Airway-Artery Ratios of Central and Peripheral Airways Quantified on CT as Independent Predictors of Airflow Obstruction in COPD

Lv, Qianting; Estrella, L. Gallardo; Latisenko, R.; Andrinopoulou, E.-R.; Lynch, David A.; Tiddens, Harm A.W.M.; Charbonnier, J.-P.

doi:10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a4573

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“…This could explain why there is a large disparity in prevalence and extent of bronchiectasis and airway wall thickening between the automated and manual method. Preliminary analysis of a large cohort of chest CT's from patients that underwent CT for a non-pulmonary indication (''Normal Chest CT study Group'') with the automatic airway-artery analysis show that the current cut-off values may well match the upper limit of normal in this ''Normal Chest CT study Group'' (data on file) [37].…”

Section: Limitationsmentioning

confidence: 99%

Children with severe asthma have substantial structural airway changes on computed tomography

van den Bosch,

Lv,

Andrinopoulou

et al. 2023

ERJ Open Res

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BackgroundIn adults with severe asthma(SA) airway wall thickening, bronchiectasis and low attenuation regions(LAR) have been described on chest computed tomography(CT) scans. The extent to which these structural abnormalities are present in children with SA is largely unknown.AimTo study the presence and extent of airway abnormalities on chest CT of children with SA.Methods161 in-and expiratory CT scans, either spirometer-controlled or technician-controlled, obtained in 131 children with SA (mean age 11.0±3.8 years) were collected retrospectively. Inspiratory scans were analysed manually using a semi-quantitative score and automatically using LungQ (v2.1.0.1, Thirona B.V., The Netherlands). LungQ segments the airway tree, identifies the generation for each airway-artery (AA)-pair, and measures the following AA-dimensions: outer airway wall diameter(Aout), adjacent artery diameter(A) and airway wall thickness(Awt). Bronchiectasis was defined as Aout/A ≥1.1, airway wall thickening as Awt/A ≥0.14. LAR, reflecting small airways disease(SAD) was measured automatically on in- and expiratory scans and manually on expiratory scans. Functional SAD was defined as FEF25–75and/or FEF75z-scores<-1.645. Results are shown as median and interquartile range.ResultsBronchiectasis was present on 95.8% and airway wall thickening on all CT's using the automated method. Bronchiectasis was present on 28% and airway wall thickening on 88.8% of the CT's using the manual semi-quantitative analysis. The percentage of AA-pairs defined as bronchiectasis was 24.62% (12.7–39.3%) and airway wall thickening was 41.7% (24.0–79.8%) per CT using the automated method. LAR was observed on all CT's using the automatic analysis and on 82.9% using the manual semi-quantitative analysis. Patients with LAR or functional SAD had more thickened airways than patients without.ConclusionDespite a large discrepancy between the automated and the manual semi-quantitative analysis, bronchiectasis and airway wall thickening are present on most CT scans of children with SA. SAD is related to airway wall thickening.

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Section: Limitationsmentioning

confidence: 99%