Surface Topographic Assessment of Forced Pulmonary Maneuvers: Reliability and Agreement with Spirometry in Healthy Participants.
prospective_cohort · Level II
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- Record sourced from PubMed, PMID 42551514.
- Also identified by DOI 10.1016/j.chest.2026.05.054.
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Abstract
Spirometry remains the clinical gold-standard for measuring pulmonary function such as forced expiratory indices, yet reliance on a mouthpiece seal, quality assurance, and infection-control procedures limit feasibility and degrade data quality. Markerless optical approaches (depth cameras, surface topography) show promise in monitoring quiet breathing but often require subject-specific calibration, with limited validation of forced expiratory indices and formal reliability testing. Can markerless surface topography (ST) provide reliable estimates of forced expiratory volume in 1 second (FEV<sub>1</sub>), forced vital capacity (FVC), and FEV<sub>1</sub>/FVC comparable to spirometry? Twenty healthy volunteers underwent prospective simultaneous STand handheld spirometry during standardized forced expiratory maneuvers. Two raters administered multiple trials per subject. Body volume was computed per frame from reconstructed surface meshes. Intra- and inter-rater reliability were assessed using intraclass correlation coefficients (ICC(2,1)) with paired permutation testing for differences. ST-spirometry agreement was evaluated by Pearson correlations and Bland-Altman analysis. Leave-one-out cross-validation tested generalizability of a universal linear correction mapping ST volumes to spirometry. ST and spirometry demonstrated similar reliability for FEV1(ICC > 0.97), FVC (ICC > 0.96) and FEV<sub>1</sub>/FVC ratio (ICC > 0.89), with no significant ICC differences between modalities or raters (all P > 0.1). ST correlated strongly with spirometry (R = 0.95 FEV<sub>1</sub>; 0.94 FVC; 0.93 FEV<sub>1</sub>/FVC). Bland-Altman analysis showed stable negative bias for absolute volumes (-0.52 L FEV<sub>1</sub>; -0.66 L FVC) and negligible bias for FEV<sub>1</sub>/FVC. Cross-validation yielded low Root-Mean-Squared errors (0.24 liters FEV<sub>1</sub>; 0.34 liters FVC; 0.025 ratio). ST provides contact-free forced expiratory estimates that correlate strongly with spirometry, with comparable reliability. This may benefit populations for whom the spirometer interface is a barrier, including young children and those with bulbar dysfunction or craniofacial abnormalities.