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. 2012 Jan;22(1):120-8.
doi: 10.1007/s00330-011-2237-9. Epub 2011 Aug 12.

The relationship between lung function impairment and quantitative computed tomography in chronic obstructive pulmonary disease

O M Mets  1 , K Murphy, P Zanen, H A Gietema, J W Lammers, B van Ginneken, M Prokop, P A de Jong
Affiliations

The relationship between lung function impairment and quantitative computed tomography in chronic obstructive pulmonary disease

O M Mets et al. Eur Radiol. 2012 Jan.

Abstract

Objectives: To determine the relationship between lung function impairment and quantitative computed tomography (CT) measurements of air trapping and emphysema in a population of current and former heavy smokers with and without airflow limitation.

Methods: In 248 subjects (50 normal smokers; 50 mild obstruction; 50 moderate obstruction; 50 severe obstruction; 48 very severe obstruction) CT emphysema and CT air trapping were quantified on paired inspiratory and end-expiratory CT examinations using several available quantification methods. CT measurements were related to lung function (FEV(1), FEV(1)/FVC, RV/TLC, Kco) by univariate and multivariate linear regression analysis.

Results: Quantitative CT measurements of emphysema and air trapping were strongly correlated to airflow limitation (univariate r-squared up to 0.72, p < 0.001). In multivariate analysis, the combination of CT emphysema and CT air trapping explained 68-83% of the variability in airflow limitation in subjects covering the total range of airflow limitation (p < 0.001).

Conclusions: The combination of quantitative CT air trapping and emphysema measurements is strongly associated with lung function impairment in current and former heavy smokers with a wide range of airflow limitation.

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Figures

Fig. 1
Fig. 1
Graphical illustration of the relationship between quantitative CT measurements and airflow obstruction (FEV1). The relationship between the quantitative CT measures and the forced expiratory volume in one second (FEV1). A log-transformed emphysema score below -950HU in inspiratory scan (logIN-950) versus FEV1; B emphysema score as 15th percentile of attenuation distribution curve in inspiratory scan (Perc15) versus FEV1; C air trapping score below -850HU in expiratory scan (EXP-850) versus FEV1; D air trapping score between -850HU and -910HU in expiratory scan (EXP-850 to -910) versus FEV1; E air trapping score as relative volume change between -860HUand -950HU (RVC-860 to -950) versus FEV1; F expiration to inspiration ratio of mean lung density (E/I-ratioMLD) versus FEV1; GOLD global initiative for chronic obstructive lung disease
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