The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: a prospective analysis from the ECLIPSE study

Coxson, Harvey O.; Dirksen, Asger; Edwards, Lisa; Yates, Julie; Agustí, Àlvar; Bakke, Per; Calverley, Peter M.A.; Celli, Bartolomé R.; Crim, Courtney; Duvoix, Annelyse; Fauerbach, Paola Nasute; Lomas, David A.; MacNee, William; Mayer, Ruth; Miller, Bruce E.; Müller, Néstor L.; Rennard, Stephen I.; Silverman, Edwin K.; Tal‐Singer, Ruth; Wouters, Emiel F.M.; Vestbo, Jørgen

doi:10.1016/s2213-2600(13)70006-7

Cited by 241 publications

(224 citation statements)

References 35 publications

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“…Although all participants had a significant smoking history (mean pack years = 28), spirometry and CT measurements showed no evidence of lung function decline or lung destruction (FEV 1 / FVC = 80 AE 6%, mean FEV 1 % pred = 104 AE 13%, mean RA 950 = 1.2 AE 1.0%). The cutoffs for diagnosing airflow obstruction using spirometry are well established as FEV 1 / FVC <70% and/or (unclassified) FEV 1 % pred <80% (3), and various thresholds ranging from RA 950 = 7%-10% have been used to identify emphysema predominant phenotypes (20), and we noted that the spirometry and CT measurements from the ex-smokers in our study did not cross any of these thresholds. At the same time, we were surprised that these same measurements showed no significant differences between subjects with elevated VDP compared to subjects with normal VDP.…”

Section: Discussionmentioning

confidence: 57%

Ventilation Heterogeneity in Ex-smokers without Airflow Limitation

et al. 2015

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Section: Discussionmentioning

confidence: 57%

Ventilation Heterogeneity in Ex-smokers without Airflow Limitation

et al. 2015

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“…In 1,928 individuals enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE study) Coxson, et al, found an average annual decline in lung density of 1.13g/L, after correction for lung volume, in a group of 1,928 current and former smokers. 6 The decline was more rapid in women than in men, and in current smokers than in former smokers. Similarly, a study of 3,670 individuals enrolled in the Dutch-Belgium randomized lung cancer screening trial, NELSON (Dutch acronym), showed that former smokers (who had quit more than 5 years before) had an annual rate of progression of emphysema (LAA -950 ) of 1.07%, compared with 1.12% in current smokers (p<0.001).…”

Section: Longitudinal Evaluationmentioning

confidence: 97%

“…26 However, because these higher thresholds may be more sensitive to noise, the threshold of -950 HU is now most commonly used ( Figure 6a). 1,6,27 An alternative approach to emphysema quantification uses the CT attenuation at a given percentile along the frequency histogram of lung attenuation (e.g. first or 15th percentile).…”

Section: Emphysemamentioning

confidence: 99%

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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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“…Tanabe et al 48 showed BARCELONA RESPIRATORY NETWORK that annual changes in CT emphysema parameters were greater in patients with a history of COPD exacerbations, although these data were not replicated in the ECLIPSE cohort 49 .…”

Section: Emphysema End Exacerbationsmentioning

confidence: 98%

The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

Torres¹,

Casanova²

2017

BRN

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Emphysema is defined as an abnormal and permanent enlargement of the air spaces distal to the terminal bronchioles that is accompanied by destruction of the air space walls, with no obvious fibrosis (i.e. there is no fibrosis visible to the naked eye) and it is usually associated to tobacco smoking. Although it is included in the pathological definition of chronic obstructive pulmonary disease (COPD), not all COPD patients have emphysema and its impact on the clinical presentation and the natural history of the disease is variable. The present review will cover the prevalence of emphysema in COPD patients, its impact on the clinical presentation, association with comorbidities and the main outcomes of the disease: exacerbations, lung function decline and mortality. In this review, we will only evaluate the relationship of tobacco-related emphysema with COPD. (BRN Rev. 2017;3:235-46)

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The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: a prospective analysis from the ECLIPSE study

Cited by 241 publications

References 35 publications

Ventilation Heterogeneity in Ex-smokers without Airflow Limitation

Ventilation Heterogeneity in Ex-smokers without Airflow Limitation

Progress in Imaging COPD, 2004 - 2014

The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

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