Validation of a software designed for computed tomographic (CT) measurement of lung water

Objective:The in-vitro validation of a computed tomographic (CT) software specifically designed for quantifying the volume of water contained in the lung. Design: An in-vitro, ex-vivo study. In 1993, a postmortem left pneumonectomy was performed in a patient who died from acute respiratory distress syndrome. The lung was fixed, inflated and dried according to a technique proposed by Markarian and Dailey in 1975 aimed at producing a lung specimen spongy in texture and suitable for radiography. Measurements and results: In 1999, 13 CT scans of this lung specimen were performed corresponding to different bronchial instillations of known volumes of water and albumin 4%. The different lung weights resulting from the successive bronchial instillations were calculated using a specially designed software, Lungview, adapted for CT measurements and compared with the actual lung weight measured by an electronic scale. The increase in lung weight measured by Lungview was closely correlated with the actual increase in lung weight resulting from bronchial instillation of water and albumin (y = 0.99x - 23, r = 1 for water and y = x - 17, r = 1 for albumin 4%) and the precision of the bias was 7 g for water and 3 g for albumin 4%. Conclusions: This study shows that the CT software Lungview accurately measured the volume of lung water present within an air-dried exsanguine human lung.