Thin-Section CT in Obstructive Pulmonary Disease: Discriminatory Value

Copley, Susan J.; Wells, Athol U.; Müller, Néstor L.; Rubens, Michael B.; Hollings, Nicholas; Cleverley, Joanne; Milne, David; Hansell, David M.

doi:10.1148/radiol.2233010760

Cited by 81 publications

(48 citation statements)

References 29 publications

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“…In addition, existing quantitative methods fail to provide detailed analysis of the type of emphysema and patterns of morphologic abnormality of large and small airways. On the other hand, visual assessment of COPD is relatively simple, cheap, and independent of machine and reconstruction algorithms and correlates with physiologic assessment (17)(18)(19)(20). It also provides more information on type of emphysema and small-airway abnormality.…”

Section: Discussionmentioning

confidence: 99%

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Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

Kim¹,

Seo²,

Lee³

et al. 2013

Radiology

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Purposes:To provide a new detailed visual assessment scheme of computed tomography (CT) for chronic obstructive pulmonary disease (COPD) by using standard reference images and to compare this visual assessment method with quantitative CT and several physiologic parameters. Materials and Methods:This research was approved by the institutional review board of each institution. CT images of 200 participants in the COPDGene study were evaluated. Four thoracic radiologists performed independent, lobar analysis of volumetric CT images for type (centrilobular, panlobular, and mixed) and extent (on a six-point scale) of emphysema, the presence of bronchiectasis, airway wall thickening, and tracheal abnormalities. Standard images for each finding, generated by two radiologists, were used for reference. The extent of emphysema, airway wall thickening, and luminal area were quantified at the lobar level by using commercial software. Spearman rank test and simple and multiple regression analyses were performed to compare the results of visual assessment with physiologic and quantitative parameters. Results:The type of emphysema, determined by four readers, showed good agreement (k = 0.63). The extent of the emphysema in each lobe showed good agreement (mean weighted k = 0.70) and correlated with findings at quantitative CT (r = 0.75), forced expiratory volume in 1 second (FEV 1 ) (r = 20.68), FEV 1 /forced vital capacity (FVC) ratio (r = 20.74) (P , .001). Agreement for airway wall thickening was fair (mean k = 0.41), and the number of lobes with thickened bronchial walls correlated with FEV 1 (r = 20.60) and FEV 1 /FVC ratio (r = 20.60) (P , .001). Conclusion:Visual assessment of emphysema and airways disease in individuals with COPD can provide reproducible, physiologically substantial information that may complement that provided by quantitative CT assessment.q RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Discussionmentioning

confidence: 99%

“…It also has an advantage for depicting and describing many accompanying pathologic changes in the small and large airways, as well as the parenchyma (17)(18)(19)(20)(44)(45)(46)(47)(48). Furthermore, COPD is not simply a homogeneous, irreversible airflow limitation.…”

Section: Discussionmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

Kim¹,

Seo²,

Lee³

et al. 2013

Radiology

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“…At CT, advanced PLE in association with a 1 -antitrypsin deficiency often occurs in a lower lobe-predominant distribution (Fig 7) (75,76). (CLE may also be found in cigarette smokers with a 1 -antitrypsin deficiency.)…”

Section: Special Report: Ct-definable Subtypes Of Chronic Obstructivementioning

confidence: 99%

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

Lynch¹,

Austin²,

Hogg³

et al. 2015

Radiology

468

413

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“…These estimates correlate with lung function abnormalities, but there are substantial variations among those interpreting the studies, particularly when features are subtle [15,16]. To mitigate interpreter variability, numerous quantitative techniques have been applied [17,18]. These techniques have not become routine clinical practice, however, due to the complex and time-consuming nature of the quantitative analysis (with the exception of emphysema), differences in the algorithms used by equipment manufacturers, the need for specialised software, the requirement of meticulous segmentation and analysis of airways, the lack of a standardised CT protocol to assess emphysema, and the lack of agreement on complex measurements (e.g.…”

Section: Clinical Presentation and Initial Assessmentmentioning

confidence: 99%

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

et al. 2015

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Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management.Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified.Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus.Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes. @ERSpublications ATS/ERS statement: which types of research will have the greatest future impact on patientcentred outcomes in COPD? http://ow.ly/I54Hb

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Thin-Section CT in Obstructive Pulmonary Disease: Discriminatory Value

Abstract: CT helps to distinguish diseases that cause airflow obstruction. Thin-section CT is particularly accurate in the identification of obliterative bronchiolitis.

Cited by 81 publications

References 29 publications

Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

Chronic Obstructive Pulmonary Disease: Lobe-based Visual Assessment of Volumetric CT by Using Standard Images—Comparison with Quantitative CT and Pulmonary Function Test in the COPDGene Study

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD

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