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Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
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COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients.

Silvia Maria Doria da Silva1, Ilma Aparecida Paschoal1, Eduardo Mello De Capitani1

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International Journal of Chronic Obstructive Pulmonary Disease
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PubMed
Summary

Computed tomography (CT) phenotyping identifies distinct chronic obstructive pulmonary disease (COPD) patient subsets. Volumetric capnography (VC) reveals functional differences, correlating with emphysema and airway disease phenotypes in COPD patients.

Keywords:
bronchiectasischronic obstructive lung diseasecomputed tomographyemphysemavolumetric capnography

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Respiratory Physiology

Background:

  • Computed tomography (CT) aids in understanding chronic obstructive pulmonary disease (COPD) patient diversity.
  • The clinical relevance of CT phenotypic characterization and its link to functional features require clarification.
  • Volumetric capnography (VC) analyzes CO2 elimination patterns (ETCO2, Slp2, Slp3) during breathing.

Purpose of the Study:

  • To determine if CT phenotypic analysis can differentiate COPD patient subsets.
  • To investigate the association between CT findings and functional variables in severe COPD patients.

Main Methods:

  • Sixty-five severe COPD (Gold III-IV) patients underwent high-resolution CT and functional assessments (spirometry, 6MWT, VC).
  • Patients were phenotyped as emphysema (EMP) or airway disease (AWD) dominant.
  • CT findings were correlated with spirometric, 6MWT, and VC variables.

Main Results:

  • Bronchiectasis and peribronchial thickening were common CT findings.
  • Air trapping and EMP strongly correlated with VC variables, but inversely.
  • EMP patients exhibited lower BMI, worse obstruction, shorter 6MWT distance, and significantly lower ETCO2, Slp2, and Slp3 on VC.

Conclusions:

  • CT phenotyping is feasible for identifying distinct functional and clinical COPD patient groups.
  • VC provides valuable insights into the heterogeneous lung involvement in COPD.