Comparison of computed density and microscopic morphometry in pulmonary emphysema.

Gevenois, Pierre-Alain; Vuyst, P De; Maertelaer, Viviane De; Zanen, J; Jacobovitz, D; Cosio, Manuel G.; Yernault, J C

doi:10.1164/ajrccm.154.1.8680679

Cited by 492 publications

(451 citation statements)

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“…(7)(8)(9)(10)(11)(12)(13)(14)(15) The method has been recommended for use in longitudinal studies of emphysema and is currently considered to be better than functional tests for disease assessment. (6,16) In addition, previous studies have reported that the correlation between CT densitometry and macroscopic morphometry is higher than is that between macroscopic morphometry and subjective visual grading of emphysema.…”

Section: Discussionmentioning

confidence: 99%

“…In order to select a reference value for comparing the EI values in a given patient, we should take into consideration the radiation dose, (18,19) the slice thickness, (18) the reconstruction algorithm, (20) the type of scanner, (21) the HU range selected for lung segmentation (usually −1,024 HU to −400 HU or −1,024 HU to −250 HU), (19,22) and the HU threshold selected in order to distinguish between normal and emphysematous lung (usually −970 HU, −950 HU, or −910 HU). (11)(12)(13)22) Various HU thresholds have been proposed in order to distinguish between normal and abnormal lungs. (10)(11)(12)(13) The initial suggestion was a threshold of −910 HU for axial scanners, with thicker collimation (i.e., 10 mm), and for examinations performed with the administration of intravenous contrast medium.…”

Section: Discussionmentioning

confidence: 99%

“…(11)(12)(13)22) Various HU thresholds have been proposed in order to distinguish between normal and abnormal lungs. (10)(11)(12)(13) The initial suggestion was a threshold of −910 HU for axial scanners, with thicker collimation (i.e., 10 mm), and for examinations performed with the administration of intravenous contrast medium. (10) For thin-slice collimation (1 mm), Gevenois et al reported good correlations with pathology specimens when the threshold was set at −950 HU.…”

Section: Discussionmentioning

confidence: 99%

“…Various thresholds have been suggested to differentiate between normal and abnormal lungs. (11)(12)(13) Based on the acquisition parameters used, we selected a threshold of −950 HU. (11,12) The EI was then calculated by dividing the TLV by the lung volume with densities below −950 HU.…”

Section: Methodsmentioning

confidence: 99%

“…(6) Additionally, HRCT and helical CT can detect and quantify pulmonary emphysema, HRCT and helical CT findings correlating well with histopathological findings. (7)(8)(9)(10)(11)(12)(13)(14) Finally, modern CT scanners with multiple rows of detectorsmultidetector CT (MDCT)-allow the acquisition of thin (< 1-mm) slices of the whole chest in a few seconds, improving spatial resolution and avoiding respiratory artifacts.…”

Section: Introductionmentioning

confidence: 99%

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Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

et al. 2012

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Objective: To investigate the effects of age on pulmonary emphysema, based on the values of the emphysema index (EI) in a cohort of patients who had never smoked and who had no recognizable lung disease. Methods: We reviewed the CT scans, reported as normal, of 315 patients. Exclusion criteria were a history of smoking, cardiorespiratory disease, and exposure to drugs that could cause lung disease. From this cohort, we selected 32 patients (16 men and 16 women), matched for gender and body mass index, who were divided equally into two groups by age (< 50 years and ≥ 50 years). We quantified emphysema using a computer program specific to that task. The EI was calculated with a threshold of −950 HU. We also evaluated total lung volume (TLV) and mean lung density (MLD). Results: The overall means for TLV, MLD, and EI were 5,027 mL, −827 HU, and 2.54%, respectively. Mean values in the older and younger groups, respectively, were as follows: for TLV, 5,229 mL vs. 4,824 mL (p > 0.05); for MLD, −846 HU vs. −813 HU (p < 0.04); and for EI, 3.30% vs. 1.28% (p < 0.001). Significant correlations were found between EI and age (r = 0.66; p = 0.001), EI and TLV (r = 0.58; p = 0.001), and EI and MLD (r = −0.67; p < 0.001). The predicted EI per age was defined by the regression equation (r 2 = 0.43): p50(EI) = 0.049 × age − 0.5353. Conclusions: It is important to consider the influence of age when quantifying emphysema in patients over 50 years of age. Based on the regression analysis, EI values of 2.6%, 3.5%, and 4.5% can be considered normal for patients 30, 50, and 70 years of age, respectively. Keywords: Pulmonary emphysema; Tomography, spiral computed; Aging; Pulmonary disease, chronic obstructive. ResumoObjetivo: Investigar os efeitos da idade no enfisema pulmonar, com base nos valores do índice de enfisema (IE) em uma coorte de pacientes que nunca fumou e que não possuía doença pulmonar conhecida. Métodos: Foram revisados exames de TC, considerados normais, de 315 pacientes. Tabagismo, doenças cardiorrespiratórias e exposição a drogas que poderiam causar doença pulmonar foram critérios de exclusão. Dessa coorte, selecionamos 32 pacientes (16 homens e 16 mulheres), igualmente divididos em dois grupos (idade < 50 anos e idade ≥ 50 anos), que foram pareados por gênero e índice de massa corpórea. Realizou-se a quantificação do enfisema utilizando um programa específico. O IE foi calculado com um limiar de −950 UH. O volume pulmonar total (VPT) e a densidade pulmonar média (DPM) também foram avaliados. Resultados: As médias gerais de VPT, DPM e IE foram 5.027 mL, −827 UH e 2,54%, respectivamente. A comparação entre os mais velhos e os mais novos mostrou as seguintes médias: VPT (5.229 mL vs. 4.824 mL; p > 0,05); DPM (−846 UH vs. −813 UH; p < 0,04) e IE (3,30% vs. 1,28%; p < 0,001). Houve correlações significativas entre IE e idade (r = 0,66; p = 0,001), IE e VPT (r = 0,58; p = 0,001) e IE e DPM (r = −0,67; p < 0,001). O IE previsto por idade foi definido através da equação de regressão (r 2 = 0,43): p50(IE) = 0,049 × i...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

