Assessment of lung volumes in pulmonary emphysema using multidetector helical CT: comparison with pulmonary function tests

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Abstract

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 pulmonary emphysema and for comparing it with pulmonary function tests. Percentage lung volume at the threshold of −930, −900, −810, −790, and −770 at expiration showed good correlation with FEV1, FEV1/FVC, and DLCO/Va. Excellent correlation was observed between percentage lung volume at the threshold of −900 and FEV1/FVC. CT densitometry at expiration showed better correlation than that at inspiration with pulmonary function tests. MDCT with 3D technique is useful for assessing the severity of pulmonary emphysema.

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.

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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.

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