Quantitative Imaging Methods in Combined Pulmonary Fibrosis and Emphysema

Area of Science:

• Pulmonology
• Radiology
• Medical Imaging

Background:

• Combined pulmonary fibrosis and emphysema (CPFE) is an underdiagnosed syndrome with high morbidity and mortality.
• Patients with CPFE experience poor exercise tolerance and increased comorbidities.
• Current understanding of CPFE is limited by a lack of precise definition.

Purpose of the Study:

• To review the evolution of defining CPFE, from visual interpretation to quantitative imaging.
• To evaluate the role of quantitative imaging methods and thresholds in defining CPFE.
• To discuss challenges and future directions for using quantitative imaging in CPFE research.

Main Methods:

• Review of early imaging studies on CPFE.
• Evaluation of quantitative imaging approaches and thresholds in large population and single-center studies.
• Analysis of how imaging-based definitions impact patient outcomes.

Main Results:

• CPFE has been visually defined by the presence of both emphysema and fibrosis on CT scans.
• Quantitative approaches have used varying thresholds for emphysema and fibrosis.
• Quantitative imaging holds potential for a more precise definition of CPFE.

Conclusions:

• Quantitative imaging techniques are essential for a standardized definition of CPFE.
• Further research is needed to establish optimal quantitative thresholds for CPFE diagnosis and prognosis.
• Addressing current challenges in quantitative imaging will improve clinical management of CPFE.