AB021. Validation of real-world, non-research thoracic CT scans for quantitative analysis of COPD

Abstract

Background Quantitative CT (QCT) imaging plays an important role in phenotyping COPD and uses the voxel density histogram to measure total lung volume (TLV) and emphysema surrogates: low attenuation area (LAA) and lung density (LD). LD is often volume corrected using the predicted total lung capacity (TLC) to compensate for submaximal inspiration prior to image acquisition. QCT is carried out with careful attention to quality control including scanner make/model, calibration frequency, lung volume, acquisition protocol, and the use of contrast, and bears a financial and radiation cost. We wished to determine if: (I) thoracic CT scans acquired for clinical indications on a variety of scanners from different centres with varying calibration frequency, acquisition protocols and only simple breath holding instructions could yield reproducible data; (II) volume correcting LAA and LD using the pulmonary function test (PFT) measured TLC would compensate for submaximal inspiration better than using the predicted TLC; and (III) contrast infusion causes predictable changes in the QCT metrics TLV, LAA and LD.