Measurement of CT lung density in patients with chronic asthma

Biernacki, W; Redpath, Anthony Thomas; Best, J. J. K.; MacNee, William

doi:10.1183/09031936.97.10112455

Cited by 71 publications

(53 citation statements)

References 30 publications

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“…The present authors considered that the discrepancy between their and the present results might be because the present subjects were older. In agreement with the present results, BIERNACKI et al [18] observed that patients with chronic stable asthma, as well as COPD, showed a reduction in CT lung density in comparison with controls. However, in five asthmatic patients, they also found no significant differences in the lowest fifth percentile MLD before and after using a nebulised b 2 -agonist as well as at the end of an exacerbation and 6 weeks later.…”

Section: Discussionsupporting

confidence: 82%

“…GEVENOIS et al [17] showed that acute expiratory airflow limitation and chronic hyperinflation did not influence mean lung density (MLD) and the relative lung area with an attenuation of v-950 HU (RA950) in nonsmoking asthmatic patients. BIERNACKI et al [18] observed that some patients with chronic stable asthma develop a reduction in CT lung density and that acute or chronic overinflation did not affect the lowest fifth percentile MLD. The presence and significance of decreased attenuation as assessed by CT scan thus remains to be clarified in nonsmoking asthmatics.…”

mentioning

confidence: 99%

“…CT lung densitometry has been studied in nonsmoking asthmatic patients [16][17][18]. NEWMAN et al [16] suggested that the percentage of pixels ofv-900 HU at full expiration reflects air trapping in asthmatic patients and correlates with pulmonary function.…”

mentioning

confidence: 99%

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Decreased computed tomographic lung density during exacerbation of asthma

Mitsunobu¹,

Ashida²,

Hosaki³

et al. 2003

Eur Respir J

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Recently, it was shown that both mean lung density (MLD) and the relative lung area with an attenuation of v-950 HU (RA950) are related to severity of asthma in nonsmoking asthmatics. The aim of the present study was to examine whether reduced computed tomography (CT) lung density during exacerbation could change after treatment.A cross-sectional study was performed to compare CT lung density in 30 stable asthmatics, 30 unstable asthmatics and 25 control subjects. In order to investigate longitudinally the effect of treatment on decreased CT lung density, 17 asthmatics with an exacerbation were followed at the initiation of treatment and 2 months after relief.The MLD was significantly lower and the RA950 significantly higher in unstable asthmatics than in controls and stable asthmatics. Both MLD and RA950 changed significantly with administration of systemic glucocorticoid therapy. The changes in forced expiratory volume in one second correlated significantly with those in both MLD and RA950. The changes in residual volume also correlated significantly with those in both MLD and RA950.It was concluded that decreased computed tomographic lung density during an asthma exacerbation is at least partially reversible, and changes in mean lung density and the relative lung area with a radiation attenuation of v-950 HU are related to the change in forced expiratory volume in one second and residual volume.

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

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Decreased computed tomographic lung density during exacerbation of asthma

Mitsunobu¹,

Ashida²,

Hosaki³

et al. 2003

Eur Respir J

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“…From a study of life-long nonsmokers with nonatopic asthma, BIERNACKI et al [11] have previously reported that the asthmatics had lower lung computed tomographic (CT) density than the normal controls, whereas no significant correlation was found between CT lung density, and FEV1, KCO, or residual volume (RV)/TLC ratio. PANHUYSEN et al [9] reported from their 25-yr follow-up of asthmatics that 22% of the patients had a postbronchodilator diffusion constant <80% pred, which might suggest disease progression to emphysema, although these patients had higher lifetime tobacco exposure (pack-yrs) than patients with a diffusion constant within the reference range.…”

Section: Discussionmentioning

confidence: 99%

Nonreversible airflow obstruction in life‐long nonsmokers with moderate to severe asthma

Ulrik¹,

Backer²

1999

Eur Respir J

155

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Nonreversible airflow obstruction in life-long nonsmokers with moderate to severe asthma. C.S. Ulrik, V. Backer. #ERS Journals Ltd 1999. ABSTRACT: The aim of this longitudinal study was to assess the frequency of nonreversible airflow obstruction (NRAO) among adults with moderate to severe asthma, and to compare the decline of forced expiratory volume in one second (FEV1) in asthmatics with reversible and nonreversible airflow obstruction.Ninety-two (31 males) life-long nonsmokers with asthma participated in a 10-yr follow-up study; mean age 37 yrs (range 18±64) and duration of asthma 16 yrs (range 2±60) at enrolment. Case history, including use of asthma medication, was obtained, and pulmonary function, including diffusion capacity, was measured using standard techniques. At enrolment, all patients had typical symptoms and reversible airflow obstruction. (NRAO) was defined as FEV1 <80% predicted and change in DFEV1 after 5 mg salbutamol <9% pred.A total of 21 (23%) patients (mean age at enrolment 32 yrs) fulfilled the criteria for NRAO at the time of follow-up; current therapy was inhaled steroids (n=21, mean daily dose 1.5 mg), oral steroids (n=14), theophylline (n=20), oral b 2 -agonist (n=6) and inhaled b 2 -agonist. The patients with NRAO (n=21) had a steeper decline in FEV1 than the remaining patients (n=71, reversible airflow obstruction (RAO)), mean SD 53 23 mL . yr -1 and 36 21 mL . yr -1 , respectively (p<0.003). Increasing degree of bronchodilator reversibility (DFEV1% pred) at enrolment (p=0.002) and long-term treatment with oral corticosteroids (p=0.009) were associated with an increased risk for the presence of NRAO at follow-up. The comparison of data for NRAO and RAO patients (at follow-up) revealed no significant differences in mean values for total diffusion capacity (TL,CO), diffusion constant (KCO), or total lung capacity.The findings suggest that a subgroup of asthmatics may experience very steep rates of decline in forced expiratory volume in one second leading to severe nonreversible airflow obstruction, whereas no indication was found that long-standing asthma may lead to the development of emphysema.

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“…Quantitative analysis for CT was devised to compensate for this difficulty. Quantitative CT (QCT) methods have beeen mainly used in other specialties, such as cardiology and pulmonology [36][37][38][39][40][41][42][43]. Recent neuroradiological studies, which used densitometry analysis, focused on finding tumors or regional pathological changes [44][45][46][47][48].…”

Section: Technical Implicationsmentioning

confidence: 99%