Quantitative assessment of emphysema and bronchial wall thickness in patients with stable chronic obstructive pulmonary disease: comparison between the eosinophilic and non-eosinophilic phenotypes

Abstract

Objective: To perform a quantitative assessment of bronchial wall thickening and the emphysema score in patients with stable chronic obstructive pulmonary disease (COPD), comparing the eosinophilic and non-eosinophilic COPD phenotypes. Materials and Methods: This was a retrospective observational study of patients with COPD followed between August 2018 and July 2019. The patients were divided into two groups by the eosinophil count in peripheral blood: eosinophilic (≥ 300 cells/µL); and non-eosinophilic (< 300 cells/µL). Quantitative, automated assessments of emphysema and bronchial wall thickness were performed by evaluating computed tomography scans of the chest. Results: We evaluated the records of 110 patients diagnosed with COPD: 28 (25.5%) in the eosinophilic group; and 82 (74.5%) in the non-eosinophilic group. The demographic, clinical, functional, and therapeutic variables were comparable between the two groups. There were no significant differences between the two groups in terms of the emphysema score or bronchial wall thickness (p > 0.05 for both). Conclusion: Patients with eosinophilic COPD do not appear to have lower emphysema scores or greater bronchial wall thickening than do those with non-eosinophilic phenotypes of the disease.

O papel da imagem quantitativa na avaliação da doença pulmonar obstrutiva crônica

“…No número anterior da Radiologia Brasileira contamos com um artigo que avaliou quantitativamente as alterações brônquicas e a presença de enfisema numa subpopulação específica de DPOC com aumento da contagem de eosinófilos no sangue periférico (10) . A DPOC com perfil eosinofílico é um tema atual da especialidade, que levou a mudanças de tratamento dessa subpopulação.…”

The role of quantitative imaging in chronic obstructive pulmonary disease

“…In the previous issue of Radiologia Brasileira, there was an article in which the authors performed a quantitative evaluation of bronchial alterations and the presence of emphysema in a specific subpopulation of COPD patients with elevated eosinophil counts in peripheral blood ( 10 ) . Eosinophilic COPD is a current topic in radiology, and discussion of the topic has led to changes in the treatment of this subpopulation.…”