Abstract
The population of patients suffering from chronic obstructive pulmonary disease (COPD) and asthma is heterogeneous, complicating therapy management and scientific analysis. Owing to the rapid technical improvements in imaging techniques in the past years, research has succeeded in gaining further insights into the different manifestations of obstructive pulmonary disease. Whereas the main parameters for differentiation and categorization of the disease in the past were pulmonary function tests and pathologic examinations, computed tomography (CT) has now made it possible to visualize alterations in the airway and parenchymal architecture induced by COPD in vivo and in unprecedented detail. The visual differentiation of COPD is currently given by the two major radiologic phenotypes, namely the airway predominant and the emphysema predominant type of COPD. Further objective and reliable categorization and classification of the different manifestations via computer-aided analysis of pulmonary CT examinations is an important goal of recent research in pulmonary imaging. While much innovation and improvement have already been made, finding a conclusive system of parameters that allow for a reliable and quantitative classification of the different imaging features of COPD remains a task to be completed. In this chapter we provide a fundamental insight into the particular imaging patterns and provide a technical basis for the use of CT in COPD. Furthermore, we illustrate the current state-of-the-art technologies in imaging analysis and the results of recent research in typecasting COPD with clinical correlation.
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References
Achenbach T, Weinheimer O, Buschsieweke C, Heussel CP, Thelen M, Kauczor HU (2004) Fully automatic detection and quantification of emphysema on thin section MD-CT of the chest by a new and dedicated software. Rofo 176(10):1409–1415. doi:10.1055/s-2004-813530
Achenbach T, Weinheimer O, Biedermann A, Schmitt S, Freudenstein D, Goutham E, Kunz RP, Buhl R, Dueber C, Heussel CP (2008) MDCT assessment of airway wall thickness in COPD patients using a new method: correlations with pulmonary function tests. Eur Radiol 18(12):2731–2738. doi:10.1007/s00330-008-1089-4
Aysola RS, Hoffman EA, Gierada D, Wenzel S, Cook-Granroth J, Tarsi J, Zheng J, Schechtman KB, Ramkumar TP, Cochran R, Xueping E, Christie C, Newell J, Fain S, Altes TA, Castro M (2008) Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology. Chest 134(6):1183–1191. chest.07-2779 [pii]. doi:10.1378/chest.07-2779
Aysola R, de Lange EE, Castro M, Altes TA (2010) Demonstration of the heterogeneous distribution of asthma in the lungs using CT and hyperpolarized helium-3 MRI. J Magn Reson Imaging 32(6):1379–1387. doi:10.1002/jmri.22388
Baldi S, Miniati M, Bellina CR, Battolla L, Catapano G, Begliomini E, Giustini D, Giuntini C (2001) Relationship between extent of pulmonary emphysema by high-resolution computed tomography and lung elastic recoil in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 164(4):585–589
Barbosa EM Jr, Song G, Tustison N, Kreider M, Gee JC, Gefter WB, Torigian DA (2011) Computational analysis of thoracic multidetector row HRCT for segmentation and quantification of small airway air trapping and emphysema in obstructive pulmonary disease. Acad Radiol 18(10):1258–1269. S1076-6332(11)00299-6 [pii]. doi:10.1016/j.acra.2011.06.004
Barnes PJ (2008) Immunology of asthma and chronic obstructive pulmonary disease. Nat Rev Immunol 8(3):183–192. doi:10.1038/nri2254
Beigelman-Aubry C, Hill C, Guibal A, Savatovsky J, Grenier PA (2005) Multi-detector row CT and postprocessing techniques in the assessment of diffuse lung disease. Radiographics 25(6):1639–1652. 25/6/1639 [pii]. doi:10.1148/rg.256055037
Berger P, Perot V, Desbarats P, Tunon-de-Lara JM, Marthan R, Laurent F (2005) Airway wall thickness in cigarette smokers: quantitative thin-section CT assessment. Radiology 235(3):1055–1064. 2353040121 [pii]. doi:10.1148/radiol.2353040121
