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Computed tomography in severe asthma assessment: a systematic review
Simona Luzzi1, Tommaso Pianigiani1, Akter Dilroba1
1Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
Summary
Chest computed tomography (CT) plays a role in assessing severe asthma (SA) by identifying airway remodeling and air trapping. While CT aids in characterizing SA, its predictive role for biologic treatments requires further investigation.
Area of Science:
- Pulmonology
- Radiology
- Medical Imaging
Background:
- Chest computed tomography (CT) is utilized in severe asthma (SA) management to rule out other conditions.
- Evidence supports CT's utility in identifying morphological abnormalities and airway remodeling in SA.
- The specific role of CT in SA assessment remains under-explored.
Purpose of the Study:
- To systematically review existing literature on the application of chest CT in patients with severe asthma.
- To evaluate the diagnostic and prognostic value of CT-derived parameters in SA.
Main Methods:
- A systematic literature search was performed using the Medline database via the Pubmed search engine.
- Fifty-three studies were included in the systematic review.
Main Results:
- Quantitative CT (qCT) parameters differ in SA patients, correlating with functional decline and identifying remodeling or air trapping.
- Mucus plugging, more frequent in eosinophilic SA, is linked to airway obstruction; Benralizumab may reduce it.
- CT's utility is noted in predicting response to bronchial thermoplasty (BT), though results in pediatric SA are conflicting and limited.
Conclusions:
- The role of CT scans in SA assessment is still debated.
- Current research emphasizes CT-derived disease clusters, but studies on CT's predictive value for biologic therapies are scarce and warrant further research.
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