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

IF 1.3 4区医学 Q4 PHYSIOLOGY Clinical Physiology and Functional Imaging Pub Date : 2024-04-04 DOI:10.1111/cpf.12880

Emelie Bäcklin, Adrian Gonon, Magnus Sköld, Örjan Smedby, Eva Breznik, Birgitta Janerot-Sjoberg

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Abstract

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

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

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

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.

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定量计算机断层扫描中的肺活量和慢性气流受限迹象

背景计算机断层扫描（CT）可提供肺容积定量，但由于辐射问题，在健康人中并不常用。慢性气流受限（CAL）是慢性阻塞性肺病（COPD）的诊断标准之一，早期诊断非常重要。我们的目的是提出胸部 CT 容积和放射密度测量的参考值，并探索它们在检测 CAL 早期症状方面的潜力。方法在基于人群的瑞典 CArdioPulmonarybioImage 研究（SCAPIS）中，294 名 50-64 岁的参与者根据肺活量被分为非 CAL 组（n = 258）和 CAL 组（n = 36）。通过吸气和呼气 CT 图像，我们比较了组间肺容积、平均肺密度（MLD）、低衰减容积百分比（LAV%）和 LAV 簇容积，并与静态肺功能测试（PFT）的参考值进行了对比。肺活量明显偏离 PFT 值。呼气测量结果比吸气测量结果更可靠。采用 0.6 的呼气 LAV% 临界值，我们的灵敏度、特异性和阳性/阴性预测值分别为 72%、85% 和 40%/96%。这些结果不能直接与 PFT 的结果相比较。测量 MLD 和 LAV 对评估疑似 CAL 很有价值。要证明其作为早期检测 COPD 的决策支持工具的潜力，还需要进一步的验证和改进。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.