A new method for objective identification and measurement of airway lumen in pediatric flexible video-bronchoscopy

Masters, I. B., Eastburn, M. M., Wootton, R., Ware, R. S., Francis, P. W., Zimmerman, P. V. and Chang, A. B. (2005) A new method for objective identification and measurement of airway lumen in pediatric flexible video-bronchoscopy. Thorax, 60 8: 652-658. doi:10.1136/thx.2004.034421

Author Masters, I. B.
Eastburn, M. M.
Wootton, R.
Ware, R. S.
Francis, P. W.
Zimmerman, P. V.
Chang, A. B.
Title A new method for objective identification and measurement of airway lumen in pediatric flexible video-bronchoscopy
Journal name Thorax   Check publisher's open access policy
ISSN 0040-6376
Publication date 2005-08-01
Sub-type Article (original research)
DOI 10.1136/thx.2004.034421
Volume 60
Issue 8
Start page 652
End page 658
Total pages 7
Editor D. Mitchell
S. Johnston
J. A. Wedzicha
Place of publication London, England
Publisher BMJ Publishing Group
Collection year 2005
Language eng
Subject C1
321027 Respiratory Diseases
730110 Respiratory system and diseases (incl. asthma)
730305 Diagnostic methods
1117 Public Health and Health Services
Formatted abstract
Background: Accurate measurements of airway and lesion dimensions are important to the developmental progress of paediatric bronchoscopy. The malacia disorders are an important cause of respiratory morbidity in children, but no methods are currently available to measure these lesions or the airway lumen accurately. A new measurement technique is described here.

Methods: The magnification power of a paediatric videobronchoscope was defined and a simple and user friendly computer based program (Image J) was used to develop an objective technique (colour histogram mode technique, CHMT) for measurement of the airway lumen.

Results: In vivo intra-observer and inter-observer repeatability coefficients for repeated area measurements from 28 images using the Bland-Altman method were 0.9 mm2 and 1.6 mm2, respectively. The average intraclass correlation coefficient for repeated measurements of area was 0.93. In vitro validation measurements using a 2 mm diameter tube resolved radii measurements to within 0.1 mm (coefficient of variability 8%). An "acceptable result" was defined in 92% of 734 images completed with the CHMT alone and 8% with its modification. The success rate for two of three images being within 10% of each other’s area was 100%. Measurements of cricoid cross sectional areas from 116 patients compared with expected airway areas for age derived from endotracheal tube sizes were comparable.

Conclusions: The CHMT method of identifying and measuring airway dimensions is objective, accurate, and versatile and, as such, is important to the future development of flexible videobronchoscopy.
Keyword Respiratory System
Cross-sectional Area
flexible videobronchoscopy
airway measurement
Q-Index Code C1
Additional Notes At top of title: Paediatric Lung Disease

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Created: Wed, 15 Aug 2007, 05:28:54 EST