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Open Access 01-10-2012 | Chest

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Authors: XueQian Xie, Pim A. de Jong, Matthijs Oudkerk, Ying Wang, Nick H. T. ten Hacken, Jingtao Miao, GuiXiang Zhang, Geertruida H. de Bock, Rozemarijn Vliegenthart

Published in: European Radiology | Issue 10/2012

Abstract

Objectives

To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD).

Methods

PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify articles that correlated CT measurements to airflow obstruction parameters of the pulmonary function test in COPD patients, rated study quality and extracted information. Three CT measurements were accessed: lung attenuation area percentage < -950 Hounsfield units, mean lung density and airway wall area percentage. Two airflow obstruction parameters were accessed: forced expiratory volume in the first second as percentage from predicted (FEV₁ %pred) and FEV₁ divided by the forced volume vital capacity.

Results

Seventy-nine articles (9,559 participants) were included in the systematic review, demonstrating different methodologies, measurements and CT airflow obstruction correlations. There were 15 high-quality articles (2,095 participants) in the meta-analysis. The absolute pooled correlation coefficients ranged from 0.48 (95 % CI, 0.40 to 0.54) to 0.65 (0.58 to 0.71) for inspiratory CT and 0.64 (0.53 to 0.72) to 0.73 (0.63 to 0.80) for expiratory CT.

Conclusions

CT measurements of emphysema or peripheral airways are significantly related to airflow obstruction in COPD patients. CT provides a morphological method to investigate airway obstruction in COPD.

Key Points

• Computed tomography is widely performed in patients with chronic obstructive pulmonary disease (COPD)

• CT provides quantitative morphological methods to investigate airflow obstruction in COPD

• CT measurements correlate significantly with the degree of airflow obstruction in COPD

• Expiratory CT measurements correlate more strongly with airflow obstruction than inspiratory CT

• Low-dose CT decreases the radiation dose for diagnosis and quantitative emphysema evaluation

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Rabe KF, Hurd S, Anzueto A et al (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease—GOLD executive summary. Am J Respir Crit Care Med 176:532–555PubMedCrossRef

Patel BD, Coxson HO, Pillai SG et al (2008) Airway wall thickening and emphysema show independent familial aggregation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 178:500–505PubMedCrossRef

Nakano Y, Muro S, Sakai H et al (2000) Computed tomographic measurements of airway dimensions and emphysema in smokers correlation with lung function. Am J Respir Crit Care Med 162:1102–1108PubMed

Coxson HO (2008) Quantitative chest tomography in COPD research: chairman's summary. Proc Am Thorac Soc 5:874–877PubMedCrossRef

Han MK, Kazerooni EA, Lynch DA et al (2011) Chronic obstructive pulmonary disease exacerbations in the COPDGene study: associated radiologic phenotypes. Radiology 261:274–282PubMedCrossRef

Muller NL, Staples CA, Miller RR, Abboud RT (1988) “Density mask”. An objective method to quantitate emphysema using computed tomography. Chest 94:782–787PubMedCrossRef

Guenard H, Diallo MHH, Laurent F, Vergeret J (1992) Lung density and lung mass in emphysema. Chest 102:198–203PubMedCrossRef

Lamers RJ, Thelissen GR, Kessels AG, Wouters EF, van Engelshoven JM (1994) Chronic obstructive pulmonary disease: evaluation with spirometrically controlled CT lung densitometry. Radiology 193:109–113PubMed

Matsuoka S, Yamashiro T, Washko GR, Kurihara Y, Nakajima Y, Hatabu H (2010) Quantitative CT assessment of chronic obstructive pulmonary disease. Radiographics 30:55–66PubMedCrossRef

10.

de Jong PA, Muller NL, Pare PD, Coxson HO (2005) Computed tomographic imaging of the airways: relationship to structure and function. Eur Respir J 26:140–152PubMedCrossRef

11.

