Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Apr;190(2):133-45.
doi: 10.1007/s00408-011-9353-9. Epub 2011 Dec 17.

Quantitative computed tomography in COPD: possibilities and limitations

O M Mets  1 , P A de Jong, B van Ginneken, H A Gietema, J W J Lammers
Affiliations
Review

Quantitative computed tomography in COPD: possibilities and limitations

O M Mets et al. Lung. 2012 Apr.

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that is characterized by chronic airflow limitation. Unraveling of this heterogeneity is challenging but important, because it might enable more accurate diagnosis and treatment. Because spirometry cannot distinguish between the different contributing pathways of airflow limitation, and visual scoring is time-consuming and prone to observer variability, other techniques are sought to start this phenotyping process. Quantitative computed tomography (CT) is a promising technique, because current CT technology is able to quantify emphysema, air trapping, and large airway wall dimensions. This review focuses on CT quantification techniques of COPD disease components and their current status and role in phenotyping COPD.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Quantitative emphysema measure. Axial CT images of the thorax in inspiration showing emphysema (left) and densitometry overlay at a threshold of −950 Hounsfield Units (right). Voxels with attenuation below the set threshold are colored white
Fig. 2
Fig. 2
Quantitative air trapping measure. Axial CT images of the thorax in inspiration (left) and expiration (middle, left) showing air trapping as sharply defined areas with less than normal increase in lung attenuation and lack of volume reduction after expiration (middle), and the densitometry overlay at a threshold between −860 HU and −950 HU (right). Voxels with attenuation within this range are colored white
Fig. 3
Fig. 3
Quantitative measurement of the large airway dimensions. An axial CT image of the right lung at the level of the upper right apical bronchus (upper left). A magnified image of this airway is shown with rays flowing out of a center point in the airway lumen in all directions, as well as the defined inner and outer edge of the airway wall (upper right). Additionally, two examples are shown with a thickened airway wall (lower left, black arrow) and a normal airway wall (lower right, black arrow). The wall area percentage (%WA) is 84% and 65%, respectively
Fig. 4
Fig. 4
Graphical illustration of the full-width-at-half-maximum (FWHM) method. An illustration of the attenuation profile along an outwards flowing ray from the luminal center-point through the airway wall (Fig. 3). In the full-width-at-half-maximum (FWHM) method, the inner and outer airway wall boundaries are assumed halfway to the maximum on the lumen side and halfway to the minimum on the parenchymal side (half-maximum), respectively. The airway wall thickness is assumed the distance between both points (full-width)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Global Initiative for Chronic Obstructive Pulmonary Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Updated 2010. Available at: http://www.goldcopd.com. Accessed September 2011
    1. Reilly JJ. COPD and declining FEV1—time to divide and conquer? N Engl J Med. 2008;359(15):1616–1618. doi: 10.1056/NEJMe0807387. - DOI - PubMed
    1. Rennard SI, Vestbo J. The many “small COPDs”: COPD should be an orphan disease. Chest. 2008;134(3):623–627. doi: 10.1378/chest.07-3059. - DOI - PubMed
    1. Friedlander AL, Lynch D, Dyar LA, Bowler RP. Phenotypes of chronic obstructive pulmonary disease. COPD. 2007;4(4):355–384. doi: 10.1080/15412550701629663. - DOI - PubMed
    1. Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, MacNee W, Miller BE, Rennard S, Silverman EK, Tal-Singer R, Wouters E, Yates JC, Vestbo J. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res. 2010;11:122. - PMC - PubMed

MeSH terms