Updates in computed tomography assessment of emphysema using computed tomography lung analysis

Abstract

IntroductionComputed tomography (CT) lung analysis is a new CT technique that allows assessment of emphysema in a quantitative pattern to avoid subjective analysis.ObjectiveThe aim of this study was to assess the role of a new CT lung analysis in quantitative assessment of pulmonary emphysema.Patients and methodsTotally, 30 patients with emphysema were included in this study who presented to the Chest Department of Ain Shams University for follow-up. All patients underwent full history taking, clinical examination, spirometry, and body plethysmography, and were then referred to the Radiology Department for noncontrast chest CT followed by lung volume analysis. Four patients among them were followed-up before and after medical volume reduction therapy.ResultsThere was a direct relationship between the CT lung volume, the percentage of low-attenuation area, as well as the total lung capacity measured by body plethysmography. Totally, 12 cases were found to be grade I by the Goddard score, with nine of them found to be GOLD I and three of them found to be GOLD II. Fifteen cases were found to be grade II by the Goddard score, with 12 of them found to be GOLD II and three of them found to be GOLD III/IV. Three cases were found to be grade III by the Goddard score with all of them found to be GOLD III/IV. The main site for distribution of the clusters according to their number was in the left upper lobe, whereas according to the cluster volume the main site was the right upper lobe. CT lung analysis guided the site of injection in four patients who underwent volume reduction therapy.ConclusionCT lung analysis is a new technique that allows quantitative assessment of emphysema, which is important for categorization, follow-up, and treatment strategies. It must be added as a routine study accompanied by spirometric function.