Brillet PY, Fetita CI, Saragaglia A, Brun AL, Beigelman-Aubry C, Preteux F, Grenier PA (2008) Investigation of airways using MDCT for visual and quantitative assessment in COPD patients. Int J Chron Obstruct Pulmon Dis 3(1):97–107
Brillet PY, Fetita CI, Capderou A, Mitrea M, Dreuil S, Simon JM, Preteux F, Grenier PA (2009) Variability of bronchial measurements obtained by sequential CT using two computer-based methods. Eur Radiol 19(5):1139–1147. doi:10.1007/s00330-008-1247-8
Busacker A, Newell JD Jr, Keefe T, Hoffman EA, Granroth JC, Castro M, Fain S, Wenzel S (2009) A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis. Chest 135(1):48–56. chest.08-0049 [pii]. doi:10.1378/chest.08-0049
Chae EJ, Seo JB, Goo HW, Kim N, Song KS, Lee SD, Hong SJ, Krauss B (2008) Xenon ventilation CT with a dual-energy technique of dual-source CT: initial experience. Radiology 248(2):615–624. 248/2/615 [pii]. doi:10.1148/radiol.2482071482
Chung KF (2005) The role of airway smooth muscle in the pathogenesis of airway wall remodeling in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2(4):347–354; discussion 371–342. doi:10.1513/pats.200504-028SR
Coxson HO, Mayo J, Lam S, Santyr G, Parraga G, Sin DD (2009) New and current clinical imaging techniques to study chronic obstructive pulmonary disease. Am J Respir Crit Care Med 180(7):588–597. 200901-0159PP [pii]. doi:10.1164/rccm.200901-0159PP
de Jong PA, Muller NL, Pare PD, Coxson HO (2005) Computed tomographic imaging of the airways: relationship to structure and function. Eur Respir J 26(1):140–152. 26/1/140 [pii]. doi:10.1183/09031936.05.00007105
Dinkel J, Hintze C, Rochet N, Thieke C, Biederer J (2009) Computed tomography of the lungs. A step into the fourth dimension. Radiologe 49(8):698–704. doi:10.1007/s00117-009-1879-y
Fain S, Schiebler ML, McCormack DG, Parraga G (2010) Imaging of lung function using hyperpolarized helium-3 magnetic resonance imaging: review of current and emerging translational methods and applications. J Magn Reson Imaging 32(6):1398–1408. doi:10.1002/jmri.22375
Gierada DS, Bierhals AJ, Choong CK, Bartel ST, Ritter JH, Das NA, Hong C, Pilgram TK, Bae KT, Whiting BR, Woods JC, Hogg JC, Lutey BA, Battafarano RJ, Cooper JD, Meyers BF, Patterson GA (2010) Effects of CT section thickness and reconstruction kernel on emphysema quantification relationship to the magnitude of the CT emphysema index. Acad Radiol 17(2):146–156. doi:10.1016/j.acra.2009.08.007
Gono H, Fujimoto K, Kawakami S, Kubo K (2003) Evaluation of airway wall thickness and air trapping by HRCT in asymptomatic asthma. Eur Respir J 22(6):965–971
Grydeland TB, Thorsen E, Dirksen A, Jensen R, Coxson HO, Pillai SG, Sharma S, Eide GE, Gulsvik A, Bakke PS (2011) Quantitative CT measures of emphysema and airway wall thickness are related to D(L)CO. Respir Med 105(3):343–351. doi:10.1016/j.rmed.2010.10.018
Gupta S, Siddiqui S, Haldar P, Raj JV, Entwisle JJ, Wardlaw AJ, Bradding P, Pavord ID, Green RH, Brightling CE (2009) Qualitative analysis of high-resolution CT scans in severe asthma. Chest 136(6):1521–1528. chest.09-0174 [pii]. doi:10.1378/chest.09-0174
Han MK, Kazerooni EA, Lynch DA, Liu LX, Murray S, Curtis JL, Criner GJ, Kim V, Bowler RP, Hanania NA, Anzueto AR, Make BJ, Hokanson JE, Crapo JD, Silverman EK, Martinez FJ, Washko GR (2011) Chronic obstructive pulmonary disease exacerbations in the COPDGene study: associated radiologic phenotypes. Radiology 261(1):274–282. radiol.11110173 [pii]. doi:10.1148/radiol.11110173
Harmanci E, Kebapci M, Metintas M, Ozkan R (2002) High-resolution computed tomography findings are correlated with disease severity in asthma. Respiration 69(5):420–426, doi:res69420 [pii]
Hasegawa M, Nasuhara Y, Onodera Y, Makita H, Nagai K, Fuke S, Ito Y, Betsuyaku T, Nishimura M (2006) Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 173(12):1309–1315. 200601-037OC [pii]. doi:10.1164/rccm.200601-037OC
