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Table 5 An overview of eight scoring systems for CT in cystic fibrosis, adapted from the original publications. In the Bhalla [22], Santamaria [28] and Helbich [30] scores, the generations of bronchial divisions involved for bronchiectasis and mucus plugging are scored separately, in this table this entity is divided between the scores for bronchiectasis and mucus plugging. In the Brody II score [34], air trapping is scored both for extent and appearance (subsegmental or larger). The maximum scores for the Maffessanti [25] and the Robinson [32] scoring systems were calculated from the data in the original publications, since they were not reported there

From: Radiography, tomosynthesis, CT and MRI in the evaluation of pulmonary cystic fibrosis: an untangling review of the multitude of scoring systems

CT scoring systems

Bhalla [22]

Nathanson [23]

Maffessanti [25]

Shah [27]

Santamaria [28]

Helbich [30]

Robinson [32]

Brody II [34]

 

(1991)

(1991)

(1996)

(1997)

(1998)

(1999)

(2001)

(2004)

Scoring area

BPS

12 zones

4 regions

6 zones + BPS

BPS

BPS

6 lobes

6 lobes

    

(modified Bhalla)

(modified Bhalla)

(modified Bhalla)

(modified Bhalla)

(modified Brody I)

Scoring components/scoring levels, scoring range

 Increased lung volume

Emphysema 02Range 02

 

Overinflation 01Range 01

 

Air trapping 02 (expiratory scans if regional reduced density)

Range 02

Emphysema 02

Range 02

Air trapping on expiratory image 04

Range 04

Air trapping on expiratory image: Extent 03 × appearance 11.5Range: 04.5

 Bronchial wall thickening

03

Range 03

 

02

Range 02

03

Range 03

03

Range 03

03

Range 03

04

Range 04

(Extent central 03 + peripheral lung 03) × severity 11.5

Range 09

 Bronchiectasis

Severity 03

Extent 03 Sacculations or abscesses 03 Generations bronchial divisions involved 03 × 0.5

Range 010.5

05

Range 05

Diameter 03

Axial extent 03

Range 06

Severity 03

Extent 03

Air-fluid levels 03

Range 09

Severity 03

Extent 03 Generations bronchial divisions involved 03 × 0.5

Range 07.5

Severity 03

Extent 03 Sacculations or abscesses 03 Generations bronchial divisions involved 03 × 0.5

Range 010.5

04

Range 04

(Extent central 03 + peripheral lung 03) × average bronchiectasis size 02

Range 012

 Mucus plugging

Extent: 03 Generations bronchial divisions involved 03 × 0.5

Range 04.5

0-1

Range 0-1

Recorded separately

Extent: 03

Centrilobular nodules, 06

Range 09

Extent: 03 Generations bronchial divisions involved 03 × 0.5

Range 04.5

Extent: 03 Generations bronchial divisions involved 03 × 0.5

Range 04.5

0-4

Range 04

Extent central lung 03

+ peripheral lung 03

Range 06

 Parenchyma

Collapse or consolidation 02 No. of bullae 03Range 05

 

Alveolar consolidations 01

Atelectasis, bullae and cysts 01

Range 02

Atelectasis or consolidation 03

Range 03

Collapse 02

No. of bullae 03 Acinar nodules/ consolidations 02 Thickened intra or inter lobular septa 03

Ground glass opacities 03

Range 013

Collapse or consolidation 02 No. of bullae 03

Mosaic perfusion 02

Range 07

Atelectasis or consolidation 04Range 04

Extent of dense opacity, ground glass opacity, and cysts or bullae. Each 03

Range 09

 Total score

Maximum 25

Per zone max. 6 p (demerit points)

Score

= 72-max. 72

=Minimum 0

% of regional involvement (thirds of lung on axial slices).

Each region × 0–3

Maximum 132

Maximum 24

Maximum 30

Maximum 27

Per lobe max. 20 Maximum 120

Per lobe max. 40.5, but max. possible score is 207. Score then normalised 0100

Maximum 100