Assessment of COPD severity by computed tomography: correlation with lung functional testing

Pauls, Sandra; Gulkin, Daniel; Feuerlein, Sebastian; Muche, Rainer; Krüger, Stefan; Schmidt, Stefan A.; Dharaiya, Ekta; Brambs, Hans‐Jürgen; Hetzel, M

doi:10.1016/j.clinimag.2009.05.004

Cited by 30 publications

(25 citation statements)

References 29 publications

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“…1,3 There is evidence for the relationship between airway diameters measured in HRCT and results of other studies quantifying airway structure and function. [4][5][6][7] Moreover, HRCT seems a reliable tool in studying the changes in airway dimensions after nonspecific challenge tests, 8,9 the effect of bronchodilators, 6,10 and the consequences of airway remodeling (eg, air trapping). 11 The objectives of our study were to assess the bronchial lumen and wall dimensions in asthma and COPD patients in relation to the disease severity, and to compare airway dimensions in patients with asthma and COPD.…”

Section: Introductionmentioning

confidence: 99%

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

et al. 2013

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BACKGROUND: Airway remodeling in asthma and COPD results in bronchial wall thickening. The thickness of the bronchial wall can be measured in high-resolution computed tomography. The objectives of the study were to assess the bronchial lumen and wall dimensions in asthma and COPD patients, in relation to disease severity, and to compare the airway dimensions in patients with asthma and COPD. METHODS: Ten asthma subjects and 12 COPD subjects with stable, mild to moderate disease were investigated. All subjects underwent chest high-resolution computed tomography (window level ؊ 450 Hounsfield units, window width 1,500 Hounsfield units). Cross-sections of bronchi (external diameter 1.0 -5.0 mm) were identified on enlarged images. The following variables were measured: external and internal diameter, wall area, lumen area, total airway area, the percentage of airway wall area, wall thickness, and the ratio of wall thickness to external diameter. Separate sub-analyses were performed for airways with external diameter < 2.0 mm and external diameter > 2.0 mm. RESULTS: We measured 261 and 348 cross-sections of small airways in subjects with asthma and COPD, respectively. There was a significant difference in wall thickness and wall area, which were both greater in asthmatics than in COPD patients. In bronchi with external diameter > 2.0 mm, all measured parameters were significantly higher in asthma than COPD. In individual asthmatics the airway wall thickness was similar in all the assessed bronchi, while in COPD it was related to the external airway diameter. CONCLUSIONS: Our results indicate that bronchial walls are thicker in asthmatics than in patients with COPD. It seems that airway wall thickness and the lumen diameter in patients with asthma are related to disease severity. There is no such a relationship in COPD patients. High-resolution computed tomography may be a useful tool in the assessment of airway structure in obstructive lung disease.

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Section: Introductionmentioning

confidence: 99%

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

et al. 2013

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“…This histogram was used to derive two different densitometric measures: the relative area below −950 HU (RA950-raw) and the 15th percentile density (PD15-raw). These densitometric measures were chosen because they have been shown to correlate well with histopathology [4,14] and because the thresholds of −950 HU and the 15th percentile have been widely adopted in the assessment of emphysema in thin-section CT [9,[15][16][17].…”

Section: Quantitative Ct Image Analysismentioning

confidence: 99%

“…Densitometric measures such as density mask and percentile density were therefore proposed as quantitative means of assessing extent and progression of emphysema [4,5]. These CT-derived measures have been shown to correlate well with emphysema assessment via PFT and histopathology [4,[6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of volume and densitometric measures of emphysema on repeat computed tomography with an interval of 1 week

Chong¹,

Brown

Kim

et al. 2011

Eur Radiol

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• Good breath-hold reproducibility is achievable between multiple CT examinations. • Reproducibility of densitometric measures may be improved by statistical volume correction. • Volume correction may result in decreased signal. • Densitometric reproducibility may also be improved by achieving good breath-hold reproduction. • Careful consideration of signal and noise is necessary in reproducibility assessment.

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“…3 The EV/TLV or the emphysema ratio (ER) (%) can then be calculated for individual lobes of the lungs. 2 The Figure shows an overall ER of 17.1%, which signifies that at least 17% of the patient's lungs are not available for active air exchange while at the same time being more susceptible to developing pneumothorax due to air-trapping. There is considerable evidence to support intraoperative use of protective ventilatory strategies, including lower tidal volumes (6-7 mLÁkg -1 for two-lung ventilation and 3-4 mLÁkg -1 for one-lung ventilation) to reduce volutrauma in general.…”

mentioning

confidence: 97%

“…1 It requires no intravenous contrast material and can be used to differentiate between airway-predominant and emphysema-predominant COPD. 2 Quantitatively, it allows assessment of the density of each voxel (three-dimensional [3D] volume unit representing a pixel on the 2D image) of lung parenchyma using vendor-specific software that calculates total lung volume (TLV) and emphysematous volume (EV) of both lungs. 3 The typical value for the attenuation coefficient, Housefield units, is set at -950 to differentiate between emphysema (seen as red dots) and normal lung tissue (Figure).…”

mentioning

confidence: 99%

Multidetector computed tomography-derived emphysema index for preoperative quantification of emphysema severity

Agarwal

Najim

Keshavamurthy

2016

Can J Anesth/J Can Anesth

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Emphysema is a chronic obstructive airway disease (COPD) characterized by loss of elastic recoil of the lungs, which results in alveolar hyperinflation and collapse of the airways during exhalation. This disease presents multiple challenges during anesthesia, and assessing its severity preoperatively may help with intraoperative management.Pulmonary function tests provide only functional information, and conventional chest radiography provides only a gross estimation of disease severity. Multidetector computed tomography (MDCT) combined with dedicated post-processing software however, is a novel tool that utilizes high-resolution imaging, thereby allowing quantitative assessment of emphysema. This rapidly evolving technology provides detailed anatomical information about lung parenchyma, the airways, and the distribution of emphysematous lung tissue.1 It requires no intravenous contrast material and can be used to differentiate between airway-predominant and emphysema-predominant COPD. Quantitatively, it allows assessment of the density of each voxel (three-dimensional [3D] volume unit representing a pixel on the 2D image) of lung parenchyma using vendor-specific software that calculates total lung volume (TLV) and emphysematous volume (EV) of both lungs. 3 The typical value for the attenuation coefficient, Housefield units, is set at -950 to differentiate between emphysema (seen as red dots) and normal lung tissue (Figure).3 The EV/TLV or the emphysema ratio (ER) (%) can then be calculated for individual lobes of the lungs.2 The Figure shows an overall ER of 17.1%, which signifies that at least 17% of the patient's lungs are not The table in the lower aspect of the image reflects the ratio between the air-trapped emphysematous volume (EV) and normal lung volumes. The blue areas are the large airways and were not included in the calculation of this patient's 17.1% EV ratio.

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Assessment of COPD severity by computed tomography: correlation with lung functional testing

Cited by 30 publications

References 29 publications

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

Reproducibility of volume and densitometric measures of emphysema on repeat computed tomography with an interval of 1 week

Multidetector computed tomography-derived emphysema index for preoperative quantification of emphysema severity

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