Heussel CP, Hafner B, Lill J, Schreiber W, Thelen M, Kauczor HU (2001) Paired inspiratory/expiratory spiral CT and continuous respiration cine CT in the diagnosis of tracheal instability. Eur Radiol 11(6):982–989
Heussel CP, Achenbach T, Buschsieweke C, Kuhnigk J, Weinheimer O, Hammer G, Duber C, Kauczor HU (2006) Quantification of pulmonary emphysema in multislice-CT using different software tools. Rofo 178(10):987–998. doi:10.1055/s-2006-926823
Heussel CP, Kappes J, Hantusch R, Hartlieb S, Weinheimer O, Kauczor HU, Eberhardt R (2009) Contrast enhanced CT-scans are not comparable to non-enhanced scans in emphysema quantification. Eur J Radiol 74(3):473–478. S0720-048X(09)00136-3 [pii]. doi:10.1016/j.ejrad.2009.03.023
Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Pare PD (2004) The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 350(26):2645–2653. doi:10.1056/NEJMoa032158350/26/2645 [pii]
Jokinen K, Palva T, Nuutinen J (1976) Chronic bronchitis. A bronchologic evaluation. ORL J Otorhinolaryngol Relat Spec 38(3):178–186
Kasahara K, Shiba K, Ozawa T, Okuda K, Adachi M (2002) Correlation between the bronchial subepithelial layer and whole airway wall thickness in patients with asthma. Thorax 57(3):242–246
Kauczor HU, Wielpütz MO, Owsijewitsch M, Ley-Zaporozhan J (2011) Computed tomographic imaging of the airways in COPD and asthma. J Thorac Imaging 26(4):290–300. 00005382-201111000-00006 [pii]. doi:10.1097/RTI.0b013e3182277113
Koenigkam-Santos M, Puderbach M, Gompelmann D, Eberhardt R, Herth F, Kauczor HU, Heussel CP (2012) Incomplete fissures in severe emphysematous patients evaluated with MDCT: incidence and interobserver agreement among radiologists and pneumologists. Eur J Radiol 81(12):4161–4166. doi:10.1016/j.ejrad.2012.06.006
Koenigkam-Santos M, de Paula WD, Owsijewitsch M, Wielputz MO, Gompelmann D, Schlemmer HP, Kauczor HU, Heussel CP, Puderbach M (2013) Incomplete pulmonary fissures evaluated by volumetric thin-section CT: semi-quantitative evaluation for small fissure gaps identification, description of prevalence and severity of fissural defects. Eur J Radiol 82(12):2365–2370. S0720-048X(13)00428-2 [pii]. doi:10.1016/j.ejrad.2013.08.029
Koenigkam-Santos M, de Paula WD, Owsijewitsch M, Wielputz MO, Gompelmann D, Schlemmer HP, Kauczor HU, Heussel CP, Puderbach M (2013b) Incomplete pulmonary fissures evaluated by volumetric thin-section CT: semi-quantitative evaluation for small fissure gaps identification, description of prevalence and severity of fissural defects. Eur J Radiol 82(12):2365–2370. doi:10.1016/j.ejrad.2013.08.029
Koyama H, Ohno Y, Nishio M, Matsumoto S, Sugihara N, Yoshikawa T, Seki S, Sugimura K (2014) Iterative reconstruction technique vs filter back projection: utility for quantitative bronchial assessment on low-dose thin-section MDCT in patients with/without chronic obstructive pulmonary disease. Eur Radiol 24(8):1860–1867. doi:10.1007/s00330-014-3207-9
Kurashima K, Kanauchi T, Hoshi T, Takaku Y, Ishiguro T, Takayanagi N, Ubukata M, Sugita Y (2008) Effect of early versus late intervention with inhaled corticosteroids on airway wall thickness in patients with asthma. Respirology 13(7):1008–1013. RES1384 [pii]. doi:10.1111/j.1440-1843.2008.01384.x
Little SA, Sproule MW, Cowan MD, Macleod KJ, Robertson M, Love JG, Chalmers GW, McSharry CP, Thomson NC (2002) High resolution computed tomographic assessment of airway wall thickness in chronic asthma: reproducibility and relationship with lung function and severity. Thorax 57(3):247–253
Loring SH, O’Donnell C R, Feller-Kopman DJ, Ernst A (2007) Central airway mechanics and flow limitation in acquired tracheobronchomalacia. Chest 131(4):1118–1124. 131/4/1118 [pii]. doi:10.1378/chest.06-2556
Madani A, De Maertelaer V, Zanen J, Gevenois PA (2007) Pulmonary emphysema: radiation dose and section thickness at multidetector CT quantification–comparison with macroscopic and microscopic morphometry. Radiology 243(1):250–257. doi:10.1148/radiol.2431060194
