Assessment of lung volumes in pulmonary emphysema using multidetector helical CT: comparison with pulmonary function tests
Introduction
CT is widely used not only for an imaging of the radiologic assessment of the thorax but also for the functional assessment including lung volume. The potential usefulness of CT for the identification of regions of pulmonary emphysema has been reported in many investigations [1], [2], [3], [4], [5], [6], [7], [8]. In the earlier investigations, single-slice analysis of CT attenuation values of the lung was applied, then the analysis was shifted lately to multiple slice levels [1], [3], [5], [9], [10].
With the recent advancement of MDCT technology, faster volumetric data can be acquired easily and used for evaluation of the volume [11], [12].
The purpose of this study is to evaluate the effectiveness and accuracy of quantification of abnormally low attenuation of the lung by using MDCT with three-dimensional (3D) postprocessing in patients with pulmonary emphysema. We also compared the data with the pulmonary function test.
Section snippets
Patient population
From August 1999 to February 2000, 28 cases with pulmonary emphysema (n=14) and control subjects (n=14) underwent MDCT and pulmonary function tests at Kumamoto University Hospital.
All patients with a pulmonary emphysema were males and aged from 59 to 80 years, with mean age of 71.9 years. Height of patients ranged from 161 to 175 cm, with mean height of 166.2 cm. Weight of patients ranged from 41 to 72 kg, with mean weight of 54.1 kg. Diagnosis of emphysema was made by the ratio of the forced
Results
Table 1 shows the comparison of pulmonary function tests and CT densitometry at inspiration and expiration between emphysema and non-emphysema group. Percentage lung volume at the threshold of −950 at inspiration could be used for differentiating emphysema and non-emphysema group (p=0.0007). Moreover, mean attenuation, percentage lung volume at the threshold of −930, −900, and −810 at expiration was also useful for differentiating emphysema from non-emphysema group (p≤0.0001) (Table 1).
Discussion
There have been numerous publications in the medical literature on the usefulness of the CT in assessing the pulmonary function not only for the pulmonary emphysema [1], [2], [3], [4], [5], [6], [7], [8], [10], but also the other lung disease such as small-airway diseases [13], asthma [14], and LAM [9].
Pulmonary emphysema may be characterized pathologically by an abnormal enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of the alveolar walls. Although
Summary
CT is widely used not only for an imaging of the radiologic assessment of the thorax but also for the functional assessment including lung volume. Particularly, with the recent advancement of MDCT technology, faster volumetric data can be acquired easily and used for evaluation of the volume.
The purpose of this study is to evaluate the usefulness of multidetector helical CT (MDCT) with three-dimensional (3D) postprocessing for assessing the lung volume at inspiration and expiration of the
Akihiko Arakawa, MD graduated from the Kumamoto University School of Medicine in 1984. He is currently a member of staff of the Department of Radiology in Kumamoto University School of Medicine. He has interests in diagnosis using MDCT and MR and interventional radiology.
References (17)
- et al.
An appraisal of CT pulmonary density mapping in normal subjects
Clin Radiol
(1991) - et al.
Quantitation of emphysema by computed tomography using a ‘density mask’ program and correlation with pulmonary function tests
Chest
(1990) - et al.
‘ Density mask’: an objective method to quantitative emphysema using computed tomography
Chest
(1988) - et al.
Quantitative CT predicts the severity of physiologic dysfunction in patients with lymphangioleiomyomatosis
Chest
(1996) - et al.
Quantitative computed tomography detects air trapping due to asthma
Chest
(1994) - et al.
Regional distribution of emphysema: correlation of high-resolution CT with pulmonary function tests in unselected smokers
Radiology
(1992) - et al.
The diagnosis of emphysema: A computed tomographic–pathologic correlation
Am Rev Respir Dis
(1986) - et al.
High-resolution CT diagnosis of emphysema in symptomatic patients with normal chest radiographs and isolated low diffusing capacity
Radiology
(1992)
Cited by (51)
Relative Regional Air Volume Change Maps at the Acinar Scale Reflect Variable Ventilation in Low Lung Attenuation of COPD patients
2020, Academic RadiologyCitation Excerpt :In COPD patients, small airway collapse may cause airflow obstruction, which is reflected by indirect air trapping on expiration CT (35). Low lung attenuation on inspiration and expiration has been shown to correlate well with PFT (36–39). However, air volume change maps constructed from direct measurements at local lung regions using inspiratory and expiratory CT images have not previously been described.
New predictive equation for lung volume using chest computed tomography for size matching in lung transplantation
2015, Transplantation ProceedingsMultidetector Computed Tomographic Imaging in Chronic Obstructive Pulmonary Disease. Emphysema and Airways Assessment.
2014, Radiologic Clinics of North AmericaQuantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT
2013, European Journal of RadiologyCitation Excerpt :It remains controversial whether inspiratory or expiratory CT indices are better predictors of COPD [14,20]. However, some studies reported that expiratory CT images were superior for determining the extent of emphysema and showed better correlation with PFTs than inspiratory images [15,21,22]. In this study, Δ%CSA < 5 was defined as the percentage change from the inspiratory to the expiratory phase, and this index was higher in patients with early-stage (stages 1 and 2) COPD than that in non-COPD smokers.
Application of 3D computed tomography in emphysematous parenchyma patients scheduled for bronchoscopic lung volume reduction
2024, Clinical and Experimental Pharmacology and Physiology
Akihiko Arakawa, MD graduated from the Kumamoto University School of Medicine in 1984. He is currently a member of staff of the Department of Radiology in Kumamoto University School of Medicine. He has interests in diagnosis using MDCT and MR and interventional radiology.
Yasuyuki Yamashita, MD graduated from the Kagoshima University School of Medicine in 1981. He specialized in abdominal and pelvic diagnosis using MDCT and MR as a staff member of the Department of Radiology, Kumamoto University Hospital.
Yoshiharu Nakayama, MD is at the Department of Radiology in Kumamoto University Hospital. He graduated from Kumamoto University School of Medicine in 1995. He has interests in 3D images of the abdomen.
Masaki Kadota, MD. He graduated from the Kumamoto University School of Medicine in 1996. He specialized in 3D imaging using MDCT.
Hirotsugu Korogi, MD is at the Department of First Internal Medicine in Kumamoto University Hospital. He graduated from the Kumamoto University School of Medicine in 1977. His main area of interest is pulmonary medicine, particularly lung infectious disease and carcinoma.
Osamu Kawano, MD is at the Department of First Internal Medicine in Kumamoto University Hospital. He graduated from the Kumamoto University School of Medicine in 1981. His main area of interest is pulmonary medicine, particularly lung function.
Misuhiro Matsumoto, MD is at the Department of First Internal Medicine in Kumamoto University Hospital. He graduated from the Kumamoto University School of Medicine in 1981. His main area of interest is pulmonary medicine, particularly chemotherapy of lung carcinomas.
Mutsumasa Takahashi, MD is a Professor and Chairman of Department of Radiology in Kumamoto University School of Medicine. He has made contributions in neuroradiology, computed tomography and interventional radiology.