Kosciuch J, Krenke R, Gorska K, Zukowska M, Maskey-Warzechowska M, Chazan R (2009) Relationship between airway wall thickness assessed by high-resolution computed tomography and lung function in patients with asthma and chronic obstructive pulmonary disease. J Physiol Pharmacol 60:71–76PubMed

12.

Washko GR, Criner GJ, Mohsenifar Z et al (2008) Computed tomographic-based quantification of emphysema and correlation to pulmonary function and mechanics. COPD 5:177–186PubMedCrossRef

13.

Akira M, Toyokawa K, Inoue Y, Arai T (2009) Quantitative CT in chronic obstructive pulmonary disease: inspiratory and expiratory assessment. Am J Roentgenol 192:267–272CrossRef

14.

Matsuoka S, Kurihara Y, Yagihashi K, Nakajima Y (2007) Quantitative assessment of peripheral airway obstruction on paired expiratory/inspiratory thin-section computed tomography in chronic obstructive pulmonary disease with emphysema. J Comput Assist Tomogr 31:384–389PubMedCrossRef

15.

Orlandi I, Moroni C, Camiciottoli G et al (2004) Spirometric-gated computed tomography quantitative evaluation of lung emphysema in chronic obstructive pulmonary disease—a comparison of 3 techniques. J Comput Assist Tomogr 28:437–442PubMedCrossRef

16.

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Br Med J 339:332–336CrossRef

17.

Whiting PF, Weswood ME, Rutjes AW, Reitsma JB, Bossuyt PN, Kleijnen J (2006) Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol 6:9PubMedCrossRef

18.

Bon JM, Leader JK, Weissfeld JL et al (2009) The influence of radiographic phenotype and smoking status on peripheral blood biomarker patterns in chronic obstructive pulmonary disease. PLoS One 4:e6865PubMedCrossRef

19.

Dransfield MT, Washko GR, Foreman MG, Estepar RSJ, Reilly J, Bailey WC (2007) Gender differences in the severity of CT emphysema in COPD. Chest 132:464–470PubMedCrossRef

20.

Hasegawa M, Nasuhara Y, Onodera Y et al (2006) Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 173:1309–1315PubMedCrossRef

21.

Leader JK, Zheng B, Sciurba FC et al (2008) The relation of airway size to lung function. Proc SPIE Med Imaging 6916:691623

22.

Lee YK, Oh YM, Lee JH et al (2008) Quantitative assessment of emphysema, air trapping, and airway thickening on computed tomography. Lung 186:157–165PubMedCrossRef

23.

Park YS, Seo JB, Kim N et al (2008) Texture-based quantification of pulmonary emphysema on high-resolution computed tomography: Comparison with density-based quantification and correlation with pulmonary function test. Investig Radiol 43:395–402CrossRef

24.

Pauls S, Gulkin D, Feuerlein S et al (2010) Assessment of COPD severity by computed tomography: correlation with lung functional testing. Clin Imaging 34:172–178PubMedCrossRef

25.

Washko GR, Dransfield MT, Estepar RS et al (2009) Airway wall attenuation: a biomarker of airway disease in subjects with COPD. J Appl Physiol 107:185–191PubMedCrossRef

26.

Yamashiro T, Matsuoka S, Bartholmai BJ et al (2010) Collapsibility of lung volume by paired inspiratory and expiratory CT scans. Correlations with lung function and mean lung density. Acad Radiol 17:489–495PubMedCrossRef

27.

Zhang J, Yu TL, Wu Q, Ye N, Cao Y, Zhou N (2008) Quantitative MSCT study of lung attenuation in patients with chronic obstructive pulmonary disease. Chin J Med Imaging Technol 24:1611–1614

28.

Yamashiro T, Matsuoka S, San Jose Estepar R et al (2010) Quantitative assessment of bronchial wall attenuation with thin-section CT: an indicator of airflow limitation in chronic obstructive pulmonary disease. Am J Roentgenol 195:363–369CrossRef

29.

Hesselbacher SE, Ross R, Schabath MB et al (2011) Cross-sectional analysis of the utility of pulmonary function tests in predicting emphysema in ever-smokers. Int J Environ Res Public Health 8:1324–1340PubMedCrossRef

30.

