Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

Kim, Song Soo; Seo, Joon Beom; Lee, Ho Yun; Nevrekar, Dipti; Forssén, Anna; Crapo, James D.; Schroeder, Joyce; Lynch, David A.

doi:10.1148/radiol.12120385

Cited by 76 publications

(80 citation statements)

References 59 publications

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“…Visual assessment of severity of emphysema and airway wall thickening correlates quite well with physiologic impairment. 15 However, observer agreement with regard to severity of emphysema on visual assessment has been quite variable and quantitative CT is preferred for assessing disease severity. 16 Bronchial wall thickening is commonly identified in heavy cigarette smokers, and is often a sign of chronic bronchitis.…”

Section: Ct: Visual Evaluationmentioning

confidence: 99%

Progress in Imaging COPD, 2004 - 2014

Lynch¹

2014

J COPD F

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Abbreviations: computed tomography, CT; magnetic resonance imaging, MRI; positron emission tomography, PET; Global Initiative for chronic Obstructive Lung Disease, GOLD; quantitative CT, QCT; Hounsfield Units, HU; percentage of low attenuation area, %LAA; relative area of lung less than -950 HU, RA950; Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints, ECLIPSE; forced expiratory volume in 1 second, FEV1; forced vital capacity, FVC. Journal of the COPD Foundation(GOLD) stage may have substantial, little, or no emphysema. Discrete subphenotypes of COPD include emphysema of varying morphologic appearance, large airway abnormality and small airway obstruction. Increasing awareness of the heterogeneity of COPD has led to increased use of CT to characterize COPD for purposes of genetic evaluation and identification of specific subgroups which may be amenable to therapeutic trials. 1-3 While visual assessment is important in determining the presence and character of emphysema, the last decade has been characterized by increasing use of quantitative imaging to provide precise estimates of the severity and distribution of emphysema, gas trapping and airway wall thickening. Several large cohorts of cigarette smokers have now been quite extensively characterized by CT, resulting in increased knowledge of the clinical correlates of quantitative CT parameters. [4][5][6] The purpose of this paper is to present the substantial contribution that imaging has made to our understanding of COPD over the past 10 years. AbstractComputed tomography (CT) has contributed substantially to our understanding of COPD over the past decade. Visual and quantitative assessments of CT in COPD are complementary. Visual assessment should provide assessment of centrilobular, panlobular and paraseptal emphysema, airway wall thickening, bronchiectasis, findings of respiratory bronchiolitis, and enlargement of the pulmonary artery. Quantitative CT permits evaluation of severity of emphysema, airway wall thickening, and expiratory air trapping, and is now being used for longitudinal evaluation of the progression of COPD. Innovative techniques are being developed to use CT to characterize the pattern of emphysema and smoking-related respiratory bronchiolitis. Magnetic resonance imaging (MRI) and positron emission tomography PET-CT are useful research tools in the evaluation of COPD.

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Section: Ct: Visual Evaluationmentioning

confidence: 99%

Progress in Imaging COPD, 2004 - 2014

Lynch¹

2014

J COPD F

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“…After reviewing the abstracts and full texts, 12 manuscripts about bronchiectasis in patients with COPD were found. 1,4,6,[11][12][13][14][15][16][17]21,22 Of those, six studies met the inclusion criteria, which included patients with COPD and comorbid bronchiectasis (n=550) and patients with COPD and without comorbid bronchiectasis (n=331). 1,4,7,[11][12][13] The flow diagram of the database search is represented in Figure 1.…”

Section: Search Resultsmentioning

confidence: 99%

“…3,10 However, in previous studies, controversial results on clinical outcomes, such as lung function and exacerbations, have been reported with relatively small patient populations (44-118 patients). 1,4,7,9,10,[11][12][13][14][15][16][17] Hence, the present meta-analysis was aimed at summarizing the reports on the comorbidity of bronchiectasis and COPD and further clarifying the impact of bronchiectasis on patients with COPD.…”

Section: Ni Et Almentioning

confidence: 99%

Clinical Characteristics of Patients With Chronic Obstructive Pulmonary Disease With Comorbid Bronchiectasis: A Systemic Review and Meta-analysis