Matsuoka S, Kurihara Y, Yagihashi K, Hoshino M, Watanabe N, Nakajima Y (2008) Quantitative assessment of air trapping in chronic obstructive pulmonary disease using inspiratory and expiratory volumetric MDCT. AJR Am J Roentgenol 190(3):762–769. 190/3/762 [pii]. doi:10.2214/AJR.07.2820
Mc LK (1957a) The histology of generalized pulmonary emphysema. II. Diffuse emphysema. Australas Ann Med 6(3):203–217
Mc LK (1957b) The histology of localized emphysema. Australas Ann Med 6(4):282–294
McDonough JE, Yuan R, Suzuki M, Seyednejad N, Elliott WM, Sanchez PG, Wright AC, Gefter WB, Litzky L, Coxson HO, Pare PD, Sin DD, Pierce RA, Woods JC, McWilliams AM, Mayo JR, Lam SC, Cooper JD, Hogg JC (2011) Small-airway obstruction and emphysema in chronic obstructive pulmonary disease. N Engl J Med 365(17):1567–1575. doi:10.1056/NEJMoa1106955
McLean KH (1956) The macroscopic anatomy of pulmonary emphysema. Australas Ann Med 5(2):73–88
McLean KH (1957) The histology of generalized pulmonary emphysema. I. The genesis of the early centrolobular lesion: focal emphysema. Australas Ann Med 6(2):124–140
Mets OM, Willemink MJ, de Kort FP, Mol CP, Leiner T, Oudkerk M, Prokop M, de Jong PA (2012) The effect of iterative reconstruction on computed tomography assessment of emphysema, air trapping and airway dimensions. Eur Radiol 22(10):2103–2109. doi:10.1007/s00330-012-2489-z
Mitsunobu F, Mifune T, Ashida K, Hosaki Y, Tsugeno H, Okamoto M, Harada S, Takata S, Tanizaki Y (2001) Influence of age and disease severity on high resolution CT lung densitometry in asthma. Thorax 56(11):851–856
Mitsunobu F, Ashida K, Hosaki Y, Tsugeno H, Okamoto M, Nishida N, Nagata T, Takata S, Tanizaki Y (2003) Decreased computed tomographic lung density during exacerbation of asthma. Eur Respir J 22(1):106–112
Nakano Y, Muro S, Sakai H, Hirai T, Chin K, Tsukino M, Nishimura K, Itoh H, Pare PD, Hogg JC, Mishima M (2000) Computed tomographic measurements of airway dimensions and emphysema in smokers. Correlation with lung function. Am J Respir Crit Care Med 162(3 Pt 1):1102–1108
Nakano Y, Muller NL, King GG, Niimi A, Kalloger SE, Mishima M, Pare PD (2002) Quantitative assessment of airway remodeling using high-resolution CT. Chest 122(6 Suppl):271S–275S
Nakano Y, Wong JC, de Jong PA, Buzatu L, Nagao T, Coxson HO, Elliott WM, Hogg JC, Pare PD (2005) The prediction of small airway dimensions using computed tomography. Am J Respir Crit Care Med 171(2):142–146. 200407-874OC [pii]. doi:10.1164/rccm.200407-874OC
Niimi A, Matsumoto H, Amitani R, Nakano Y, Mishima M, Minakuchi M, Nishimura K, Itoh H, Izumi T (2000) Airway wall thickness in asthma assessed by computed tomography. Relation to clinical indices. Am J Respir Crit Care Med 162(4 Pt 1):1518–1523
Niimi A, Matsumoto H, Amitani R, Nakano Y, Sakai H, Takemura M, Ueda T, Chin K, Itoh H, Ingenito EP, Mishima M (2004) Effect of short-term treatment with inhaled corticosteroid on airway wall thickening in asthma. Am J Med 116(11):725–731. doi:10.1016/j.amjmed.2003.11.026, S0002934304000464 [pii]
Nishio M, Matsumoto S, Ohno Y, Sugihara N, Inokawa H, Yoshikawa T, Sugimura K (2012) Emphysema quantification by low-dose CT: potential impact of adaptive iterative dose reduction using 3D processing. AJR Am J Roentgenol 199(3):595–601. doi:10.2214/AJR.11.8174
Paganin F, Seneterre E, Chanez P, Daures JP, Bruel JM, Michel FB, Bousquet J (1996) Computed tomography of the lungs in asthma: influence of disease severity and etiology. Am J Respir Crit Care Med 153(1):110–114
Pansini V, Remy-Jardin M, Faivre JB, Schmidt B, Dejardin-Bothelo A, Perez T, Delannoy V, Duhamel A, Remy J (2009) Assessment of lobar perfusion in smokers according to the presence and severity of emphysema: preliminary experience with dual-energy CT angiography. Eur Radiol 19:2834–2843. doi:10.1007/s00330-009-1475-6
Park JW, Hong YK, Kim CW, Kim DK, Choe KO, Hong CS (1997) High-resolution computed tomography in patients with bronchial asthma: correlation with clinical features, pulmonary functions and bronchial hyperresponsiveness. J Investig Allergol Clin Immunol 7(3):186–192
