J Korean Soc Radiol.  2011 Sep;65(3):247-256.

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

• Park HJ
• Hwang JH

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.

MeSH Terms

Densitometry
Dyspnea
Emphysema
Humans
Lung
Male
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Respiratory Function Tests
Thorax

Figure

• 

  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

• 

  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

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