Clinical Utility of Computed Tomographic Lung Volumes in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background: Published data concerning the utility of computed tomography (CT)-based lung volumes are limited to correlation with lung function. Objectives: The aim of this study was to evaluate the clinical utility of the CT expiratory-to-inspiratory lung volume ratio (CT V_ratio) by assessing the relationship with clinically relevant outcomes. Methods: A total of 75 stable chronic obstructive pulmonary disease (COPD) patients having pulmonary function testing and volumetric CT at full inspiration and expiration were retrospectively evaluated. Inspiratory and expiratory CT lung volumes were measured using in-house software. Correlation of the CT V_ratio with patient-centered outcomes, including the modified Medical Research Council (MMRC) dyspnea score, the 6-min walk distance (6MWD), the St. George's Respiratory Questionnaire (SGRQ) score, and multidimensional COPD severity indices, such as the BMI, airflow obstruction, dyspnea, and exercise capacity index (BODE) and age, dyspnea, and airflow obstruction (ADO), were analyzed. Results: The CT V_ratio correlated significantly with BMI (r = −0.528, p < 0.001). The CT V_ratio was also significantly associated with MMRC dyspnea (r = 0.387, p = 0.001), 6MWD (r = −0.459, p < 0.001), and SGRQ (r = 0.369, p = 0.001) scores. Finally, the CT V_ratio had significant correlations with the BODE and ADO multidimensional COPD severity indices (r = 0.605, p < 0.001; r = 0.411, p < 0.001). Conclusion: The CT V_ratio had significant correlations with patient-centered outcomes and multidimensional COPD severity indices.

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

“…In recent years, it has been recognized that a small airway, which is typically defined as that which has an internal diameter of less than 2 mm, may represent a potential focus for treating COPD and asthma [7,8] . Specifically, CT can provide valuable information about these areas in such a way that PFTs, including lung volume (LV), mean lung density (MLD), emphysema index (EI) -910 (%), EI -950 (%), EI -850/-950 (%), and other parameters in both inspiratory and expiratory phases [9][10][11][12] , cannot. We postulate that CT can be explored to find the parameters that can differentiate between COPD and asthma [11,[13][14][15][16] .…”

Uncertainty analysis of chest X-ray lung height measurements and size matching for lung transplantation

“…Quantitative computed tomography could overcome this limitation. However, in clinical practice it will likely be subject to errors in measurement similar to those observed in our study (29).…”

Implications of the pulmonary artery to ascending aortic ratio in patients with relatively mild chronic obstructive pulmonary disease

“…CT is an important tool to evaluate different characteristics and clinical outcomes in patients with COPD (19,20). Relative pulmonary arterial enlargement, as measured by CT (PA-A ratio), provides independent predictive information about patient outcome.…”