Park EA, Goo JM, Park SJ, Lee HJ, Lee CH, Park CM, Yoo CG, Kim JH (2010) Chronic obstructive pulmonary disease: quantitative and visual ventilation pattern analysis at xenon ventilation CT performed by using a dual-energy technique. Radiology 256(3):985–997. radiol.10091502 [pii]. doi:10.1148/radiol.10091502
Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS (2001) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop summary. Am J Respir Crit Care Med 163(5):1256–1276
Pontana F, Duhamel A, Pagniez J, Flohr T, Faivre JB, Hachulla AL, Remy J, Remy-Jardin M (2011) Chest computed tomography using iterative reconstruction vs filtered back projection (part 2): image quality of low-dose CT examinations in 80 patients. Eur Radiol 21(3):636–643. doi:10.1007/s00330-010-1991-4
Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J (2007) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 176(6):532–555. 200703-456SO [pii]. doi:10.1164/rccm.200703-456SO
Reinhardt JM, D’Souza ND, Hoffman EA (1997) Accurate measurement of intrathoracic airways. IEEE Trans Med Imaging 16(6):820–827. doi:10.1109/42.650878
Remy-Jardin M, Remy J (2008) Vascular disease in chronic obstructive pulmonary disease. Proc Am Thorac Soc 5(9):891–899. 5/9/891 [pii]. doi:10.1513/pats.200804-036QC
Saba OI, Hoffman EA, Reinhardt JM (2003) Maximizing quantitative accuracy of lung airway lumen and wall measures obtained from X-ray CT imaging. J Appl Physiol 95(3):1063–1075. doi:10.1152/japplphysiol.00962.2002, 00962.2002 [pii]
Stoel BC, Putter H, Bakker ME, Dirksen A, Stockley RA, Piitulainen E, Russi EW, Parr D, Shaker SB, Reiber JH, Stolk J (2008) Volume correction in computed tomography densitometry for follow-up studies on pulmonary emphysema. Proc Am Thorac Soc 5(9):919–924. doi:10.1513/pats.200804-040QC
Takemura M, Niimi A, Minakuchi M, Matsumoto H, Ueda T, Chin K, Mishima M (2004) Bronchial dilatation in asthma: relation to clinical and sputum indices. Chest 125(4):1352–1358
Venkatraman R, Raman R, Raman B, Moss RB, Rubin GD, Mathers LH, Robinson TE (2006) Fully automated system for three-dimensional bronchial morphology analysis using volumetric multidetector computed tomography of the chest. J Digit Imaging 19(2):132–139. doi:10.1007/s10278-005-9240-0
Weinheimer O, Achenbach T, Bletz C, Duber C, Kauczor HU, Heussel CP (2008) About objective 3-d analysis of airway geometry in computerized tomography. IEEE Trans Med Imaging 27(1):64–74. doi:10.1109/TMI.2007.902798
Wielputz MO, Bardarova D, Weinheimer O, Kauczor HU, Eichinger M, Jobst BJ, Eberhardt R, Koenigkam-Santos M, Puderbach M, Heussel CP (2014) Variation of densitometry on computed tomography in COPD – influence of different software tools. PLoS One 9(11), e112898. doi:10.1371/journal.pone.0112898
Wildberger JE, Klotz E, Ditt H, Spuntrup E, Mahnken AH, Gunther RW (2005) Multislice computed tomography perfusion imaging for visualization of acute pulmonary embolism: animal experience. Eur Radiol 15(7):1378–1386. doi:10.1007/s00330-005-2718-9
Woods AQ, Lynch DA (2009) Asthma: an imaging update. Radiol Clin North Am 47 (2):317–329. S0033-8389(08)00219-4 [pii]. doi:10.1016/j.rcl.2008.11.008
Zaporozhan J, Ley S, Eberhardt R, Weinheimer O, Iliyushenko S, Herth F, Kauczor HU (2005) Paired inspiratory/expiratory volumetric thin-slice CT scan for emphysema analysis: comparison of different quantitative evaluations and pulmonary function test. Chest 128(5):3212–3220. 128/5/3212 [pii]. doi:10.1378/chest.128.5.3212
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Meredig, H., Jobst, B., Wielpütz, M.O., Kauczor, HU. (2016). CT in Chronic Obstructive Pulmonary Disease/Pulmonary Emphysema. In: Schoepf, U., Meinel, F. (eds) Multidetector-Row CT of the Thorax. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-319-30355-0_6
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