Ohno Y, Koyama H, Yoshikawa T et al (2011) Comparison of capability of dynamic O2-enhanced MRI and quantitative thin-section MDCT to assess COPD in smokers. Eur J Radiol. doi:10.1016/j.ejrad.2011.1002.1004

31.

Iwasawa T, Takahashi H, Ogura T et al (2011) Influence of the distribution of emphysema on diaphragmatic motion in patients with chronic obstructive pulmonary disease. Jpn J Radiol 29:256–264PubMedCrossRef

32.

Jin LF, Miao JT, Li ZY, Xie XQ, Dai XM (2007) Study of voxel index from multislice CT in evaluating chronic obstructive pulmonary disease air-trapping. Chin J Med Imaging Technol 23:1033–1036

33.

Falaschi F, Miniati M, Battolla L et al (1995) Quantification of pulmonary emphysema with computerized tomography. Comparison with various methods. Radiol Med 90:16–23PubMed

34.

Deveci F, Murat A, Turgut T, Altuntas E, Muz MH (2004) Airway wall thickness in patients with COPD and healthy current smokers and healthy non-smokers: assessment with high resolution computed tomographic scanning. Respiration 71:602–610PubMedCrossRef

35.

Iwasawa T, Takahashi H, Ogura T et al (2007) Correlation of lung parenchymal MR signal intensity with pulmonary function tests and quantitative computed tomography (CT) evaluation: a pilot study. J Magn Reson Imaging 26:1530–1536PubMedCrossRef

36.

Heussel CP, Herth FJ, Kappes J et al (2009) Fully automatic quantitative assessment of emphysema in computed tomography: comparison with pulmonary function testing and normal values. Eur Radiol 19:2391–2402PubMedCrossRef

37.

Shaker SB, Maltbaek N, Brand P, Haeussermann S, Dirksen A (2005) Quantitative computed tomography and aerosol morphometry in COPD and alpha-antitrypsin deficiency. Eur Respir J 25:23–30PubMedCrossRef

38.

Hogg JC, Chu F, Utokaparch S et al (2004) The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 350:2645–2653PubMedCrossRef

39.

Camiciottoli G, Bartolucci M, Maluccio NM et al (2006) Spirometrically gated high-resolution CT findings in COPD—lung attenuation vs lung function and dyspnea severity. Chest 129:558–564PubMedCrossRef

40.

O'Donnell RA, Peebles C, Ward JA et al (2004) Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD. Thorax 59:837–842PubMedCrossRef

41.

Zaporozhan J, Ley S, Eberhardt R et al (2005) Paired inspiratory/expiratory volumetric thin-slice CT scan for emphysema analysis: comparison of different quantitative evaluations and pulmonary function test. Chest 128:3212–3220PubMedCrossRef

42.

Achenbach T, Weinheimer O, Biedermann A et al (2008) MDCT assessment of airway wall thickness in COPD patients using a new method: correlations with pulmonary function tests. Eur Radiol 18:2731–2738PubMedCrossRef

43.

Boschetto P, Quintavalle S, Zeni E et al (2006) Association between markers of emphysema and more severe chronic obstructive pulmonary disease. Thorax 61:1037–1042PubMedCrossRef

44.

Newell JD Jr (2008) Quantitative computed tomography of lung parenchyma in chronic obstructive pulmonary disease: an overview. Proc Am Thorac Soc 5:915–918PubMedCrossRef

45.

Mohamed Hoesein FAA, De Hoop B, Zanen P et al (2011) CT-quantified emphysema in male heavy smokers: association with lung function decline. Thorax 66:782–787PubMedCrossRef

Title: Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis
Authors: XueQian Xie
Pim A. de Jong
Matthijs Oudkerk
Ying Wang
Nick H. T. ten Hacken
Jingtao Miao
GuiXiang Zhang
Geertruida H. de Bock
Rozemarijn Vliegenthart
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2480-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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