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

European Radiology volume 23, pages 1564–1572 (2013)Cite this article

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.

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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

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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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Affiliations

  1. Department of Radiology, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Suicheng Gu, Joseph K. Leader, David Gur & Jiantao Pu

  2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Shinjini Kundu & Jiantao Pu

  3. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    John R. Tedrow, Frank C. Sciurba & Naftali Kaminski

  4. School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Shinjini Kundu

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  1. Shinjini Kundu
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  2. Suicheng Gu
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  6. David Gur
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Correspondence to Jiantao Pu.

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Kundu, S., Gu, S., Leader, J.K. et al. Assessment of lung volume collapsibility in chronic obstructive lung disease patients using CT. Eur Radiol 23, 1564–1572 (2013). https://doi.org/10.1007/s00330-012-2746-1

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  • DOI: https://doi.org/10.1007/s00330-012-2746-1

Keywords

  • Lung volume
  • Collapsibility
  • COPD
  • Computed tomography
  • Disease severity