Author/Authors :
Gawlitza, Joshua Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Trinkmann, Frederik Department of Medicine (Cardiology, Angiology, Pulmonary, and Intensive Care) - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Scheffel, Hans Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Fischer, Andreas Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Nance, John W. Department of Radiology and Radiological Science - Medical University of South Carolina, Charleston, USA , Henzler, Claudia Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Vogler, Nils Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Saur, Joachim Department of Medicine (Cardiology, Angiology, Pulmonary, and Intensive Care) - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Akin, Ibrahim Department of Medicine (Cardiology, Angiology, Pulmonary, and Intensive Care) - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Borggrefe, Martin Department of Medicine (Cardiology, Angiology, Pulmonary, and Intensive Care) - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Schoenberg, Stefan O. Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany , Henzler, Thomas Institute of Clinical Radiology and Nuclear Medicine - University Medical Center Mannheim - Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany
Abstract :
Objectives. Diagnostic guidelines for chronic obstructive pulmonary disease (COPD) are based on spirometry and clinical criteria.
However, this does not address the pathophysiological complexity of the disease sufficiently. Until now, inspiratory chest
computed tomography (CT) has been considered as the preferred imaging method in these patients. We hypothesized that
expiratory CTmay be superior to demonstrate pathophysiological changes. /e aim of this prospective study was to systematically
compare lung function tests with quantified CT parameters in inspiration and expiration. Materials and Methods. Forty-six
patients with diagnosed COPD underwent spirometry, body plethysmography, and dose-optimized CT in maximal inspiration
and expiration. Four quantified CT parameters were acquired in inspiration, expiration, and their calculated delta values. These
parameters were correlated with seven established lung function parameters. Results. For inspiratory scans, a weak-to-moderate
correlation with the lung function parameters was found. These correlations significantly improved when adding the expiratory
scan (p < 0.05). Moreover, some parameters showed a significant correlation only in expiratory datasets. Calculated delta values
showed even stronger correlation with lung function testing. Conclusions. Expiratory quantified CT and calculated delta values
significantly improve the correlation with lung function parameters. Thus, an additional expiratory CTmay improve image-based
phenotyping of patients with COPD.
