RATIONALE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and/or airway narrowing. Computed tomography has been widely used to assess emphysema severity, but less attention has been paid to the assessment of airway disease using computed tomography. OBJECTIVES: To obtain longitudinal images and accurately analyze short axis images of airways with an inner diameter>or=2 mm located anywhere in the lung with new software for measuring airway dimensions using curved multiplanar reconstruction. METHODS: In 52 patients with clinically stable COPD (stage I, 14; stage II, 22; stage III, 14; stage IV, 2), we used the software to analyze the relationship of the airflow limitation index (FEV1, % predicted) with the airway dimensions from the third to the sixth generations of the apical bronchus (B1) of the right upper lobe and the anterior basal bronchus (B8) of the right lower lobe. MEASUREMENTS AND MAIN RESULTS: Airway luminal area (Ai) and wall area percent (WA%) were significantly correlated with FEV1 (% predicted). More importantly, the correlation coefficients (r) improved as the airways became smaller in size from the third (segmental) to sixth generations in both bronchi (Ai: r=0.26, 0.37, 0.58, and 0.64 for B1; r=0.60, 0.65, 0.63, and 0.73 for B8). CONCLUSIONS: We are the first to use three-dimensional computed tomography to demonstrate that airflow limitation in COPD is more closely related to the dimensions of the distal (small) airways than proximal (large) airways.
RATIONALE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and/or airway narrowing. Computed tomography has been widely used to assess emphysema severity, but less attention has been paid to the assessment of airway disease using computed tomography. OBJECTIVES: To obtain longitudinal images and accurately analyze short axis images of airways with an inner diameter>or=2 mm located anywhere in the lung with new software for measuring airway dimensions using curved multiplanar reconstruction. METHODS: In 52 patients with clinically stable COPD (stage I, 14; stage II, 22; stage III, 14; stage IV, 2), we used the software to analyze the relationship of the airflow limitation index (FEV1, % predicted) with the airway dimensions from the third to the sixth generations of the apical bronchus (B1) of the right upper lobe and the anterior basal bronchus (B8) of the right lower lobe. MEASUREMENTS AND MAIN RESULTS: Airway luminal area (Ai) and wall area percent (WA%) were significantly correlated with FEV1 (% predicted). More importantly, the correlation coefficients (r) improved as the airways became smaller in size from the third (segmental) to sixth generations in both bronchi (Ai: r=0.26, 0.37, 0.58, and 0.64 for B1; r=0.60, 0.65, 0.63, and 0.73 for B8). CONCLUSIONS: We are the first to use three-dimensional computed tomography to demonstrate that airflow limitation in COPD is more closely related to the dimensions of the distal (small) airways than proximal (large) airways.
Authors: Jin Hwa Lee; Michael H Cho; Merry-Lynn N McDonald; Craig P Hersh; Peter J Castaldi; James D Crapo; Emily S Wan; Jennifer G Dy; Yale Chang; Elizabeth A Regan; Megan Hardin; Dawn L DeMeo; Edwin K Silverman Journal: Respir Med Date: 2014-08-11 Impact factor: 3.415
Authors: Prescott G Woodruff; Maarten van den Berge; Richard C Boucher; Christopher Brightling; Esteban G Burchard; Stephanie A Christenson; MeiLan K Han; Michael J Holtzman; Monica Kraft; David A Lynch; Fernando D Martinez; Helen K Reddel; Don D Sin; George R Washko; Sally E Wenzel; Antonello Punturieri; Michelle M Freemer; Robert A Wise Journal: Am J Respir Crit Care Med Date: 2017-08-01 Impact factor: 21.405
Authors: Christopher Kloth; Wolfgang Maximilian Thaiss; Hendrik Ditt; Jürgen Hetzel; Eva Schülen; Konstantin Nikolaou; Marius Horger Journal: J Thorac Dis Date: 2016-12 Impact factor: 2.895
Authors: G R Washko; A A Diaz; V Kim; R G Barr; M T Dransfield; J Schroeder; J J Reilly; J W Ramsdell; A McKenzie; E J R Van Beek; D A Lynch; J P Butler; M K Han Journal: J Appl Physiol (1985) Date: 2014-01-16
Authors: Song Soo Kim; Joon Beom Seo; Ho Yun Lee; Dipti V Nevrekar; Anna V Forssen; James D Crapo; Joyce D Schroeder; David A Lynch Journal: Radiology Date: 2012-12-06 Impact factor: 11.105