Asynchrony in respiratory movements between the pulmonary lobes in patients with COPD: continuous measurement of lung density by 4-dimensional dynamic-ventilation CT

Four-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density duri...

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Bibliographic Details
Published in:	International journal of chronic obstructive pulmonary disease 2017-01, Vol.12, p.2101-2109
Main Authors:	Yamashiro, Tsuneo, Moriya, Hiroshi, Matsuoka, Shin, Nagatani, Yukihiro, Tsubakimoto, Maho, Tsuchiya, Nanae, Murayama, Sadayuki
Format:	Article
Language:	eng
Subjects:	Aged Aged, 80 and over airflow limitation Care and treatment CAT scans Chronic obstructive lung disease Chronic obstructive pulmonary disease Computed tomography CT imaging Diaphragm (Anatomy) Emphysema Emphysema, Pulmonary Female Forced Expiratory Volume Four-Dimensional Computed Tomography Health aspects Humans Lung - diagnostic imaging Lung - physiopathology Lung diseases, Obstructive Lungs Male mean lung density Measurement Medical imaging Middle Aged Movement Multidetector Computed Tomography Original Research Predictive Value of Tests Pulmonary Disease, Chronic Obstructive - diagnostic imaging Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary Ventilation Radiation Radiographic Image Interpretation, Computer-Assisted Respiration Smokers Smoking - adverse effects Smoking - physiopathology Software Spirometry Thorax Time Factors Vital Capacity
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Summary:	Four-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density during respiration on the dynamic-ventilation CT. Thirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during free breathing. CT data were continuously reconstructed every 0.5 sec. Mean lung density (MLD) of the five lobes (right upper [RU], right middle [RM], right lower [RL], left upper [LU], and left lower [LL]) was continuously measured by commercially available software using a fixed volume of volume of interest which was placed and tracked on a single designated point in each lobe. Concordance between the MLD time curves of six pairs of lung lobes (RU-RL, RU-RM, RM-RL, LU-LL, RU-LU, and RL-LL lobes) was expressed by cross-correlation coefficients. The relationship between these cross-correlation coefficients and the forced expiratory volume in one second/forced vital capacity (FEV /FVC) values was assessed by Spearman rank correlation analysis. In all six pairs of the pulmonary lobes, the cross-correlation coefficients of the two MLD curves were significantly positively correlated with FEV /FVC (ρ =0.60-0.73,
ISSN:	1178-2005 1176-9106 1178-2005