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Park and Hwang: Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity
Chest Radiology
Original Article

Journal of the Korean Society of Radiology 2011; 65(3): 247-256.

Published online: 30 September 2011

DOI: https://doi.org/10.3348/jksr.2011.65.3.247

Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

Hyun Jeong Park, MD, Jung Hwa Hwang, MD

Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea.

Corresponding author: Jung Hwa Hwang, MD. Department of Radiology, Soonchunhyang University Seoul Hospital, 22 Daesagwan-gil, Yongsan-gu, Seoul 140-743, Korea. Tel. 82-2-709-9396, Fax. 82-2-709-9066, jhhwang@schmc.ac.kr

Received 18 March 2011       Accepted 23 May 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

Purpose

We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD).

Materials and Methods

Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score.

Results

A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV1/FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant.

Conclusion

Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV1/FVC and the dyspnea score.

Keywords: 3D Chest CT, Pulmonary Function Tests, Chronic Obstructive Pulmonary Disease, Quantitative Assessment, Dyspnea Severity

Figures and Tables

Fig. 1

Workstation images and table of data from a 68-year-old man with COPD.

A. Axial image demonstrates centriacinar emphysema seen as areas of hypoattenuation.
B. Three dimensional display of the lungs reconstructed from MDCT data shows upper lobe predominance of emphysema, which is seen as less dense areas than middle to lower lung zones.
C. Table obtained from the 3D CT data set shows total lung volumes, mean lung density and standard deviations.
Note.-COPD = chronic obstructive pulmonary disease, MDCT = multi-detector row CT
jksr-65-247-g001
Fig. 2

Histograms and table of data from the 3D CT data set in a 68-year-old man with COPD and emphysema.

A. Absolute frequency histogram represents number of voxels of a specific density (eg. the absolute frequency of -900 HU is 35,000).
B. Cumulative frequency histogram represents a percentile of voxels below a specific density (eg. the cumulated frequency of -950 HU is 40% of total lung volume).
C. Percentile (x)% is the highest density of the lowest densities in (x)% of the total lung (eg. the value of the percentile15% in this patient is -993 HU).
Note.-COPD = chronic obstructive pulmonary disease
jksr-65-247-g002
Table 1

Baseline Patient Characteristics and Results of Pulmonary Function Tests, Visual Emphysema Score, and Dyspnea Score

jksr-65-247-i001

Note.-*Total n = 27, †Total n = 23.

NA = not applicable, Percentile15% = the highest density of the lowest lung densities in 15%.

DLco = Diffusion capacity of lung for carbon monoxide, FEV1 = Forced expiratory volume in 1 second, FVC = Forced expiratory vital capacity, TLC = Total lung capacity

Table 2

Correlation Coefficients of 3D CT Densitometry with Results of Pulmonary Function Tests

jksr-65-247-i002

Note.-Values given are r values on top and p values on bottom.

Percentile15% = the highest density of the lowest lung densities in 15%.

DLco = diffusion capacity of lung for carbon monoxide, FEV1 = forced expiratory volume in 1 second, FVC = forced expiratory vital capacity, TLC = total lung capacity

Table 3

Correlation Coefficients (r) of Visual Emphysema Score with Results of 3D CT Densitometry and Pulmonary Function Tests

jksr-65-247-i003

Note.-Values given are r values on top and p values on bottom.

Percentile15% = the highest density of the lowest lung densities in 15%.

DLco = diffusion capacity of lung for carbon monoxide, FEV1 = forced expiratory volume in 1 second, FVC = forced expiratory vital capacity, TLC = total lung capacity

Table 4

Correlation Coefficients (r) of Dyspnea Score with Results of 3D CT Densitometry and Visual Emphysema Score

jksr-65-247-i004

Note.-Values given are r values on top and p values on bottom.

Percentile15% = the highest density of the lowest lung densities in 15%

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