The Role of Multidetector Computed Tomography and the Forced Oscillation Technique in Assessing Lung Damage in Adults With Cystic Fibrosis

Abstract

In adults with CF, lung-volume quantification using multidetector CT can destimate the lung volumes of compartments with different densities and determine the aerated and non-aerated contents of the lungs; furthermore, lung-volume quantification using multidetector CT is clearly related to pulmonary function parameters.

Impulse oscillometry and spirometry measurements relative to personal best values at the time of acute exacerbations of cystic fibrosis in adults

“…Patients in our study were comparable to the French adult CF population regarding demographic and clinical criteria (French CF Registry—Annual Data Report, 2017, Paris May 2019). As expected, lung function indices differed from reference values for a healthy population (Kalchiem‐Dekel & Hines, 2018; Quanjer et al., 2012) and were consistent with previous studies that compared spirometric and oscillometry indices in CF patients versus healthy subjects (Gangell et al., 2007; Lacerda et al., 2018; Lima et al., 2015; Sakarya et al., 2016).…”

“…Both oscillometry and FOT are sensitive to detect lung function changes associated with CF in adults. Two studies have shown increased resistance and decreased reactance at low frequency in CF patients in comparison with healthy subjects and a correlation between variations in R4 and X and variation in FEV1 (Lacerda et al., 2018; Lima et al., 2015). Oscillometry is currently available for routine use in the clinic.…”

<p>Lung Function Assessment by Impulse Oscillometry in Adults</p>

“…86 A Brazilian study on 26 cystic fibrosis patients that consisted in assessment of lung volume by computer tomography and pulmonary function tests, revealed that hypoventilated regions of the lungs correlate with increasing restrictive parameters of oscillometry and also with reduced diffusing capacity of the lungs. 87…”

Impulse oscillometry indices to detect an abnormal lung clearance index in childhood cystic fibrosis

“…These distal IOS parameters are peripheral resistance (R5‐R20Hz), reactance reflecting the balance between inertial and elastic properties of distensible airways, which is measured at 5 Hz (X5Hz) or as the area under the reactance curve (AX) between 5 Hz and the resonant frequency (Fres), the latter representing the point at which opposing inertial and capacitive components cancel each other out. Using forced oscillation with several frequency components, Lacerda and colleagues showed that adult CF subjects showed changes in both resistive properties and reactive properties of the respiratory system and that the decrease in normally aerated regions using multi‐detector computed tomography was associated with an increase in the resistive parameters 2 . Thus, this technique may allow detecting small airway disease and its consequence on ventilation distribution.…”

“…Using forced oscillation with several frequency components, Lacerda and colleagues showed that adult CF subjects showed changes in both resistive properties and reactive properties of the respiratory system and that the decrease in normally aerated regions using multi-detector computed tomography was associated with an increase in the resistive parameters. 2 Thus, this technique may allow detecting small airway disease and its consequence on ventilation distribution.…”