CT Metrics of Airway Disease and Emphysema in Severe COPD

Woo Jin Kim, Edwin K. Silverman, Eric Hoffman, Gerald J. Criner, Zab Mosenifar, Frank C. Sciurba, Barry J. Make, Vincent Carey, R. San Jose Estepar, Alejandro Diaz, John J. Reilly, Fernando J. Martinez, George R. Washko
Chest
2009

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Abstract

Background: CT measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT-assessed airway disease to objective measures of lung function and respiratory symptoms such as dyspnea in severe emphysema is less clear.

Methods: Using data from 338 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study, densitometric measures of emphysema using a threshold of -950 (%LAA-950) Hounsfield Units and airway wall phenotypes of the wall thickness (WT) and the square root of wall area (SRWA) of a 10mm luminal perimeter airway were calculated for each subject. Linear regression analysis was performed for outcome variables FEV1 and percent predicted value of FEV1 with CT measures of emphysema and airway disease.

Results: In univariate analysis, there were significant negative correlations between %LAA-950 and both the WT (r= -20.28, p = 0.0001) and SRWA (r= -0.19, p = 0.0008). Airway wall thickness was weakly but significantly correlated with post-bronchodilator FEV1% predicted (R= -0.12, p = 0.02). Multivariate analysis showed significant associations between either WT or SRWA (beta=-5.2, p = 0.009, beta=-2.6, p = 0.008), and %LAA-950 (beta=-10.6, p = 0.03) with the post-bronchodilator FEV1% predicted. Male subjects exhibited significantly thicker airway wall phenotypes (p = 0.007 for WT and p = 0.0006 for SRWA).

Conclusion: CT airway disease and emphysema are inversely related in severe COPD. Airway wall phenotypes were influenced by gender and associated with lung function in subjects with severe emphysema. %%%%%%%%%%%%%%%%% lmi.bib, 2008 %%%%%%%%%%%%%%%%%%%%%%

Reference

Kim WJ, Silverman EK, Hoffman E, Criner GJ, Mosenifar Z, Sciurba FC, Make BJ, Carey V, San Jose Estepar R, Diaz A, Reilly JJ, Martinez FJ, Washko GR. Ct metrics of airway disease and emphysema in severe copd. Chest 2009;.

Bibtex entry

@Article{kimChest09,
  author         = {Woo Jin Kim and Edwin K. Silverman and Eric Hoffman and    
                   Gerald J. Criner and  Zab Mosenifar and Frank C. Sciurba and
                   Barry J. Make and Vincent Carey and  Raul {San Jose Estepar}
                   and Alejandro Diaz and John J. Reilly and Fernando J.       
                   Martinez  and George R. Washko},                            
  title          = {CT Metrics of Airway Disease and Emphysema in Severe COPD},
  journal        = {Chest},                                                    
  year           = {2009},                                                     
  annote         = {In Press}
}