Quantitative Thin-Section CT Analysis of the Enlargement and Coalescence of Low-Attenuation Clusters in Patients with Emphysema

Matsuoka, Shin; Kurihara, Yasuyuki; Yagihashi, Kunihiro; Nakajima, Yasuo

doi:10.1159/000096034

Cited by 12 publications

(10 citation statements)

References 26 publications

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“…When combined with PFTs, we can expect an even higher sensitivity in differentiating between the two diseases. Quantitative modeling and analysis of CT scans of the lungs are quickly advancing our applications of CT to monitor the course of lung diseases and assess their prognoses [3,20,38] . Computer-aided analysis can also be used to reach quick and objective results in practice [18,39,40] .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, PFTs require the cooperation of patients for an accurate reading, which is not always achievable with pediatric patients or patients with advanced stages of pulmonary diseases. A radiological examination may provide an independent approach for assessing lung diseases or can be used in combination with PFTs for accurate and early diagnosis [2,3] . In a study comparing chronic obstructive pulmonary disease (COPD) patients and asthma patients, we evaluated how low-dose computed tomography (CT) and its quantitative analysis may be used to diagnose and differentiate between COPD and asthma.…”

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confidence: 99%

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Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Chen

Zeng²,

Zhang³

et al. 2017

Respiration

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Background: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD) and asthma in clinics; therefore, for diagnostic purposes, imaging-based measurements could be beneficial to differentiate between the two diseases. Objectives: We aim to analyze quantitative measurements of the lung and bronchial parameters that are provided by low-dose computed tomography (CT) to differentiate COPD and asthma from an imaging perspective. Materials and Methods: 69 COPD patients, 52 asthma patients, and 20 healthy subjects were recruited to participate in CT imaging and pulmonary function tests (PFTs). Comparative analysis was performed to identify differences between COPD and asthma in CT measurements. PFT measurements enabled validation of the differentiation between COPD and asthma patients. Results: There were significant differences among the COPD, asthma, and healthy control groups. The differences were more significant among the following: inspiratory emphysema index (EI)_-950 (%), expiratory lung volume, expiratory mean lung density (MLD), and expiratory EI_-950 (%) and EI_-850 (%). The COPD group had a significantly higher EI_-950 (%) than the asthma group (p = 0.008). There were significant differences among the three groups in lumen area (LA), wall area (WA), total area, and Pi10WA. The asthma group had significantly higher WA%/WV% than both the COPD (p = 0.002) and the control group (p = 0.012). There was high sensitivity in EI_-950 (%), EI_-850 (%) and expiratory MLD in the parenchyma and high sensitivity in LA and Pi10WA in small airways in the differential diagnosis of COPD and asthma. Conclusion: To aid the diagnosis, CT can provide quantitative measurements to differentiate between COPD and asthma patients.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Chen

Zeng²,

Zhang³

et al. 2017

Respiration

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“…The article by Matsuoka et al [16] , published in this issue of Respiration , further extends the analysis of this topic, with a detailed examination of the relationship between the number of LAC of various sizes and the progressive extent of emphysema. Their results clearly show that the degree of cluster coalescence depends on the size of clusters and the extent of emphysema.…”

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confidence: 93%

The Heresy of One Age Becomes the Orthodoxy of the Next: What Is New about Detecting Emphysema?

Zompatori¹,

Laporta

2006

Respiration

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“…4 In addition, a recent study analyzed the mean size of LAA clusters (LAS) and the number of low-attenuation clusters (LAN) by their sizes (small LAN, medium LAN, large LAN). 5,6 Focusing on the airway disease, it was possible to analyze the inner luminal area and the wall thickness of airways at the level of the distal bronchi (from the third to the fifth or sixth bronchi) as inner luminal area (Ai) and wall area percentage (WA%), respectively. 7,8 These indices were associated with airflow limitation, and such correlations were significant at the distal (small) rather than the proximal (large) airways.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal changes in structural abnormalities using MDCT in chronic obstructive pulmonary disease

Kawata¹,

Takayanagi²,

Tada³

et al. 2017

Imaging

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BACKGROUND: Recent advances in multi-detector computed tomography (MDCT) facilitate acquiring important clinical information for managing patients with COPD. MDCT can detect the loss of lung tissue associated with emphysema as a low-attenuation area (LAA) and the thickness of airways as the wall area percentage (WA%). The percentage of small pulmonary vessels less than 5 mm 2 (%CSA<5) has been recently recognized as a parameter for expressing pulmonary perfusion. We aimed to analyze the longitudinal changes in structural abnormalities using these CT parameters and analyze the effect of exacerbation and smoking cessation on structural changes in COPD patients. METHOD: We performed pulmonary function tests (PFTs), an MDCT and a COPD assessment test (CAT) in 58 patients with COPD at the time of their enrollment at the hospital and two years later. We analyzed the change in clinical parameters including CT indices and examined the effect of exacerbations and smoking cessation on the structural changes. RESULTS: The CAT score and FEV 1 did not significantly change during the follow-up period. The parameters of emphysematous changes significantly increased. On the other hand, the WA% at the distal airways significantly decreased or tended to decrease, and the %CSA<5 slightly but significantly increased over the same period, especially in ex-smokers. The parameters of emphysematous change were greater in patients with exacerbations and continued to progress even after smoking cessation. In contrast, the WA% and %CSA<5 did not change in proportion to emphysema progression. CONCLUSION: The WA% at the distal bronchi and the %CSA<5 did not change in parallel with parameters of LAA over the same period. We propose that airway disease and vascular remodeling may be reversible to some extent by smoking cessation and appropriate treatment. Optimal management may have a greater effect on pulmonary vascularity and airway disease than parenchymal deconstruction in the early stage of COPD.

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Quantitative Thin-Section CT Analysis of the Enlargement and Coalescence of Low-Attenuation Clusters in Patients with Emphysema

Cited by 12 publications

References 26 publications

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

The Heresy of One Age Becomes the Orthodoxy of the Next: What Is New about Detecting Emphysema?

Longitudinal changes in structural abnormalities using MDCT in chronic obstructive pulmonary disease

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