Pulmonary emphysema: comparison of preoperative quantitative CT and physiologic index values with clinical outcome after lung-volume reduction surgery.

Gierada, David S.; Slone, Richard M.; Bae, Kyungsoo; Yusen, Roger D.; Lefrak, S S; Jd, Cooper

doi:10.1148/radiology.205.1.9314991

Cited by 82 publications

(49 citation statements)

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“…Many subsequent reports confirmed good correlations of histogram-derived, quantitative CT techniques with lung function tests and pathological evidence of emphysema [36][37][38][39][40][41].…”

Section: Image Analysismentioning

confidence: 78%

Report of a workshop: quantitative computed tomography scanning in longitudinal studies of emphysema

Newell

Hogg²,

Snider³

2004

Eur Respir J

156

138

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It has been reported that quantitative computed tomography (CT) scanning of the lungs showed decreased progression of emphysema in a randomised clinical trial in patients with severe a 1 -antitrypsin (a 1 -AT) deficiency receiving monthly intravenous augmentation therapy with human a 1 -AT. Comparable results were not obtained using rate of decline of forced expiratory volume in one second.Accordingly, the Alpha-1 Foundation convened a workshop to explore the feasibility of using quantitative CT data as a primary outcome variable in trials of drugs for treating a 1 -AT deficiency.This report reviews the following: the principles for the use of modern CT scanners for quantifying emphysema; the methods and data on validation by comparison with measurements of severity of emphysema in inflation-fixed specimens of lungs; and the possibility of decreasing radiation dosage from CT to make it safe and ethically possible to use CT in longitudinal studies.The workshop concluded that it is feasible, safe and ethically possible to use computed tomography in longitudinal studies of emphysema. It recommended that the primary end-point should be a significant shift in the 15th percentile of lung density. Eur Respir J 2004; 23: 769-775.

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Section: Image Analysismentioning

confidence: 78%

Report of a workshop: quantitative computed tomography scanning in longitudinal studies of emphysema

Newell

Hogg²,

Snider³

2004

Eur Respir J

156

138

View full text Add to dashboard Cite

show abstract

“…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 results [2]. 3) CT could be a sensitive way of quantitating the progression of emphysema as the determination of the efficacy of replacement therapy in patients with a 1 -antitrypsin deficiency [3].…”

mentioning

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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“…Cavigli et al (6) revealed that quantitative CT densitometry is a method that should be preferred to visual assessment because it enables a more reproducible evaluation of the extent of pulmonary emphysema. In 1997, Gierada et al (19) found a high correlation between quantitative CT densitometry scan values and preoperative physiologic values in 46 patients who underwent lung volume reduction surgery for palliation for severe emphysema. Gierada et al (19) also found a high correlation between quantitative CT densitometry scan values and outcome measures in those study participants.…”

Section: Discussionmentioning

confidence: 99%

“…In 1997, Gierada et al (19) found a high correlation between quantitative CT densitometry scan values and preoperative physiologic values in 46 patients who underwent lung volume reduction surgery for palliation for severe emphysema. Gierada et al (19) also found a high correlation between quantitative CT densitometry scan values and outcome measures in those study participants. Quantitative CT densitometry of emphysema is highly valuable in the assessment of pulmonary functions, in the planning of surgical treatment, and in the application of pharmacotherapy methods (17,20).…”

Section: Discussionmentioning

confidence: 99%

The benefit of expiratory phase quantitative CT densitometry in the early diagnosis of copd

Beşır

Mahmutyazıcıoğlu²,

Aydın³

et al. 2011

Diagn Interv Radiol

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Pulmonary emphysema: comparison of preoperative quantitative CT and physiologic index values with clinical outcome after lung-volume reduction surgery.

Abstract: In emphysema, quantitative CT values correlate with outcome. Quantitative assessment of emphysema in candidates for lung-volume reduction surgery is potentially useful.

Cited by 82 publications

References 0 publications

Report of a workshop: quantitative computed tomography scanning in longitudinal studies of emphysema

Report of a workshop: quantitative computed tomography scanning in longitudinal studies of emphysema

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

The benefit of expiratory phase quantitative CT densitometry in the early diagnosis of copd

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