Semi-Automatic Measurement of the Airway Dimension by Computed Tomography Using the Full-Width-Half- Maximum Method: a Study on the Measurement Accuracy according to the CT Parameters and Size of the Airway

To assess the influence of variable factors such as the size of the airway and the CT imaging parameters such as the reconstruction kernel, field-of view (FOV), and slice thickness on the automatic measurement of airway dimension. An airway phantom was fabricated that contained eleven poly-acryl tubes of various lumen diameters and wall thicknesses. The measured density of the poly-acryl wall was 150 HU, and the measured density of the airspace filled with polyurethane foam was 900 HU. CT images were obtained using a 16-MDCT (multidetector CT) scanner and were reconstructed with various reconstruction kernels, thicknesses and FOV. The luminal radius and wall thickness were measured using in-house software based on the full width- half-maximum method. The measured values as determined by CT and the actual dimensions of the tubes were compared. Measurements were most accurate on images reconstructed with use of a standard kernel (mean error: 0.03 ± 0.21 mm for wall thickness and 0.12 ± 0.11 mm for the luminal radius). There was no significant difference in accuracy among images with the use of variable slice thicknesses or a variable FOV. Below a 1-mm threshold, the measurement failed to represent the change of the real dimensions. Measurement accuracy was strongly influenced by the specific reconstruction kernel utilized. For accurate measurement, standardization of the imaging protocol and selection of the appropriate anatomic level are essential