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Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema
A Madani1, C Keyzer, P A Gevenois
1Dept of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
The European Respiratory Journal
|November 22, 2001
Summary
Computed tomography (CT) shows promise for diagnosing and quantifying pulmonary emphysema. However, this imaging technique requires standardization for reliable clinical application in assessing disease extent and treatment efficacy.
Area of Science:
- Pulmonary Medicine
- Radiology
- Medical Imaging Analysis
Background:
- Accurate diagnosis and quantification of pulmonary emphysema are crucial for understanding disease progression and evaluating therapeutic interventions.
- Pathological criteria define emphysema, necessitating validation of new diagnostic methods against histological references.
- Computed tomography (CT) has emerged as a key imaging modality for assessing pulmonary emphysema.
Purpose of the Study:
- To review recent studies on the capability of computed tomography (CT) to accurately quantify pulmonary emphysema.
- To assess the application of CT in disease assessment, patient selection for treatment, and pharmacotherapeutical trials.
- To identify remaining challenges and areas for standardization in CT-based emphysema quantification.
Main Methods:
- Review of studies utilizing CT scans acquired during deep inspiration or expiration.
- Inclusion of methods involving subjective visual grading and objective measurements of attenuation values.
- Application of dedicated software for two- and three-dimensional quantitative analysis, including fractal and textural analyses.
- Comparison of CT data with pulmonary function tests.
Main Results:
- CT demonstrates capability in quantifying pulmonary emphysema using various objective measurement techniques.
- Quantitative CT has been successfully applied in clinical settings, including patient selection for surgery and drug trials.
- Advanced analyses like fractal and textural approaches show potential for assessing emphysema presence, extent, and types.
Conclusions:
- Quantitative computed tomography is a valuable tool for the diagnosis and quantification of pulmonary emphysema.
- Despite advancements, CT-based quantification of emphysema is not yet standardized.
- Further research is needed to resolve outstanding issues regarding the optimal use of CT for emphysema assessment.
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