3D-CT Lung Volumetry Using Multidetector Row Computed Tomography

Matsuo, Keiji; Iwano, Shingo; Koike, Wataru; Naganawa, Shinji

doi:10.1097/rti.0b013e31822641c9

Cited by 24 publications

(25 citation statements)

References 27 publications

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“…7,8 These measures are commonly reported in clinical investigation and have been shown to correlate with spirometric and clinical measures of disease. [9][10][11][12] Little attention has been paid, however, to using chest CT scans to determine the normal range of lobe volumes at full infl ation and relaxed exhalation. Once such models have been developed, investigators could then determine the absolute amount of lobe-specifi c hyperinfl ation present on the inspiratory scan (ie, how much lobe volume exceeds predicted at full infl ation) and the lobe-specifi c volume of gas trapped on an expiratory CT image.…”

Section: Discussionmentioning

confidence: 99%

Characterizing Functional Lung Heterogeneity in COPD Using Reference Equations for CT Scan-Measured Lobar Volumes

Come

Díaz

Curran‐Everett

et al. 2013

Chest

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OPD is characterized by emphysematous destruction of the lung parenchyma and remodeling of the distal small airways. [1][2][3] Emphysema is associated with hyperinfl ation, and the combination of emphysema and airway disease leads to gas trapping on exhalation. The degree to which these abnormalities exist for the whole lung can be easily assessed by either plethysmographic-or helium dilution-based measures of lung volume and regression models for predicted values derived from populations of healthy nonsmokers. 4 However, given that the abnormalities associated with COPD pathology are not homogeneous, measures capable of assessing regional lung volumes and dysfunction rather than providing "averages" over the entire lung may provide useful information for developing and monitoring targeted therapy.CT scanning is increasingly used for clinical, epidemiologic, and genetic investigations of COPD. 5,6 Using readily available tools, investigators can now report regional and lobe-specifi c measures of emphysema Background: CT scanning is increasingly used to characterize COPD. Although it is possible to obtain CT scan-measured lung lobe volumes, normal ranges remain unknown. Using COPDGene data, we developed reference equations for lobar volumes at maximal infl ation (total lung capacity [TLC]) and relaxed exhalation (approximating functional residual capacity [FRC]). Methods: Linear regression was used to develop race-specifi c (non-Hispanic white [NHW], African American) reference equations for lobar volumes. Covariates included height and sex. Models were developed in a derivation cohort of 469 subjects with normal pulmonary function and validated in 546 similar subjects. These cohorts were combined to produce fi nal prediction equations, which were applied to 2,191 subjects with old GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage II to IV COPD. Results: In the derivation cohort, women had smaller lobar volumes than men. Height positively correlated with lobar volumes. Adjusting for height, NHWs had larger total lung and lobar volumes at TLC than African Americans; at FRC, NHWs only had larger lower lobes. Age and weight had no effect on lobar volumes at TLC but had small effects at FRC. In subjects with COPD at TLC, upper lobes exceeded 100% of predicted values in GOLD II disease; lower lobes were only infl ated to this degree in subjects with GOLD IV disease. At FRC, gas trapping was severe irrespective of disease severity and appeared uniform across the lobes. Conclusions: Reference equations for lobar volumes may be useful in assessing regional lung dysfunction and how it changes in response to pharmacologic therapies and surgical or endoscopic lung volume reduction.CHEST 2013; 143(6):1607-1617Abbreviations: AA 5 African American; FRC 5 functional residual capacity; GOLD 5 Global Initiative for Chronic Obstructive Lung Disease; HU 5 Hounsfi eld Units; LLL 5 left lower lobe; LUL 5 left upper lobe; NHW 5 non-Hispanic white; %LAA-856 5 % of total lung volume falling below an attenuation thresho...

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Section: Discussionmentioning

confidence: 99%

Characterizing Functional Lung Heterogeneity in COPD Using Reference Equations for CT Scan-Measured Lobar Volumes

Come

Díaz

Curran‐Everett

et al. 2013

Chest

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“…We chose a threshold of −950 HU as proposed in previous studies 20–22. Furthermore, we used the software for semiautomatic segmentation of the lung into the lung lobes (left upper lobe, left lower lobe, right upper lobe, right middle lobe, and right lower lobe) as described in the literature 19,23. See also example in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Comparison of distinctive models for calculating an interlobar emphysema heterogeneity index in patients prior to endoscopic lung volume reduction

Theilig

Doellinger

Poellinger

et al. 2017

COPD

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BackgroundThe degree of interlobar emphysema heterogeneity is thought to play an important role in the outcome of endoscopic lung volume reduction (ELVR) therapy of patients with advanced COPD. There are multiple ways one could possibly define interlobar emphysema heterogeneity, and there is no standardized definition.PurposeThe aim of this study was to derive a formula for calculating an interlobar emphysema heterogeneity index (HI) when evaluating a patient for ELVR. Furthermore, an attempt was made to identify a threshold for relevant interlobar emphysema heterogeneity with regard to ELVR.Patients and methodsWe retrospectively analyzed 50 patients who had undergone technically successful ELVR with placement of one-way valves at our institution and had received lung function tests and computed tomography scans before and after treatment. Predictive accuracy of the different methods for HI calculation was assessed with receiver-operating characteristic curve analysis, assuming a minimum difference in forced expiratory volume in 1 second of 100 mL to indicate a clinically important change.ResultsThe HI defined as emphysema score of the targeted lobe (TL) minus emphysema score of the ipsilateral nontargeted lobe disregarding the middle lobe yielded the best predicative accuracy (AUC =0.73, P=0.008). The HI defined as emphysema score of the TL minus emphysema score of the lung without the TL showed a similarly good predictive accuracy (AUC =0.72, P=0.009). Subgroup analysis suggests that the impact of interlobar emphysema heterogeneity is of greater importance in patients with upper lobe predominant emphysema than in patients with lower lobe predominant emphysema.ConclusionThis study reveals the most appropriate ways of calculating an interlobar emphysema heterogeneity with regard to ELVR.

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“…Retrospective studies of the VENT results indicated that post-procedure lung function improvement did not differ significantly when an upper or lower lobe was treated (42,43). However, recent studies have found that each lobe plays a different role in lung functioning, with the lower lobe of the lung having more of an impact on FEV 1 than the upper lobe (44,45). Therefore, EBV implantation in the lower lobe may have more of a benefit, but this contention needs to be verified.…”

Section: Other Predictorsmentioning

confidence: 99%

Status of and prospects for bronchoscopic lung volume reduction for patients with severe emphysema

Wang

et al. 2016

BST

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3D-CT Lung Volumetry Using Multidetector Row Computed Tomography

Abstract: Pulmonary function results, particularly DLCO, were primarily affected by the NLVs of the lower lobes.

Cited by 24 publications

References 27 publications

Characterizing Functional Lung Heterogeneity in COPD Using Reference Equations for CT Scan-Measured Lobar Volumes

Characterizing Functional Lung Heterogeneity in COPD Using Reference Equations for CT Scan-Measured Lobar Volumes

Comparison of distinctive models for calculating an interlobar emphysema heterogeneity index in patients prior to endoscopic lung volume reduction

Status of and prospects for bronchoscopic lung volume reduction for patients with severe emphysema

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