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. KEY POINTS: - CT helps to automatically assess lung disease in heavy smokers - CT quantitatively measures emphysema and small airways disease in heavy smokers - CT air trapping and CT emphysema are associated with lung function impairment.
The relationship between lung function impairment and quantitative computed tomography in chronic obstructive pulmonary disease
O. Mets, K. Murphy, P. Zanen, H. Gietema, J. Lammers, B. van Ginneken, M. Prokop and P. de Jong
European Radiology 2012;22(1):120-128.