Progress in Imaging COPD, 2004 - 2014

Lynch, David A.

doi:10.15326/jcopdf.1.1.2014.0125

Cited by 31 publications

(54 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Qualitative visual assessment of the lung must always be performed before densitometry ("eye-first" rule), since it is fundamental for diagnostic purposes in the single patient and decreases the risk of false interpretation of the lung density values (14). However, lung densitometry can replace semi-quantitative visual rating of severity and extension of lung changes.…”

Section: Why To Use Lung Densitometry?mentioning

confidence: 99%

“…However, PFT provide a global assessment of the lung damage. The regional information provided by CT, especially if assessed quantitatively with densitometry, along with its capability to differentiate and to monitor the components underlying obstructive, cystic, or fibrotic lung disease is a distinct advantage (14).…”

Section: Why To Use Lung Densitometry?mentioning

confidence: 99%

“…In the latter case, once the lung mask is considered valid, the lung volume can be computed. This can be used to check the quality of the respiratory maneuver performed by the patient, enables application of volume correction techniques before densitometry measurements (50)(51)(52)(53)(54), but also represents a valuable information per se in many diffuse lung diseases, especially in longitudinal studies (14).…”

Section: Lung Segmentationmentioning

confidence: 99%

“…Thus, when emphysema extent increases, the RA value increases as well. For pulmonary emphysema, in inspiratory scans, RA at −970 (RA970) (23), −960 (RA960) (23), −950 (RA950) (19) (Figure 2) and −910 (RA910) (57) Hounsfield units (HU) significantly correlated with microscopic and/or macroscopic measurements of pulmonary emphysema and are currently utilized in clinical studies (14). …”

Section: Indexes Derived From the Lung Density Histogrammentioning

confidence: 99%

See 3 more Smart Citations

Lung densitometry: why, how and when

Mascalchi¹,

Camiciottoli²,

Diciotti

2017

J. Thorac. Dis.

102

View full text Add to dashboard Cite

Lung densitometry assesses with computed tomography (CT) the X-ray attenuation of the pulmonary tissue which reflects both the degree of inflation and the structural lung abnormalities implying decreased attenuation, as in emphysema and cystic diseases, or increased attenuation, as in fibrosis. and with pulmonary fibrosis. It has also been applied to assess prevalence of smoking-related emphysema and to monitor progression of smoking-related emphysema, alpha1 antitrypsin deficiency emphysema, and pulmonary fibrosis. Finally, it is recommended as end-point in pharmacological trials of emphysema and lung fibrosis.

show abstract

Section: Why To Use Lung Densitometry?mentioning

confidence: 99%

Section: Why To Use Lung Densitometry?mentioning

confidence: 99%

Section: Lung Segmentationmentioning

confidence: 99%

Section: Indexes Derived From the Lung Density Histogrammentioning

confidence: 99%

See 2 more Smart Citations

Lung densitometry: why, how and when

Mascalchi¹,

Camiciottoli²,

Diciotti

2017

J. Thorac. Dis.

102

View full text Add to dashboard Cite

show abstract

“…Since the first description, over 35 years ago, of the use of computed tomography (CT) lung density measurements to quantify the extent of emphysema [4], CT lung imaging has been used as a noninvasive method to evaluate changes in pulmonary structure [5] and thus to assess the pathological phenotype in COPD patients [6].…”

Section: @Erspublicationsmentioning

confidence: 99%

Computed tomography-derived pathological phenotypes in COPD

MacNee

2016

Eur Respir J

View full text Add to dashboard Cite

@ERSpublicationsThere is a need to reach a consensus on the most appropriate method for quantifying emphysema and airways by CT http://ow.ly/YCKP300tQQiChronic obstructive pulmonary disease (COPD) is considered to be a complex, multicomponent, heterogeneous disease, the pathology, clinical and functional presentation of which vary greatly between individual patients despite similar degrees of airflow limitation [1]. COPD has therefore been considered to have distinct phenotypes that represent a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes such as symptoms, exacerbations, rate of disease progression or death [2]. Importantly, these phenotypes of COPD may require different targeted treatment strategies [3].From the early descriptions of COPD, the major pathological features of COPD (chronic bronchitis in the large airways, emphysema in the lung parenchyma and small-airway disease in airways less than 2-3 mm in diameter) have been considered as potential phenotypes of COPD. Since the first description, over 35 years ago, of the use of computed tomography (CT) lung density measurements to quantify the extent of emphysema [4], CT lung imaging has been used as a noninvasive method to evaluate changes in pulmonary structure [5] and thus to assess the pathological phenotype in COPD patients [6].Emphysema was the first pathological phenotype to be assessed by CT imaging where the lung density value (in Hounsfield units (HU)) characterising the fifth percentile (and later the 15th percentile (Perc15/PD15)) of the frequency histogram of lung density values was shown to correlate with morphometric measurements of airspace size [7]. Other reports have used the percentage of low-attenuation lung voxels below a threshold value, commonly of −950 HU (% low attenuation areas (%LAA) or relative area −950 (RA−950)), and shown it to have the strongest pathological correlation with both macroscopic and microscopic emphysema [8,9]. It is now fairly well established that both measures are reliable and reproducible measures to quantify emphysema in cross-sectional studies [10]. However, the use of a single threshold can over-or under-estimate the presence of emphysema [11]. Some would also argue that the Perc15/PD15 is a more sensitive and reproducible measure to assess a change in the extent of emphysema in longitudinal and interventional studies (as an aside, we need to agree on a standard nomenclature for these values) [12].There are important factors that influence the measurement of CT lung density and need standardisation in all studies, particularly in multicentre and longitudinal studies. These include the type and manufacturer of the CT scanner, the radiation dose, slice thickness, the image reconstruction algorithm, body size and the lung volume at which the scan was acquired [13,14]. The latter is of particular importance and methods are required to compensate for variations in lung volume, including spirometrically gating ...

show abstract