Three-dimensional volumetric computed tomographic scoring as an objective outcome measure for chronic rhinosinusitis: clinical correlations and comparison to Lund-Mackay scoring

• Published in: International forum of allergy & rhinology Vol. 3; no. 12; pp. 963 - 972
• Main Authors: Pallanch, John F., Yu, Lifeng, Delone, David, Robb, Rich, Holmes III, David R., Camp, Jon, Edwards, Phil, McCollough, Cynthia H., Ponikau, Jens, Dearking, Amy C., Lane, John, Primak, Andrew, Shinkle, Aaron, Hagan, John, Frigas, Evangelo, Ocel, Joseph J., Tombers, Nicole, Siwani, Rizwan, Orme, Nicholas M., Reed, Kurtis B., Jerath, Nivedita, Dhillon, Robinder, Kita, Hirohito
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.12.2013; Wiley Subscription Services, Inc
• Subjects: Adult; Chronic Disease; computed tomography; computer-assisted image analysis; Cone-Beam Computed Tomography - methods; endoscopy; Humans; Imaging, Three-Dimensional; Lund-Mackay; Medical treatment; Paranasal Sinuses - diagnostic imaging; Prospective Studies; Quality of Life; Reproducibility of Results; Rhinitis - diagnostic imaging; Severity of Illness Index; Sinusitis - diagnostic imaging; computed tomography; endoscopy; computer-assisted image analysis; Lund-Mackay; quality of life
• ISSN: 2042-6976; 2042-6984; 2042-6984
• DOI: 10.1002/alr.21219

Background We aimed to test the hypothesis that three‐dimensional (3D) volume‐based scoring of computed tomography (CT) images of the paranasal sinuses was superior to Lund‐Mackay CT scoring of disease severity in chronic rhinosinusitis (CRS). We determined correlation between changes in CT scores (using each scoring system) with changes in other measures of disease severity (symptoms, endoscopic scoring, and quality of life) in patients with CRS treated with triamcinolone. Methods The study group comprised 48 adult subjects with CRS. Baseline symptoms and quality of life were assessed. Endoscopy and CT scans were performed. Patients received a single systemic dose of intramuscular triamcinolone and were reevaluated 1 month later. Strengths of the correlations between changes in CT scores and changes in CRS signs and symptoms and quality of life were determined. Results We observed some variability in degree of improvement for the different symptom, endoscopic, and quality‐of‐life parameters after treatment. Improvement of parameters was significantly correlated with improvement in CT disease score using both CT scoring methods. However, volumetric CT scoring had greater correlation with these parameters than Lund‐Mackay scoring. Conclusion Volumetric scoring exhibited higher degree of correlation than Lund‐Mackay scoring when comparing improvement in CT score with improvement in score for symptoms, endoscopic exam, and quality of life in this group of patients who received beneficial medical treatment for CRS.