Clinical features of three-dimensional computed tomography-based radiologic phenotypes of chronic obstructive pulmonary disease.

Abstract

Purpose:

The diagnosis and severity of chronic obstructive pulmonary disease (COPD) are defined by airflow limitation using spirometry. However, COPD has diverse clinical features, and several phenotypes based on non-spirometric data have been investigated. To identify novel phenotypes of COPD using radiologic data obtained by three-dimensional computed tomography (3D-CT).

Patients and methods:

The inner luminal area and wall thickness of third- to sixth-generation bronchi and the percentage of the low-attenuation area (less than -950 HU) of the lungs were measured using 3D-CT in patients with COPD. Using the radiologic data, hierarchical clustering was performed. Respiratory reactance and resistance were measured to evaluate functional differences among the clusters.

Results:

Four clusters were identified among 167 patients with COPD: Cluster I, mild emphysema with severe airway changes, severe airflow limitation, and high exacerbation risk; Cluster II, mild emphysema with moderate airway changes, mild airflow limitation, and mild dyspnea; Cluster III, severe emphysema with moderate airway changes, severe airflow limitation, and increased dyspnea; and Cluster IV, moderate emphysema with mild airway changes, mild airflow limitation, low exacerbation risk, and mild dyspnea. Cluster I had the highest respiratory resistance among the four clusters. Clusters I and III had higher respiratory reactance than Clusters II and IV.

Conclusions:

The 3D-CT-based radiologic phenotypes were associated with the clinical features of COPD. Measurement of respiratory resistance and reactance may help to identify phenotypic differences.

• Authors: Masato Karayama, Naoki Inui, Hideki Yasui, Masato Kono, Hironao Hozumi, Yuzo Suzuki, Kazuki Furuhashi, Dai Hashimoto, Noriyuki Enomoto, Tomoyuki Fujisawa, Yutaro Nakamura, Hiroshi Watanabe, Takafumi Suda
• Journal: International journal of chronic obstructive pulmonary disease (Int J Chron Obstruct Pulmon Dis) Vol. 14 Pg. 1333-1342 ( 2019) ISSN: 1178-2005 [Electronic] New Zealand
• PMID: 31296985 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Airway Remodeling
• Airway Resistance
• Cluster Analysis
• Cross-Sectional Studies
• Dyspnea (diagnostic imaging, physiopathology)
• Female
• Humans
• Imaging, Three-Dimensional
• Lung (diagnostic imaging, physiopathology)
• Male
• Middle Aged
• Phenotype
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• Pulmonary Disease, Chronic Obstructive (diagnostic imaging, physiopathology)
• Pulmonary Emphysema (diagnostic imaging, physiopathology)
• Severity of Illness Index
• Tomography, X-Ray Computed