Pulmonary volumes and signs of chronic airflow limitation in quantitative computed tomography.

COPD CT emphysema lung reference values thorax

Journal

Clinical physiology and functional imaging
ISSN: 1475-097X
Titre abrégé: Clin Physiol Funct Imaging
Pays: England
ID NLM: 101137604

Informations de publication

Date de publication:
04 Apr 2024
Historique:
revised: 11 03 2024
received: 21 06 2022
accepted: 22 03 2024
medline: 5 4 2024
pubmed: 5 4 2024
entrez: 5 4 2024
Statut: aheadofprint

Résumé

Computed tomography (CT) offers pulmonary volumetric quantification but is not commonly used in healthy individuals due to radiation concerns. Chronic airflow limitation (CAL) is one of the diagnostic criteria for chronic obstructive pulmonary disease (COPD), where early diagnosis is important. Our aim was to present reference values for chest CT volumetric and radiodensity measurements and explore their potential in detecting early signs of CAL. From the population-based Swedish CArdioPulmonarybioImage Study (SCAPIS), 294 participants aged 50-64, were categorized into non-CAL (n = 258) and CAL (n = 36) groups based on spirometry. From inspiratory and expiratory CT images we compared lung volumes, mean lung density (MLD), percentage of low attenuation volume (LAV%) and LAV cluster volume between groups, and against reference values from static pulmonary function test (PFT). The CAL group exhibited larger lung volumes, higher LAV%, increased LAV cluster volume and lower MLD compared to the non-CAL group. Lung volumes significantly deviated from PFT values. Expiratory measurements yielded more reliable results for identifying CAL compared to inspiratory. Using a cut-off value of 0.6 for expiratory LAV%, we achieved sensitivity, specificity and positive/negative predictive values of 72%, 85% and 40%/96%, respectively. We present volumetric reference values from inspiratory and expiratory chest CT images for a middle-aged healthy cohort. These results are not directly comparable to those from PFTs. Measures of MLD and LAV can be valuable in the evaluation of suspected CAL. Further validation and refinement are necessary to demonstrate its potential as a decision support tool for early detection of COPD.

Sections du résumé

BACKGROUND BACKGROUND
Computed tomography (CT) offers pulmonary volumetric quantification but is not commonly used in healthy individuals due to radiation concerns. Chronic airflow limitation (CAL) is one of the diagnostic criteria for chronic obstructive pulmonary disease (COPD), where early diagnosis is important. Our aim was to present reference values for chest CT volumetric and radiodensity measurements and explore their potential in detecting early signs of CAL.
METHODS METHODS
From the population-based Swedish CArdioPulmonarybioImage Study (SCAPIS), 294 participants aged 50-64, were categorized into non-CAL (n = 258) and CAL (n = 36) groups based on spirometry. From inspiratory and expiratory CT images we compared lung volumes, mean lung density (MLD), percentage of low attenuation volume (LAV%) and LAV cluster volume between groups, and against reference values from static pulmonary function test (PFT).
RESULTS RESULTS
The CAL group exhibited larger lung volumes, higher LAV%, increased LAV cluster volume and lower MLD compared to the non-CAL group. Lung volumes significantly deviated from PFT values. Expiratory measurements yielded more reliable results for identifying CAL compared to inspiratory. Using a cut-off value of 0.6 for expiratory LAV%, we achieved sensitivity, specificity and positive/negative predictive values of 72%, 85% and 40%/96%, respectively.
CONCLUSION CONCLUSIONS
We present volumetric reference values from inspiratory and expiratory chest CT images for a middle-aged healthy cohort. These results are not directly comparable to those from PFTs. Measures of MLD and LAV can be valuable in the evaluation of suspected CAL. Further validation and refinement are necessary to demonstrate its potential as a decision support tool for early detection of COPD.

Identifiants

pubmed: 38576112
doi: 10.1111/cpf.12880
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

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Auteurs

Emelie Bäcklin (E)

Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden.
Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden.
Department of Biomedical Engineering, Karolinska University Hospital, Stockholm, Sweden.

Adrian Gonon (A)

Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.

Magnus Sköld (M)

Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden.

Örjan Smedby (Ö)

Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden.
Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden.

Eva Breznik (E)

Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden.

Birgitta Janerot-Sjoberg (B)

Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.

Classifications MeSH