Shi

2016

Chest

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Background: In the 2014 Global initiative for chronic Obstructive Lung Disease guidelines, bronchiectasis was for the first time defined as a comorbidity of chronic obstructive pulmonary disease (COPD), and this change has been retained in the 2015 update, which emphasizes the influence of bronchiectasis in the natural history of COPD. The present meta-analysis was aimed at summarizing the impact of bronchiectasis on patients with COPD. Methods: Databases including Embase, PubMed, and the Cochrane Central Register of Controlled Trials were searched comprehensively to identify all relevant human clinical studies published until August 2014. Bronchiectasis was confirmed either by computed tomography or high-resolution computed tomography. One or more clinicopathological or demographical characteristics, including age, sex, smoking history, daily sputum production, exacerbations, inflammatory biomarkers, lung function, and colonization by potentially pathogenic microorganisms (PPMs), were compared between COPD patients with and without bronchiectasis. Results: Six observational studies with 881 patients were included in the meta-analysis. The mean prevalence of bronchiectasis in patients with COPD was 54.3%, ranging from 25.6% to 69%. Coexistence of bronchiectasis and COPD occurred more often in male patients with longer smoking history. Patients with COPD and comorbid bronchiectasis had greater daily sputum production, more frequent exacerbation, poorer lung function, higher level of inflammatory biomarkers, more chronic colonization by PPMs, and higher rate of Pseudomonas aeruginosa isolation. Conclusion: In spite of the heterogeneity between included studies and detectable publication bias, this meta-analysis demonstrated the impact of bronchiectasis in patients with COPD in all directions, indicating that coexistence of bronchiectasis should be considered a pathological phenotype of COPD, which may have a predictive value.

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“…12 Two radiologists performed visual assessment: reader 1 and reader 2 were chest radiologists with 8 years and 10 years of experience, respectively. The readers were blind to any clinical and functional information.…”

Section: Methodsmentioning

confidence: 99%

“…Bronchial wall thickening was visually defined by a ratio of the inner to outer lumen of less than 0.8. 12 Bronchiectasis was considered present when the diameter of the inner bronchial lumen was greater than the diameter of the accompanying pulmonary artery, or when a bronchus was visible within 1 cm of the pleural surface. Centrilobular nodules were defined if more than 50% of a segment was affected.…”

Section: Methodsmentioning

confidence: 99%

Visual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in the COPDGene® Study

et al. 2014

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Within the COPD Genetic Epidemiology (COPDGene®) study population of cigarette smokers, 9% were found to be unclassifiable by the Global Initiative for chronic Obstructive Lung Disease (GOLD) criteria. This study was to identify the differences in computed tomography (CT) findings between this nonobstructed (GOLDU) group and a control group of smokers with normal lung function. This research was approved by the institutional review board of each institution. CT images of 400 participants in the COPDGene® study (200 GOLDU, 200 smokers with normal lung function) were retrospectively evaluated in a blinded fashion. Visual CT assessment included lobar analysis of emphysema (type, extent), presence of paraseptal emphysema, airway wall thickening, expiratory air trapping, centrilobular nodules, atelectasis, non-fibrotic and fibrotic interstitial lung disease (ILD), pleural thickening, diaphragmatic eventration, vertebral body changes and internal thoracic diameters (in mm). Univariate comparisons of groups for each CT parameter and multiple logistic regression were performed to determine the imaging features associated with GOLDU. When compared with the control group, GOLDU participants had a significantly higher prevalence of unilateral diaphragm eventration (30% vs. 16%), airway wall thickening, centrilobular nodules, reticular abnormality, paraseptal emphysema (33% vs. 17%), linear atelectasis (60% vs. 35.6%), kyphosis (12% vs. 4%), and a smaller internal transverse thoracic diameter (255 ± 22.5 [standard deviation] vs. 264.8 ± 22.4, mm) (all p<0.05). With multiple logistic regression, all of these CT parameters, except non-fibrotic ILD and kyphosis, remained significantly associated with GOLDU status (p<0.05). In cigarette smokers, chest wall abnormalities and parenchymal lung disease, which contribute to restrictive physiologic impairment, are associated with GOLD-nonobstructed status.

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Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

Cited by 76 publications

References 59 publications

Progress in Imaging COPD, 2004 - 2014

Progress in Imaging COPD, 2004 - 2014

Clinical Characteristics of Patients With Chronic Obstructive Pulmonary Disease With Comorbid Bronchiectasis: A Systemic Review and Meta-analysis

Visual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in the COPDGene® Study

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