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A Method for Visual Scoring of Pulmonary Mycobacterium Avium Complex Disease: “ NICE Scoring System ”

Atsuyuki Kurashima, Kozo Morimoto, Mitsuko Horibe, Yoshihiko Hoshino, Yuji Shiraishi and Shoji Kudoh

Recently, increase of non-HIV nontuberculous lung disease has been noticed but the chemotherapy of this disease is prolonged because no bactericidal drugs are available. To correctively evaluate the course of disease, X-ray images have been the most reliable method. Yet a quantitative assessment has not been established. Method: Image of M. avium complex lung disease (MAC) is composed of nodule, infiltration (consolidation), cavity and bronchiectasis. We assess the occupied area of each factor on 6-divided lung field, and constructed a system named “NICE scoring system” on PC that makes it possible to easily score in actual practice. Results: This method is well performed for chest radiography (CXR) images and also CT images. Validation tests of intra rater, inter rater and scoring for identical case by CXR images versus CT images show moderate to substantial kappa statistics and significant correlations. Conclusion: This method is useful to evaluate the radiographic image of MAC lung disease.