Is the airway volume being correctly analyzed?

Abstract

The aim of the study was to determine the most accurate threshold value for airway volume quantification based on specific experimental conditions. Ten scans from the airway prototype were obtained by using cone-beam computed tomography. The volume from each scan was measured with 8 values (25, 50, 70, 71, 72, 73, 74, and 75) of the threshold tool from the Dolphin software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). The gold standard method used was the actual volume of the airway prototype, which was compared with the different threshold values. An intraclass correlation coefficient test was applied to evaluate the intraexaminer calibration and verify differences among the airway volumes measured in all cone-beam computed tomography scans. Analysis of variance with the Tukey post-hoc test was used to compare differences among the measurements with different threshold values with the gold standard. The intraexaminer reliability was confirmed by the intraclass correlation coefficient, which was ≥0.99. The intraclass correlation coefficient used to verify the differences among the airway volume measurements in all cone-beam computed tomography scans was ≥0.98, showing that they were comparable. Analysis of variance and the Tukey post-hoc test showed that the volumes measured with the threshold values of the 25 and 50 filters had statistically significant differences from the gold standard. However, volumes measured with the threshold values of the 70, 71, 72, 73, 74, and 75 showed no statistically significant differences from the gold standard and among them. In our study for the cone-beam machine and the acquisition parameters used, the threshold value of the 73 used in Dolphin 3D software was the most accurate to measure airway volume, but the threshold values of the 70, 71, 72, 74, and 75 had no statistically significant differences compared with the gold standard, showing they are also reliable.