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European Radiology

, Volume 19, Issue 10, pp 2391–2402 | Cite as

Fully automatic quantitative assessment of emphysema in computed tomography: comparison with pulmonary function testing and normal values

  • C. P. Heussel
  • F. J. F. Herth
  • J. Kappes
  • R. Hantusch
  • S. Hartlieb
  • O. Weinheimer
  • H. U. Kauczor
  • R. Eberhardt
Chest

Abstract

Characterisation and quantification of emphysema are necessary for planning of local treatment and monitoring. Sensitive, easy to measure, and stable parameters have to be established and their relation to the well-known pulmonary function testing (PFT) has to be investigated. A retrospective analysis of 221 nonenhanced thin-section MDCT with a corresponding PFT was carried out, with a subgroup analysis in 102 COPD stage III+IV, 44 COPD stage 0, and 33 investigations into interstitial lung disease (ILD). The in-house YACTA software was used for automatic quantification of lung and emphysema volume [l], emphysema index, mean lung density (MLD [HU]) and 15th percentile [HU]. CT-derived lung volume is significantly smaller in ILD (3.8) and larger in COPD (7.2) than in controls (5.9, p < 0.0001). Emphysema volume and index are significantly higher in COPD than in controls (3.2 vs. 0.5, p < 0.0001, 45% vs. 8%, p < 0.0001). MLD and 15th percentile are significantly smaller in COPD (−877/−985, p < 0.0001) and significantly higher in ILD (−777, p < 0.0006/−914, p < 0.0001) than in controls (−829/−935). A relevant amount of COPD patients apparently do not suffer from emphysema, while controls who do not fulfil PFT criteria for COPD also demonstrate CT features of emphysema. Automatic quantification of thin-section CT delivers convincing parameters and ranges that are able to differentiate among emphysema, control and ILD. An emphysema index of lower 20%, MLD higher than −850, and 15th percentile lower than −950 might be regarded as normal (thin-section, nonenhanced, B40, YACTA). These ranges might be helpful in the judgement of individual measures.

Keywords

Emphysema MDCT  COPD Lung attenuation Quantitative assessment 

Abbreviations

6MWT

six-minute-walk test

COPD

chronic obstructive pulmonary disease

EI

emphysema index

EV

emphysema volume

FEV1

forced expiratory volume in 1 s

FVC

forced vital capacity

ILD

interstitial lung disease

ITGV

intrathoracic gas volume

LV

lung volume

MLD

mean lung density

NSIP

nonspecific interstitial pneumonia

PFT

pulmonary function test

RV

residual volume

TLC

total lung capacity

UIP

usual interstitial pneumonia

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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • C. P. Heussel
    • 1
    • 2
  • F. J. F. Herth
    • 1
    • 3
  • J. Kappes
    • 1
    • 3
  • R. Hantusch
    • 1
    • 2
  • S. Hartlieb
    • 1
    • 2
  • O. Weinheimer
    • 4
  • H. U. Kauczor
    • 5
  • R. Eberhardt
    • 1
    • 3
  1. 1.Thoraxklinik HeidelbergUniversity Hospital HeidelbergHeidelbergGermany
  2. 2.Department of Interventional and Diagnostic Radiology, Thoraxklinik HeidelbergUniversity Hospital HeidelbergHeidelbergGermany
  3. 3.Department of Pneumology and Critical Care MedicineJohannes Gutenberg UniversityHeidelbergGermany
  4. 4.Department of Interventional and Diagnostic Radiology (Prof. Dr. C. Düber)Johannes Gutenberg UniversityMainzGermany
  5. 5.Department of Diagnostic RadiologyUniversity Hospital HeidelbergHeidelbergGermany

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