Emphysematous and nonemphysematous gas trapping in chronic obstructive pulmonary disease

Quantitative CT findings and pulmonary function

Mariaelena Occhipinti, Matteo Paoletti, Francesca Bigazzi, Gianna Camiciottoli, Riccardo Inchingolo, Anna Rita Larici, Massimo Pistolesi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To identify a prevalent computed tomography (CT) subtype in patients with chronic obstructive pulmonary disease (COPD) by separating emphysematous from nonemphysematous contributions to total gas trapping and to attempt to predict and grade the emphysematous gas trapping by using clinical and functional data. Materials and Methods: Two-hundred and two consecutive eligible patients (159 men and 43 women; mean age, 70 years [age range, 41-85 years]) were prospectively studied. Pulmonary function and CT data were acquired by pulmonologists and radiologists. Noncontrast agent-enhanced thoracic CT scans were acquired at full inspiration and expiration, and were quantitatively analyzed by using two software programs. CT parameters were set as follows: 120 kVp; 200 mAs; rotation time, 0.5 second; pitch, 1.1; section thickness, 0.75 mm; and reconstruction kernels, b31f and b70f. Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds (percentage area with CT attenuation values less than-950 HU at inspiration and percentage area with CT attenuation values less than-856 HU at expiration) was compared with that obtained by coregistration analysis. A logistic regression model on the basis of anthropometric and functional data was cross-validated and trained to classify patients with COPD according to the relative contribution of emphysema to total gas trapping, as assessed at CT. Results: Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds was highly correlated (r = 0.99) with that obtained by coregistration analysis. Four groups of patients were distinguished according to the prevalent CT subtype: prevalent emphysematous gas trapping, prevalent functional gas trapping, mixed severe, and mixed mild. The predictive model included predicted forced expiratory volume in 1 second/vital capacity, percentage of predicted forced expiratory volume in 1 second, percentage of diffusing capacity for carbon monoxide, and body mass index as emphysema regressors at CT, with 81% overall accuracy in classifying patients according to its extent. Conclusion: The relative contribution of emphysematous and nonemphysematous gas trapping obtained by coregistration of inspiratory and expiratory CT scanning can be determined accurately by difference of CT inspiratory and expiratory density thresholds. CT extent of emphysema can be predicted with accuracy suitable for clinical purposes by pulmonary function data and body mass index.

Original languageEnglish
Pages (from-to)683-692
Number of pages10
JournalRadiology
Volume287
Issue number2
DOIs
Publication statusPublished - May 1 2018

Fingerprint

Chronic Obstructive Pulmonary Disease
Gases
Tomography
Lung
Emphysema
Forced Expiratory Volume
Body Mass Index
Logistic Models
Vital Capacity
Carbon Monoxide
Thorax
Software

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Emphysematous and nonemphysematous gas trapping in chronic obstructive pulmonary disease : Quantitative CT findings and pulmonary function. / Occhipinti, Mariaelena; Paoletti, Matteo; Bigazzi, Francesca; Camiciottoli, Gianna; Inchingolo, Riccardo; Larici, Anna Rita; Pistolesi, Massimo.

In: Radiology, Vol. 287, No. 2, 01.05.2018, p. 683-692.

Research output: Contribution to journalArticle

Occhipinti, Mariaelena ; Paoletti, Matteo ; Bigazzi, Francesca ; Camiciottoli, Gianna ; Inchingolo, Riccardo ; Larici, Anna Rita ; Pistolesi, Massimo. / Emphysematous and nonemphysematous gas trapping in chronic obstructive pulmonary disease : Quantitative CT findings and pulmonary function. In: Radiology. 2018 ; Vol. 287, No. 2. pp. 683-692.
@article{cd2c6a4c6f02434e907e4e36783695f4,
title = "Emphysematous and nonemphysematous gas trapping in chronic obstructive pulmonary disease: Quantitative CT findings and pulmonary function",
abstract = "Purpose: To identify a prevalent computed tomography (CT) subtype in patients with chronic obstructive pulmonary disease (COPD) by separating emphysematous from nonemphysematous contributions to total gas trapping and to attempt to predict and grade the emphysematous gas trapping by using clinical and functional data. Materials and Methods: Two-hundred and two consecutive eligible patients (159 men and 43 women; mean age, 70 years [age range, 41-85 years]) were prospectively studied. Pulmonary function and CT data were acquired by pulmonologists and radiologists. Noncontrast agent-enhanced thoracic CT scans were acquired at full inspiration and expiration, and were quantitatively analyzed by using two software programs. CT parameters were set as follows: 120 kVp; 200 mAs; rotation time, 0.5 second; pitch, 1.1; section thickness, 0.75 mm; and reconstruction kernels, b31f and b70f. Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds (percentage area with CT attenuation values less than-950 HU at inspiration and percentage area with CT attenuation values less than-856 HU at expiration) was compared with that obtained by coregistration analysis. A logistic regression model on the basis of anthropometric and functional data was cross-validated and trained to classify patients with COPD according to the relative contribution of emphysema to total gas trapping, as assessed at CT. Results: Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds was highly correlated (r = 0.99) with that obtained by coregistration analysis. Four groups of patients were distinguished according to the prevalent CT subtype: prevalent emphysematous gas trapping, prevalent functional gas trapping, mixed severe, and mixed mild. The predictive model included predicted forced expiratory volume in 1 second/vital capacity, percentage of predicted forced expiratory volume in 1 second, percentage of diffusing capacity for carbon monoxide, and body mass index as emphysema regressors at CT, with 81{\%} overall accuracy in classifying patients according to its extent. Conclusion: The relative contribution of emphysematous and nonemphysematous gas trapping obtained by coregistration of inspiratory and expiratory CT scanning can be determined accurately by difference of CT inspiratory and expiratory density thresholds. CT extent of emphysema can be predicted with accuracy suitable for clinical purposes by pulmonary function data and body mass index.",
author = "Mariaelena Occhipinti and Matteo Paoletti and Francesca Bigazzi and Gianna Camiciottoli and Riccardo Inchingolo and Larici, {Anna Rita} and Massimo Pistolesi",
year = "2018",
month = "5",
day = "1",
doi = "10.1148/radiol.2017171519",
language = "English",
volume = "287",
pages = "683--692",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Emphysematous and nonemphysematous gas trapping in chronic obstructive pulmonary disease

