Spirometrically Gated High-Resolution CT Findings in COPD

Camiciottoli, Gianna; Bartolucci, Maurizio; Maluccio, Nazzarena M.; Moroni, Chiara; Mascalchi, Mario; Giuntini, C.; Pistolesi, M

doi:10.1378/chest.129.3.558

Cited by 85 publications

(34 citation statements)

References 26 publications

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“…Some authors have reported that CT measurements in expiration are more closely correlated with airflow obstruction than in inspiration [14, 39–41]. Our results indicate that CT measurements in expiration rather than in inspiration were more correlated with FEV 1 %pred, not with FEV 1 /FVC.…”

Section: Discussionmentioning

confidence: 40%

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

et al. 2012

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ObjectivesTo determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD).MethodsPubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify articles that correlated CT measurements to airflow obstruction parameters of the pulmonary function test in COPD patients, rated study quality and extracted information. Three CT measurements were accessed: lung attenuation area percentage < -950 Hounsfield units, mean lung density and airway wall area percentage. Two airflow obstruction parameters were accessed: forced expiratory volume in the first second as percentage from predicted (FEV1 %pred) and FEV1 divided by the forced volume vital capacity.ResultsSeventy-nine articles (9,559 participants) were included in the systematic review, demonstrating different methodologies, measurements and CT airflow obstruction correlations. There were 15 high-quality articles (2,095 participants) in the meta-analysis. The absolute pooled correlation coefficients ranged from 0.48 (95 % CI, 0.40 to 0.54) to 0.65 (0.58 to 0.71) for inspiratory CT and 0.64 (0.53 to 0.72) to 0.73 (0.63 to 0.80) for expiratory CT.ConclusionsCT measurements of emphysema or peripheral airways are significantly related to airflow obstruction in COPD patients. CT provides a morphological method to investigate airway obstruction in COPD.Key Points• Computed tomography is widely performed in patients with chronic obstructive pulmonary disease (COPD)• CT provides quantitative morphological methods to investigate airflow obstruction in COPD• CT measurements correlate significantly with the degree of airflow obstruction in COPD• Expiratory CT measurements correlate more strongly with airflow obstruction than inspiratory CT• Low-dose CT decreases the radiation dose for diagnosis and quantitative emphysema evaluationElectronic supplementary materialThe online version of this article (doi:10.1007/s00330-012-2480-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 40%

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

et al. 2012

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“…With dedicated post-processing software, rapid and reproducible estimates of tissue and air volume, mean lung density, percent emphysema, and airway anatomy are now available 24,25. Standardized computer-generated HRCT instructions have improved reproducibility and accuracy 26,27…”

Section: Discussionmentioning

confidence: 99%

Total lung capacity by plethysmography and high-resolution computed tomography in COPD

Garfield

Marchetti²,

Gaughan³

et al. 2012

COPD

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AimTo characterize and compare total lung capacity (TLC) measured by plethysmography with high-resolution computed tomography (HRCT), and to identify variables that predict the difference between the two modalities.MethodsFifty-nine consecutive patients referred for the evaluation of COPD were retrospectively reviewed. Patients underwent full pulmonary function testing and HRCT within 3 months. TLC was obtained by plethysmography as per American Thoracic Society/European Respiratory Society standards and by HRCT using custom software on 0.75 and 5 mm thick contiguous slices performed at full inspiration (TLC).ResultsTLC measured by plethysmography correlated with TLC measured by inspiratory HRCT (r = 0.92, P < 0.01). TLC measured by plethysmography was larger than that determined by inspiratory HRCT in most patients (mean of 6.46 ± 1.28 L and 5.34 ± 1.20 L respectively, P < 0.05). TLC measured by both plethysmography and HRCT correlated significantly with indices of airflow obstruction (forced expiratory volume in 1 second/forced vital capacity [FVC] and FVC%), static lung volumes (residual volume, percent predicted [RV%], total lung capacity, percent predicted [TLC%], functional residual capacity, percent predicted [FRC%], and inspiratory capacity, percent predicted), and percent emphysema. TLC by plethysmography and HRCT both demonstrated significant inverse correlations with diffusion impairment. The absolute difference between TLC measured by plethysmography and HRCT increased as RV%, TLC%, and FRC% increased. Gas trapping (RV% and FRC%) independently predicted the difference in TLC between plethysmography and HRCT.ConclusionIn COPD, TLC by plethysmography can be up to 2 L greater than inspiratory HRCT. Gas trapping independently predicts patients for whom TLC by plethysmography differs significantly from HRCT.

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“…The correlations between dyspnea and imaging parameters in COPD patients were presented in several studies,20,24 as well as the association of dyspnea and CAT scores 9,27. Our study showed that both CT measurements and CAT scores were positively correlated with mMRC grades.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated that −950 Hounsfield units (HU) in the inspiratory phase is a suitable threshold for the measurements of retention volume in emphysema,15,16 and the ratio of airway wall thickness to total diameter (WT/D) and wall area percentage (%WA) from CT scans can represent the airway dimensions in COPD patients 17,18. Moreover, researchers have conducted a series of studies on the relationships between disease-specific parameters and quantitative CT measurements 18–20. As far as we know, little is known about the relationships between CAT scores and quantitative CT measurements of emphysema and airway wall thickness in COPD patients in the People’s Republic of China.…”

Section: Introductionmentioning

confidence: 99%

The COPD assessment test correlates well with the computed tomography measurements in COPD patients in China

Zhang

2015

COPD

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BackgroundThe chronic obstructive pulmonary disease (COPD) assessment test (CAT) is a validated simple instrument to assess health status, and it correlates well with the severity of airway obstruction in COPD patients. However, little is known about the relationships between CAT scores and quantitative computed tomography (CT) measurements of emphysema and airway wall thickness in COPD patients in the People’s Republic of China.MethodsOne hundred and twelve participants including 63 COPD patients and 49 normal control subjects were recruited. All participants were examined with high-resolution CT to get the measurements of emphysema (percentage of pixels below −950 HU [%LAA–950]) and airway wall thickness (wall area percentage and the ratio of airway wall thickness to total diameter). Meanwhile, they completed the CAT and modified Medical Research Council questionnaire independently.ResultsSignificantly higher CAT scores and CT measurements were found in COPD patients compared with normal control subjects (P<0.05), and there was a tendency of higher CAT scores and CT measurements with increasing disease severity measured by GOLD staging system. Positive correlations were found between CAT scores and CT measurements (P<0.01). Using multiple linear stepwise regression, CAT score =−46.38+0.778× (wall area percentage) +0.203× (%LAA–950) (P<0.001). Meanwhile, CAT scores and CT measurements in COPD patients all positively correlated with the modified Medical Research Council grades and negatively correlated with FEV1% (P<0.01).ConclusionCAT scores correlate well with the quantitative CT measurements in COPD patients, which may provide an imaging evidence that the structural changes of the lungs in this disease are associated with the health status measured by CAT.

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Spirometrically Gated High-Resolution CT Findings in COPD

Cited by 85 publications

References 26 publications

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Total lung capacity by plethysmography and high-resolution computed tomography in COPD

The COPD assessment test correlates well with the computed tomography measurements in COPD patients in China

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Spirometrically Gated High-Resolution CT Findings in COPD

Cited by 85 publications

References 26 publications

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Total lung capacity by plethysmography and high-resolution computed tomography in COPD

The COPD assessment test correlates well with&nbsp;the computed tomography measurements in&nbsp;COPD patients in China

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The COPD assessment test correlates well with the computed tomography measurements in COPD patients in China