Lobar Distribution of Emphysema in Computed Tomographic Densitometric Analysis

Saitoh, Takayuki R.; Koba, Hayato; Shijubo, Noriharu; Tanaka, Hiroshi; Sugaya, Fumiko

doi:10.1097/00004424-200004000-00004

Cited by 44 publications

(43 citation statements)

References 16 publications

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“…Three studies are of special interest because they quantified emphysema automatically, based on the percentage of LAAs below a specified threshold. SAITOH et al [30] reported that FEV1/ FVC showed the strongest correlation with lower lobe emphysema distribution, but that the transfer factor of the lung for carbon monoxide showed the strongest correlation with upper lobe emphysema distribution. MAIR et al [28] showed that upper zone distribution of emphysema in COPD subjects was associated with a higher total score on the St George's Respiratory Questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography-quantified emphysema distribution is associated with lung function decline

et al. 2012

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Emphysema distribution is associated with chronic obstructive pulmonary disease. It is, however, unknown whether computed tomography (CT)-quantified emphysema distribution (upper/lower lobe) is associated with lung function decline in heavy (former) smokers.587 male participants underwent lung CT and pulmonary function testing at baseline and after a median (interquartile range) follow-up of 2.9 (2.8-3.0) yrs. The lungs were automatically segmented based on anatomically defined lung lobes. Severity of emphysema was automatically quantified per anatomical lung lobe and was expressed as the 15th percentile (Hounsfield unit point below which 15% of the low-attenuation voxels are distributed (Perc15)). The CT-quantified emphysema distribution was based on principal component analysis. Linear mixed models were used to assess the association of emphysema distribution with forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), FEV1 and FVC decline.Mean¡SD age was 60.2¡5.4 yrs, mean baseline FEV1/FVC was 71.6¡9.0% and overall mean Perc15 was -908.5¡20.9 HU. Participants with upper lobe-predominant CT-quantified emphysema had a lower FEV1/FVC, FEV1 and FVC after follow-up compared with participants with lower lobe-predominant CT-quantified emphysema (p50.001), independent of the total extent of CTquantified emphysema.Heavy (former) smokers with upper lobe-predominant CT-quantified emphysema have a more rapid decrease in lung function than those with lower lobe-predominant CT-quantified emphysema.

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Section: Discussionmentioning

confidence: 99%

Computed tomography-quantified emphysema distribution is associated with lung function decline

et al. 2012

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“…Consistently, Gurney et al and Haragushi et al showed that the extent of emphysema had higher correlations with D L CO in the lower lung zone than in the upper lung zone, even though the upper lung zone was more severely affected by emphysema [68,69]. On the basis of the lobar distribution of emphysema as determined by CT, Saitoh et al reported that the airflow limitation, the residual volume, and the total lung capacity were higher in the predominantly lower-lobe emphysematous group than in the predominantly upper-lobe emphysematous group [70]. However, Nakano et al reported that the correlations between the RA 960 , and FEV1 or RV/TLC were higher in the lower lobes, but the correlation between RA 960 and D L CO was higher in the upper lobes.…”

Section: Comparison Between Ct Quantification and Pulmonary Function mentioning

confidence: 99%

CT of pulmonary emphysema - current status, challenges, and future directions

2008

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Pulmonary emphysema is characterized by irreversible destruction of lung parenchyma. Emphysema is a major contributor to chronic obstructive pulmonary disease (COPD), which by itself is a major cause of morbidity and mortality in the western world. Computed tomography (CT) is an established method for the in-vivo analysis of emphysema. This review first details the pathological basis of emphysema and shows how the subtypes of emphysema can be characterized by CT. The review then shows how CT is used to quantify emphysema, and describes the requirements and foundations for quantification to be accurate. Finally, the review discusses new challenges and their potential solution, notably focused on multi-detector-row CT, and emphasizes the open questions that future research on CT of pulmonary emphysema will have to address.

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“…Consistently, GURNEY et al [67] and HARAGUSHI et al [68] showed that the extent of emphysema had higher correlations with DL,CO in the lower lung zone than in the upper lung zone, even though the upper lung zone was more severely affected by emphysema. On the basis of the lobar distribution of emphysema as determined by CT, SAITOH et al [69] reported that the airflow limitation, the RV and the TLC were higher in the predominantly lower-lobe emphysematous group than in the predominantly upper-lobe emphysematous group. However, NAKANO et al [34] reported that the correlations between the RA960, and FEV1 or RV/TLC were higher in the lower lobes but the correlation between RA960 and DL,CO was higher in the upper lobes.…”

Section: Factors Influencing Computed Tomography Densitometrymentioning

confidence: 99%

Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema

2001

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Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema. A. Madani, C. Keyzer, P.A. Gevenois. #ERS Journals Ltd 2001. ABSTRACT: Accurate diagnosis and quantification of pulmonary emphysema during life is important to understand the natural history of the disease, to assess the extent of the disease, and to evaluate and follow-up therapeutic interventions.Since pulmonary emphysema is defined through pathological criteria, new methods of diagnosis and quantification should be validated by comparisons against histological references.Recent studies have addressed the capability of computed tomography (CT) to quantify pulmonary emphysema accurately. The studies reviewed in this article have been based on CT scans obtained after deep inspiration or expiration, on subjective visual grading and on objective measurements of attenuation values. Especially dedicated software was used for this purpose, which provided numerical data, on both two-and three-dimensional approaches, and compared CT data with pulmonary function tests.More recently, fractal and textural analyses were applied to computed tomography scans to assess the presence, the extent, and the types of emphysema. Quantitative computed tomography has already been used in patient selection for surgical treatment of pulmonary emphysema and in pharmacotherapeutical trials. Computed tomography (CT) is an imaging method providing transverse anatomical images in which the value of each picture element (i.e. pixel) corresponds to the x-ray attenuation of a defined volume of tissue (i.e. voxel). The X-ray attenuation values for each set of projections (i.e. slice) are registered by the computer and organized in a matrix form. The number of calculated pixels determines the image matrix size, influences the image resolution, and should thus be as high as possible. In clinical practice, the matrix size is actually 5126512 pixels. The X-ray attenuation, also called tissue density, is numerically expressed in Hounsfield units (HU). The scale of attenuation values ranges from -1,000 HU, corresponding to the attenuation value of air, to 3,000 HU, with 0 HU corresponding to the attenuation value of water. The thousands of pixels included in one scan make CT the most precise morphological method able to assess the pulmonary structure in vivo [1].In pulmonary emphysema, the major advantage of CT is that in addition to providing data concerning overall lung destruction, it also identifies the specific locations in the lung where the alveolar surface has been destroyed. The ability to estimate the extent and severity of pulmonary emphysema during life is important for several reasons. 1) Accurate detection of lung destruction when it appears and careful mapping of its progression are required to understand the natural history of emphysema.2) The treatment of advanced disease by lung volume reduction surgery (LVRS) requires knowledge of the location of the lesions and objective methods of assessing the surgical

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Lobar Distribution of Emphysema in Computed Tomographic Densitometric Analysis

Abstract: CT densitometry showed a distinct lobar distribution of emphysema. Pulmonary function is significantly different between predominantly upper- and lower-lobe emphysema groups.

Cited by 44 publications

References 16 publications

Computed tomography-quantified emphysema distribution is associated with lung function decline

Computed tomography-quantified emphysema distribution is associated with lung function decline

CT of pulmonary emphysema - current status, challenges, and future directions

Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema

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