Automatic Quantification of Pulmonary Fissure Integrity: A Repeatability Analysis

The pulmonary fissures divide the lungs into lobes and can vary widely in shape, appearance, and completeness. Fissure completeness, or integrity, has been studied to assess relationships with airway function measurements, chronic obstructive pulmonary disease (COPD) progression, and collateral ventilation between lobes. Fissure integrity measured from computed tomography (CT) images is already used as a non-invasive method to screen emphysema patients for endobronchial valve treatment, as the procedure is not effective when collateral ventilation is present. We describe a method for automatically computing fissure integrity from lung CT images. Our method is tested using 60 subjects from a COPD study. We examine the repeatability of fissure integrity measurements across inspiration and expiration images, assess changes in fissure integrity over time using a longitudinal dataset, and explore fissure integrity's relationship with COPD severity.