计算机断层扫描协议的比较https://orcid.org/0000-0002-2681-93783306-1387BlokhinIvan A.БлохинИван АндреевичBlokhinIvan A.
Russian Federation
i.blokhin@npcmr.ruhttps://orcid.org/0000-0001-5161-65403513-9531GoncharAnna P.ГончарАнна ПавловнаGoncharAnna P.
Russian Federation
a.gonchar@npcmr.ruhttps://orcid.org/0000-0002-0166-37685789-0319KodenkoMaria R.КоденкоМария РомановнаKodenkoMaria R.
Russian Federation
m.kodenko@npcmr.ruhttps://orcid.org/0000-0003-4485-26389654-4005SolovevAlexander V.СоловьевАлександр ВладимировичSolovevAlexander V.
Russian Federation
a.solovev@npcmr.ruhttps://orcid.org/0000-0003-1816-13156810-3279GombolevskiyVictor A.ГомболевскийВиктор АлександровичGombolevskiyVictor A.
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

MD, Cand. Sci. (Med.)

g_victor@mail.ruhttps://orcid.org/0000-0002-9661-02548592-0558ReshetnikovRoman V.РешетниковРоман ВладимировичReshetnikovRoman V.
Russian Federation

Cand. Sci. (Phys.-Math.)

к.ф.-м.н.

Cand. Sci. (Phys.-Math.)

reshetnikov@fbb.msu.ruMoscow Center for Diagnostics and TelemedicineНаучно-практический клинический центр диагностики и телемедицинских технологийMoscow Center for Diagnostics and TelemedicineBauman Moscow State Technical UniversityМосковский государственный технический университет имени Н.Э. Баумана (национальный исследовательский университет)Bauman Moscow State Technical UniversityArtificial Intelligence Research InstituteИнститут искусственного интеллекта (AIRI)Artificial Intelligence Research InstituteThe First Sechenov Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)The First Sechenov Moscow State Medical University (Sechenov University)0806202214072022321081180203202226052022Copyright ©; 2022, Blokhin I.A., Gonchar A.P., Kodenko M.R., Solovev A.V., Gombolevskiy V.A., Reshetnikov R.V.Copyright ©; 2022, Блохин И.А., Гончар А.П., Коденко М.Р., Соловьев А.В., Гомболевский В.А., Решетников Р.В.Copyright ©; 2022, Blokhin I.A., Gonchar A.P., Kodenko M., Solovev A.V., Gombolevskiy V.A., Reshetnikov R.V.2022Blokhin I.A., Gonchar A.P., Kodenko M.R., Solovev A.V., Gombolevskiy V.A., Reshetnikov R.V.Блохин И.А., Гончар А.П., Коденко М.Р., Соловьев А.В., Гомболевский В.А., Решетников Р.В.Blokhin I.A., Gonchar A.P., Kodenko M., Solovev A.V., Gombolevskiy V.A., Reshetnikov R.V.https://creativecommons.org/licenses/by-nc-nd/4.0https://jdigitaldiagnostics.com/DD/article/view/104358

BACKGROUND: The increased frequency of chest computed tomography utilization in the fight against COVID-19 has made usage of low-dose computed tomography necessary to reduce the radiation dose while preserving diagnostic quality. However, in the published literature, there were no data on the effect of body mass index on low-dose computed tomography accuracy in patients with COVID-19.

AIM: To assess the effect of patient body mass index on the level of agreement between radiologists interpreting standard-dose computed tomography and low-dose computed tomography in COVID-19-associated pneumonia using visual semiquantitative CT 0–4 scale.

MATERIALS AND METHODS: In this retrospective multicenter study, each participant underwent two consecutive chest scans at a single visit using standard-dose and low-dose protocols. Standard-dose and low-dose computed tomography with pulmonary and soft tissue kernels were interpreted using a visual semiquantitative CT 0–4 grading system. Data for each protocol were grouped by body mass index value (threshold value for pathology was equal to 25 kg/m2). Agreement was calculated based on binary and weighted classifications. One-way ANOVA analysis of variance was used to assess the presence of statistically significant differences in the mean for the groups.

RESULTS: Two hundred thirty patients met the established inclusion criteria for the study. The experts processed 4 studies for each patient: standard-dose and low-dose computed tomography with pulmonary and soft tissue kernels. The proportion of normal-weight patients was 31% (71 subjects), and the sample’s median body mass index was 27.5 (18.3; 48.3) kg/m2. There were no statistically significant differences in intergroup pairwise comparisons for both the binary and weighted classifications (p values were 0.09 and 0.12, respectively). The group of overweight patients was further subdivided according to the degrees of obesity; however, the results were invariant to this division (no statistically significant differences: for the most different body mass index groups “normal” and “3rd degree obesity” p-value 0.17).

