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European Radiology

, Volume 23, Issue 6, pp 1564–1572 | Cite as

Assessment of lung volume collapsibility in chronic obstructive lung disease patients using CT

  • Shinjini Kundu
  • Suicheng Gu
  • Joseph K. Leader
  • John R. Tedrow
  • Frank C. Sciurba
  • David Gur
  • Naftali Kaminski
  • Jiantao Pu
Chest

Abstract

Objective

To investigate the collapsibility of the lung and individual lobes in patients with COPD during inspiration/expiration and assess the association of whole lung and lobar volume changes with pulmonary function tests (PFTs) and disease severity.

Methods

PFT measures used were RV/TLC%, FEV1% predicted, FVC, FEV1/FVC%, DLco% predicted and GOLD category. A total of 360 paired inspiratory and expiratory CT examinations acquired in 180 subjects were analysed. Automated computerised algorithms were used to compute individual lobe and total lung volumes. Lung volume collapsibility was assessed quantitatively using the simple difference between CT computed inspiration (I) and expiration (E) volumes (I-E), and a relative measure of volume changes, (I-E)/I.

Results

Mean absolute collapsibility (I-E) decreased in all lung lobes with increasing disease severity defined by GOLD classification. Relative collapsibility (I-E)/I showed a similar trend. Upper lobes had lower volume collapsibility across all GOLD categories and lower lobes collectively had the largest volume collapsibility. Whole lung and left lower lobe collapsibility measures tended to have the highest correlations with PFT measures. Collapsibility of lung lobes and whole lung was also negatively correlated with the degree of air trapping between expiration and inspiration, as measured by mean lung density. All measured associations were statistically significant (P < 0.01).

Conclusion

Severity of COPD appears associated with increased collapsibility in the upper lobes, but change (decline) in collapsibility is faster in the lower lobes.

Key Points

Inspiratory and expiratory computed tomography allows assessment of lung collapsibility

Lobe volume collapsibility is significantly correlated with measures of lung function.

As COPD severity increases, collapsibility of individual lung lobes decreases.

Upper lobes exhibit more severe disease, while lower lobes decline faster.

Keywords

Lung volume Collapsibility COPD Computed tomography Disease severity 

Abbreviations

GOLD

Global initiative for chronic obstructive lung disease

COPD

Chronic obstructive pulmonary disease

TLC

Total lung capacity

FEV

Forced expiratory volume

LTRC

Lung Tissue Research Consortium

RV

Residual volume

LVRS

Lung volume reduction surgery

MLD

Mean lung density

FVC

Forced vital capacity

DLco

Diffusion capacity for carbon monoxide

PFT

Pulmonary function tests

CT

Computed tomography

LUL, RUL, LLL, RLL, RML

Right or left, upper or lower lobes

Notes

Acknowledgement

This work was supported in part by grants RO1 HL096613, P50 CA090440, P50 HL084948, R01 HL095397, U01 HL108642, RC2 HL101715, and 2013KTCL03-07 from the National Institute of Health, the Bonnie J. Addario Lung Cancer Foundation, and the SPORE in Lung Cancer Career development program.

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Shinjini Kundu
    • 2
    • 4
  • Suicheng Gu
    • 1
  • Joseph K. Leader
    • 1
  • John R. Tedrow
    • 3
  • Frank C. Sciurba
    • 3
  • David Gur
    • 1
  • Naftali Kaminski
    • 3
  • Jiantao Pu
    • 1
    • 2
  1. 1.Department of RadiologyUniversity of PittsburghPittsburghUSA
  2. 2.Department of BioengineeringUniversity of PittsburghPittsburghUSA
  3. 3.Department of MedicineUniversity of PittsburghPittsburghUSA
  4. 4.School of MedicineUniversity of PittsburghPittsburghUSA

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