et al. 2012

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Identification of Chronic Obstructive Pulmonary Disease in Lung Cancer Screening Computed Tomographic Scans

Mets¹,

Buckens²,

Zanen³

et al. 2011

JAMA

126

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Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function

Wang

Pistenmaa

Madrigano

et al. 2019

JAMA

252

123

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IMPORTANCE While air pollutants at historical levels have been associated with cardiovascular and respiratory diseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema. OBJECTIVE To assess the longitudinal association of ambient ozone (O 3), fine particulate matter (PM 2.5), oxides of nitrogen (NO x), and black carbon exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018. EXPOSURES Residence-specific air pollutant concentrations (O 3 , PM 2.5 , NO x , and black carbon) were estimated by validated spatiotemporal models incorporating cohort-specific monitoring, determined from 1999 through the end of follow-up. MAIN OUTCOMES AND MEASURES Percent emphysema, defined as the percent of lung pixels less than −950 Hounsfield units, was assessed up to 5 times per participant via cardiac CT scan (2000-2007) and equivalent regions on lung CT scans (2010-2018). Spirometry was performed up to 3 times per participant (2004-2018). RESULTS Among 7071 study participants (mean [range] age at recruitment, 60 [45-84] years; 3330 [47.1%] were men), 5780 were assigned outdoor residential air pollution concentrations in the year of their baseline examination and during the follow-up period and had at least 1 follow-up CT scan, and 2772 had at least 1 follow-up spirometric assessment, over a median of 10 years. Median percent emphysema was 3% at baseline and increased a mean of 0.58 percentage points per 10 years. Mean ambient concentrations of PM 2.5 and NO x , but not O 3 , decreased substantially during follow-up. Ambient concentrations of O 3 , PM 2.5 , NO x , and black carbon at study baseline were significantly associated with greater increases in percent emphysema per 10 years (O 3 : 0.13 per 3 parts per billion [95% CI, 0.03-0.24]; PM 2.5 : 0.11 per 2 μg/m 3 [95% CI, 0.03-0.19]; NO x : 0.06 per 10 parts per billion [95% CI, 0.01-0.12]; black carbon: 0.10 per 0.2 μg/m 3 [95% CI, 0.01-0.18]). Ambient O 3 and NO x concentrations, but not PM 2.5 concentrations, during follow-up were also significantly associated with greater increases in percent emphysema. Ambient O 3 concentrations, but not other pollutants, at baseline and during follow-up were significantly associated with a greater decline in forced expiratory volume in 1 second per 10 years (baseline: 13.41 mL per 3 parts per billion [95% CI, 0.7-26.1]; follow-up: 18.15 mL per 3 parts per billion [95% CI, 1.59-34.71]). CONCLUSIONS AND RELEVANCE In this cohort study conducted between 2000 and 2018 in 6 US metropolitan regions, long-term exposure to...

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Comparison of computed density and microscopic morphometry in pulmonary emphysema.

Cited by 492 publications

References 12 publications

Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

Índice de enfisema pulmonar em coorte de pacientes sem doença pulmonar conhecida: influência da idade

Identification of Chronic Obstructive Pulmonary Disease in Lung Cancer Screening Computed Tomographic Scans

Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function

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