Lobe-based computed tomography assessment of airway diameter, airway or vessel number, and emphysema extent in relation to the clinical outcomes of COPD

Abstract

Objective

The aim of this study was to evaluate the relationship between computed tomography assessed lobe-based lung parameters and the clinical outcomes of patients with chronic obstructive pulmonary disease (COPD), including the frequency of exacerbation and annual change in forced expiratory volume in 1 second (FEV₁).

Patients and methods

We studied 65 patients with COPD. We reconstructed computed tomography images to trace the bronchial tree from right B1 to B10 and created 3 cm circle images around the airways exactly perpendicular to the airway axis in the central, middle, and peripheral zones of the bronchi. The number of airways and vessels, airway inner diameter and area of emphysema in the circles were calculated for each segment. Then, we analyzed the relationships between the lobe-based image parameters and the frequency of exacerbation and annual decline in the FEV₁. In addition, we assessed the effects of proximal airway lumen-obliterated emphysema (ALOE) on these clinical features.

Results

The airway diameter was not associated with the frequency of exacerbation or annual decline in FEV₁. Among the structural parameters, lower lobe emphysema was most associated with the frequency of exacerbation. The reductions in the number of airways and vessels in total lobe were associated with the annual decline in FEV₁. The subgroup of patients with ALOE demonstrated lower FEV₁ and more frequent exacerbation than those without ALOE.

Conclusion

Lower lobe emphysema predicts frequent COPD exacerbation, whereas the annual decline in FEV₁ is associated with the number of airways and vessels in total lobe.

Keywords:

• chronic obstructive pulmonary disease
• computed tomography
• acute exacerbation
• pulmonary function tests
• low attenuation area

Disclosure

The authors have no conflict of interest to disclose.