Reproducibility of thrombus volume quantification in multicenter computed tomography pulmonary angiography studies

Figure 1 Schematic of segmental distribution of pulmonary arteries. MPA: Main pulmonary artery; RPA: Right pulmonary artery; TA: Truncus anterior; RILA: Right interlobar artery; RBT: Right basal trunk; RA1: Right upper lobe, apical; RA2: Right upper lobe, posterior; RA3: Right upper lobe, anterior; RA4: Right middle lobe, lateral; RA5: Right middle lobe, medial; RA6: Right lower lobe, superior; RA7: Right lower lobe, medial basal; RA8: Right lower lobe, anterior basal; RA9: Right lower lobe, lateral basal; RA10: Right lower lobe, posterior basal; LPA: Left pulmonary artery; LILA: Left interlobar artery; LBT: Left basal trunk; LA1: Left upper lobe, apical; LA2: Left upper lobe, posterior; LA3: Left upper lobe, anterior; LA4: Lingula, superior; LA5: Lingula, inferior; LA6: Left lower lobe, superior; LA7: Left lower lobe, medial basal; LA8: Left lower lobe, anterior basal; LA9: Left lower lobe, lateral basal; LA10: Left lower lobe, posterior basal.

Figure 2 Computed tomography pulmonary angiogram images demonstrating segmentation of a saddle embolus in three orthogonal views (arrows).

Figure 3 Total thrombus volume inter- and intra-observer reproducibility (A) Intra-class correlation coefficient (ICC) plot and (B) Bland Altman plot comparing the total PE thrombus volume results of the primary and secondary image analyst for the inter-observer reproducibility analysis (C) ICC plot and (D) Bland Altman plot comparing the total pulmonary embolism thrombus volume results of the first and second read of the primary image analyst for the intra-observer reproducibility analysis.

Figure 4 Individual thrombus volume inter- and intra-observer reproducibility (A) Intra-class correlation coefficient (ICC) plot and (B) Bland Altman plot comparing the individual PE thrombus volumes results of the primary and secondary image analyst for the inter-observer reproducibility analysis (C) ICC plot and (D) Bland Altman plot comparing the individual pulmonary embolism thrombus volumes results of the first and second read of the primary image analyst for the intra-observer reproducibility analysis.

Figure 5 Qanadli score inter- and intra-observer reproducibility (A) Intra-class correlation coefficient (ICC) plot and (B) Bland Altman plot comparing the Qanadli score results of the primary and secondary image analyst for the inter-observer reproducibility analysis (C) ICC plot and (D) Bland Altman plot comparing the results of the first and second read of the primary image analyst for the intra-observer reproducibility analysis of the PE obstruction index (Qanadli score).

Figure 6 Modified Qanadli score inter- and intra-observer reproducibility (A) Intra-class correlation coefficient (ICC) plot and (B) Bland Altman plot comparing the modified Qanadli results of the primary and secondary image analyst for the inter-observer reproducibility analysis (C) ICC plot and (D) Bland Altman plot comparing the results of the first and second read of the primary image analyst for the intra-observer reproducibility analysis.

Figure 7 Bland Altman analysis of total thrombus volume normalized to clot size (Mean vs Difference/Mean) for (A) intra and (B) inter observer analysis.