T2 - Quantitative CT findings and pulmonary function

AU - Occhipinti, Mariaelena

AU - Paoletti, Matteo

AU - Bigazzi, Francesca

AU - Camiciottoli, Gianna

AU - Inchingolo, Riccardo

AU - Larici, Anna Rita

AU - Pistolesi, Massimo

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Purpose: To identify a prevalent computed tomography (CT) subtype in patients with chronic obstructive pulmonary disease (COPD) by separating emphysematous from nonemphysematous contributions to total gas trapping and to attempt to predict and grade the emphysematous gas trapping by using clinical and functional data. Materials and Methods: Two-hundred and two consecutive eligible patients (159 men and 43 women; mean age, 70 years [age range, 41-85 years]) were prospectively studied. Pulmonary function and CT data were acquired by pulmonologists and radiologists. Noncontrast agent-enhanced thoracic CT scans were acquired at full inspiration and expiration, and were quantitatively analyzed by using two software programs. CT parameters were set as follows: 120 kVp; 200 mAs; rotation time, 0.5 second; pitch, 1.1; section thickness, 0.75 mm; and reconstruction kernels, b31f and b70f. Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds (percentage area with CT attenuation values less than-950 HU at inspiration and percentage area with CT attenuation values less than-856 HU at expiration) was compared with that obtained by coregistration analysis. A logistic regression model on the basis of anthropometric and functional data was cross-validated and trained to classify patients with COPD according to the relative contribution of emphysema to total gas trapping, as assessed at CT. Results: Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds was highly correlated (r = 0.99) with that obtained by coregistration analysis. Four groups of patients were distinguished according to the prevalent CT subtype: prevalent emphysematous gas trapping, prevalent functional gas trapping, mixed severe, and mixed mild. The predictive model included predicted forced expiratory volume in 1 second/vital capacity, percentage of predicted forced expiratory volume in 1 second, percentage of diffusing capacity for carbon monoxide, and body mass index as emphysema regressors at CT, with 81% overall accuracy in classifying patients according to its extent. Conclusion: The relative contribution of emphysematous and nonemphysematous gas trapping obtained by coregistration of inspiratory and expiratory CT scanning can be determined accurately by difference of CT inspiratory and expiratory density thresholds. CT extent of emphysema can be predicted with accuracy suitable for clinical purposes by pulmonary function data and body mass index.

AB - Purpose: To identify a prevalent computed tomography (CT) subtype in patients with chronic obstructive pulmonary disease (COPD) by separating emphysematous from nonemphysematous contributions to total gas trapping and to attempt to predict and grade the emphysematous gas trapping by using clinical and functional data. Materials and Methods: Two-hundred and two consecutive eligible patients (159 men and 43 women; mean age, 70 years [age range, 41-85 years]) were prospectively studied. Pulmonary function and CT data were acquired by pulmonologists and radiologists. Noncontrast agent-enhanced thoracic CT scans were acquired at full inspiration and expiration, and were quantitatively analyzed by using two software programs. CT parameters were set as follows: 120 kVp; 200 mAs; rotation time, 0.5 second; pitch, 1.1; section thickness, 0.75 mm; and reconstruction kernels, b31f and b70f. Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds (percentage area with CT attenuation values less than-950 HU at inspiration and percentage area with CT attenuation values less than-856 HU at expiration) was compared with that obtained by coregistration analysis. A logistic regression model on the basis of anthropometric and functional data was cross-validated and trained to classify patients with COPD according to the relative contribution of emphysema to total gas trapping, as assessed at CT. Results: Gas trapping obtained by difference of inspiratory and expiratory CT density thresholds was highly correlated (r = 0.99) with that obtained by coregistration analysis. Four groups of patients were distinguished according to the prevalent CT subtype: prevalent emphysematous gas trapping, prevalent functional gas trapping, mixed severe, and mixed mild. The predictive model included predicted forced expiratory volume in 1 second/vital capacity, percentage of predicted forced expiratory volume in 1 second, percentage of diffusing capacity for carbon monoxide, and body mass index as emphysema regressors at CT, with 81% overall accuracy in classifying patients according to its extent. Conclusion: The relative contribution of emphysematous and nonemphysematous gas trapping obtained by coregistration of inspiratory and expiratory CT scanning can be determined accurately by difference of CT inspiratory and expiratory density thresholds. CT extent of emphysema can be predicted with accuracy suitable for clinical purposes by pulmonary function data and body mass index.

UR - http://www.scopus.com/inward/record.url?scp=85046023771&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046023771&partnerID=8YFLogxK

U2 - 10.1148/radiol.2017171519

DO - 10.1148/radiol.2017171519

M3 - Article

VL - 287

SP - 683

EP - 692

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -