Paired Inspiratory/Expiratory Volumetric Thin-Slice CT Scan for Emphysema Analysis

Zaporozhan, J.; Ley, Sebastian; Eberhardt, Ralf; Weinheimer, Oliver; Iliyushenko, Svitlana; Herth, Felix J.F.; Kauczor, Hans‐Ulrich

doi:10.1378/chest.128.5.3212

Cited by 109 publications

(30 citation statements)

References 34 publications

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“…Emphysema volume or mean lung density in expiratory CT images has been reported to be a superior predictor of pulmonary function tests (PFTs) abnormalities compared to those in inspiratory CT images [13][14][15]. Yet, there has been no study comparing paired inspiratory and expiratory CT images with regard to CSA in patients with COPD.…”

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

Matsuura

Kawata

Yanagawa

et al. 2013

European Journal of Radiology

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Section: Introductionmentioning

confidence: 99%

Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

Matsuura

Kawata

Yanagawa

et al. 2013

European Journal of Radiology

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“…Secondly, the threshold of −400 HU for determining the lung parenchyma could be debated. Although several previous studies have adopted this threshold both for inspiratory and for expiratory CT scans [11,14], a higher threshold has also been reported [12,15]. However, we think our study results may be robust, relative to different thresholds, because it has been reported that various higher thresholds (−200 to −500 HU) do not significantly influence correlations with TLC or RV [11].…”

Section: Discussionmentioning

confidence: 76%

“…Though many studies have reported significant correlations between quantitative CT metrics and clinically relevant outcomes in patients with COPD [8], CT-based lung volume has not been as rigorously assessed in patients with COPD. The published data concerning the utility of CT-based lung volumes are limited to their correlation with lung function [9,10,11,12,13,14]. In this study, we hypothesized that the CT expiratory-to-inspiratory lung volume ratio (CT V ratio ) would show significant correlations with clinically relevant outcomes in patients with COPD.…”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of Computed Tomographic Lung Volumes in Patients with Chronic Obstructive Pulmonary Disease

Lee

Lee²,

Seo³

et al. 2013

Respiration

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Background: Published data concerning the utility of computed tomography (CT)-based lung volumes are limited to correlation with lung function. Objectives: The aim of this study was to evaluate the clinical utility of the CT expiratory-to-inspiratory lung volume ratio (CT V_ratio) by assessing the relationship with clinically relevant outcomes. Methods: A total of 75 stable chronic obstructive pulmonary disease (COPD) patients having pulmonary function testing and volumetric CT at full inspiration and expiration were retrospectively evaluated. Inspiratory and expiratory CT lung volumes were measured using in-house software. Correlation of the CT V_ratio with patient-centered outcomes, including the modified Medical Research Council (MMRC) dyspnea score, the 6-min walk distance (6MWD), the St. George's Respiratory Questionnaire (SGRQ) score, and multidimensional COPD severity indices, such as the BMI, airflow obstruction, dyspnea, and exercise capacity index (BODE) and age, dyspnea, and airflow obstruction (ADO), were analyzed. Results: The CT V_ratio correlated significantly with BMI (r = −0.528, p < 0.001). The CT V_ratio was also significantly associated with MMRC dyspnea (r = 0.387, p = 0.001), 6MWD (r = −0.459, p < 0.001), and SGRQ (r = 0.369, p = 0.001) scores. Finally, the CT V_ratio had significant correlations with the BODE and ADO multidimensional COPD severity indices (r = 0.605, p < 0.001; r = 0.411, p < 0.001). Conclusion: The CT V_ratio had significant correlations with patient-centered outcomes and multidimensional COPD severity indices.

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“…The proposed approach here has several advantages compared with previous studies. Several researchers have addressed the ability of 3D volumetric data to accurately quantify the extent and severity of emphysema 27–29. In previous studies, which compared only a few single inspiratory and expiratory image pairs, misregistrations of the CT slices between inspiration and expiration might have been due to disturbances of the accurate evaluation of airway dysfunction 30.…”

Section: Discussionmentioning

confidence: 99%

Size variation and collapse of emphysema holes at inspiration and expiration CT scan: evaluation with modified length scale method and image co-registration

Oh¹,

Seo²,

Kim³

et al. 2017

COPD

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A novel approach of size-based emphysema clustering has been developed, and the size variation and collapse of holes in emphysema clusters are evaluated at inspiratory and expiratory computed tomography (CT). Thirty patients were visually evaluated for the size-based emphysema clustering technique and a total of 72 patients were evaluated for analyzing collapse of the emphysema hole in this study. A new approach for the size differentiation of emphysema holes was developed using the length scale, Gaussian low-pass filtering, and iteration approach. Then, the volumetric CT results of the emphysema patients were analyzed using the new method, and deformable registration was carried out between inspiratory and expiratory CT. Blind visual evaluations of EI by two readers had significant correlations with the classification using the size-based emphysema clustering method (r-values of reader 1: 0.186, 0.890, 0.915, and 0.941; reader 2: 0.540, 0.667, 0.919, and 0.942). The results of collapse of emphysema holes using deformable registration were compared with the pulmonary function test (PFT) parameters using the Pearson’s correlation test. The mean extents of low-attenuation area (LAA), E1 (<1.5 mm), E2 (<7 mm), E3 (<15 mm), and E4 (≥15 mm) were 25.9%, 3.0%, 11.4%, 7.6%, and 3.9%, respectively, at the inspiratory CT, and 15.3%, 1.4%, 6.9%, 4.3%, and 2.6%, respectively at the expiratory CT. The extents of LAA, E2, E3, and E4 were found to be significantly correlated with the PFT parameters (r=−0.53, −0.43, −0.48, and −0.25), with forced expiratory volume in 1 second (FEV1; −0.81, −0.62, −0.75, and −0.40), and with diffusing capacity of the lungs for carbon monoxide (cDLco), respectively. The fraction of emphysema that shifted to the smaller subgroup showed a significant correlation with FEV1, cDLco, forced expiratory flow at 25%–75% of forced vital capacity, and residual volume (RV)/total lung capacity (r=0.56, 0.73, 0.40, and −0.58). A detailed assessment of the size variation and collapse of emphysema holes may be useful for understanding the dynamic collapse of emphysema and its functional relation.

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Paired Inspiratory/Expiratory Volumetric Thin-Slice CT Scan for Emphysema Analysis

Cited by 109 publications

References 34 publications

Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

Clinical Utility of Computed Tomographic Lung Volumes in Patients with Chronic Obstructive Pulmonary Disease

Size variation and collapse of emphysema holes at inspiration and expiration CT scan: evaluation with modified length scale method and image co-registration

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