Details

Autor(en) / Beteiligte

• Konietzke, Philip
• Wielpütz, Mark O.
• Wagner, Willi L.
• Wuennemann, Felix
• Kauczor, Hans-Ulrich
• Heussel, Claus P.
• Eichinger, Monika
• Eberhardt, Ralf
• Gompelmann, Daniela
• Weinheimer, Oliver

Titel

Quantitative CT detects progression in COPD patients with severe emphysema in a 3-month interval

Ist Teil von

• European radiology, 2020-05, Vol.30 (5), p.2502-2512

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Objectives Chronic obstructive pulmonary disease (COPD) is characterized by variable contributions of emphysema and airway disease on computed tomography (CT), and still little is known on their temporal evolution. We hypothesized that quantitative CT (QCT) is able to detect short-time changes in a cohort of patients with very severe COPD. Methods Two paired in- and expiratory CT each from 70 patients with avg. GOLD stage of 3.6 (mean age = 66 ± 7.5, mean FEV1/FVC = 35.28 ± 7.75) were taken 3 months apart and analyzed by fully automatic software computing emphysema (emphysema index (EI), mean lung density (MLD)), air-trapping (ratio expiration to inspiration of mean lung attenuation (E/I MLA), relative volume change between − 856 HU and − 950 HU (RVC 856–950 )), and parametric response mapping (PRM) parameters for each lobe separately and the whole lung. Airway metrics measured were wall thickness (WT) and lumen area (LA) for each airway generation and the whole lung. Results The average of the emphysema parameters (EI, MLD) increased significantly by 1.5% ( p  < 0.001) for the whole lung, whereas air-trapping parameters (E/I MLA, RVC 856–950 ) were stable. PRM Emph increased from 34.3 to 35.7% ( p  < 0.001), whereas PRM Normal decrased from 23.6% to 22.8% ( p  = 0.012). WT decreased significantly from 1.17 ± 0.18 to 1.14 ± 0.19 mm ( p  = 0.036) and LA increased significantly from 25.08 ± 4.49 to 25.84 ± 4.87 mm 2 ( p  = 0.041) for the whole lung. The generation-based analysis showed heterogeneous results. Conclusion QCT detects short-time progression of emphysema in severe COPD. The changes were partly different among lung lobes and airway generations, indicating that QCT is useful to address the heterogeneity of COPD progression. Key Points • QCT detects short-time progression of emphysema in severe COPD in a 3-month period. • QCT is able to quantify even slight parenchymal changes, which were not detected by spirometry. • QCT is able to address the heterogeneity of COPD, revealing inconsistent changes individual lung lobes and airway generations.