CONCLUSION: Body mass index does not affect chest standard-dose and low-dose computed tomography interpretation in COVID-19 using the visual semiquantitative CT 0–4 grading system.

Обоснование. Из-за повышения частоты использования компьютерной томографии органов грудной клетки в борьбе с COVID-19 возникла необходимость применения низкодозной компьютерной томографии для снижения дозовой нагрузки на организм пациента при сохранении диагностической ценности исследования. При этом данных о влиянии индекса массы тела пациента на точность низкодозной компьютерно-томографической диагностики у пациентов с COVID-19 в опубликованной литературе не обнаружено.

Цель ― оценить влияние индекса массы тела пациента на уровень согласия между врачами-рентгенологами при интерпретации стандартной и низкодозной компьютерной томографии органов грудной клетки при COVID-19-ассоциированной пневмонии по визуальной полуколичественной шкале КТ 0–4.

Материалы и методы. Ретроспективное многоцентровое исследование, в котором каждому из участников в рамках одного визита было последовательно выполнено два исследования органов грудной клетки по стандартному и низкодозному протоколу. Интерпретация стандартной и низкодозной компьютерной томографии органов грудной клетки с лёгочным и мягкотканным кернелами проводилась по визуальной полуколичественной шкале КТ 0–4. Данные для каждого протокола были сгруппированы по значению индекса массы тела (пороговое значение для патологии было принято равным 25 кг/м2). Согласие рассчитывали на основе бинарной и взвешенной классификаций. Оценку наличия статистически значимых различий средних для полученных групп проводили методом однофакторного дисперсионного анализа ANOVA.

Результаты. Из общего количества пациентов (n=231) 230 соответствовали установленным критериям включения в исследование. Эксперты обработали по 4 исследования стандартной и низкодозной компьютерной томографии с лёгочным и мягкотканным кернелами для каждого пациента. Доля пациентов с нормальным весом составила 31% (71 человек), медиана индекса массы тела для выборки равна 27,5 (18,3; 48,3) кг/м2. Статистически значимых различий при межгрупповом попарном сравнении не выявлено ни для бинарной, ни для взвешенной классификации (p-value 0,09 и 0,12 соответственно). Группа пациентов с избыточным весом была дополнительно разделена по степеням ожирения, однако результаты исследования оказались инвариантны к такому делению (статистически значимых различий нет: для максимально различных по индексу массы тела групп «норма» и «ожирение 3-й степени» p-value 0,17).

Заключение. Индекс массы тела пациента не влияет на интерпретацию стандартной и низкодозной компьютерной томографии органов грудной клетки при COVID-19 по визуальной полуколичественной шкале КТ 0–4.

论证。由于在对抗COVID-19的过程中使用胸部计算机断层扫描的频率越来越高，因此有必要应用低剂量计算机断层扫描(LDCT)来减少患者身体的剂量负荷，同时保持研究的诊断价值.然而，在已发表的文献中未发现有关患者体重指数对COVID-19患者LDCT诊断准确性影响的数据。

目的是评估患者的BMI对放射科医生在解释COVID-١٩相关肺炎的标准和低剂量胸部CT扫描时在٠-٤视觉半定量CT评分上的一致程度的影响。

材料与方法。一项回顾性多中心研究，其中在一次访问时每位参与者接受了两次连续的胸部检查，使用标准和低剂量方案。对标准和低剂量胸部CT扫描的肺部和软组织核素的解释是以视觉半定量的CT ٠-٤尺度进行的。每个方案的数据根据体重指数的值进行分组（病理学阈值等于公斤/平方米）。协议是根据二元和加权分类计算的。通过方差单因素方差分析来评估各组平均值之间是否存在统计学上的显著差异。

结果。在患者总数（n=231）中，٢٣٠人符合确立的研究纳入标准。专家为每位患者处理了٤项标准和低剂量计算机断层扫描研究，包括肺和软组织卷积核。体重正常的患者比例为 ٣١٪（٧١ 人），样本的中位体重指数中位为 ٢٧.٥（١٨.٣；٤٨.٣）公斤/平方米。无论是二元分类还是加权分类，组间配对比较未发现统计学上的显著差异（p值分别为٠.٠٩和٠.١٢）。超重患者组根据肥胖程度进一步划分，但研究结果对这种划分是不变的（没有统计学上的显着差异：身体质量参数最大不同组别»正常»和»٣度肥胖»的p值为٠.١٧）。

结论。患者的体重指数不影响在٠-٤的视觉半定量CT等级上对 COVID-١٩胸部标准和低剂量计算机断层扫描的解释。

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