Relationship Between Quantitative CT Metrics and Pulmonary Function in Combined Pulmonary Fibrosis and Emphysema

Purpose Combined pulmonary fibrosis and emphysema (CPFE) is increasingly recognized, as current reports of its clinical features show. To determine CPFE’s physiologic and radiologic features, we conducted quantitative assessment of computed tomography scans to compare with those of chronic obstructi...

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Veröffentlicht in:Lung 2013-12, Vol.191 (6), p.585-591
Hauptverfasser: Ando, Katsutoshi, Sekiya, Mitsuaki, Tobino, Kazunori, Takahashi, Kazuhisa
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creator Ando, Katsutoshi
Sekiya, Mitsuaki
Tobino, Kazunori
Takahashi, Kazuhisa
description Purpose Combined pulmonary fibrosis and emphysema (CPFE) is increasingly recognized, as current reports of its clinical features show. To determine CPFE’s physiologic and radiologic features, we conducted quantitative assessment of computed tomography scans to compare with those of chronic obstructive pulmonary disease (COPD). Methods In 23 patients with CPFE and 42 patients with COPD, we measured the extent of emphysema (LAA %), parenchymal density, and total cross-sectional areas of pulmonary vessels smaller than 5 mm 2 (%CSA
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To determine CPFE’s physiologic and radiologic features, we conducted quantitative assessment of computed tomography scans to compare with those of chronic obstructive pulmonary disease (COPD). Methods In 23 patients with CPFE and 42 patients with COPD, we measured the extent of emphysema (LAA %), parenchymal density, and total cross-sectional areas of pulmonary vessels smaller than 5 mm 2 (%CSA &lt;5) and 5–10 mm 2 (%CSA 5–10). Results For CPFE, airflow was better, but diffusing capacity for carbon monoxide (DL CO ) was worse than for COPD, whereas LAA % was similar for both groups. The %CSA &lt;5 was greater but %CSA5–10 was less in CPFE than COPD. COPD involved a negative correlation between DL CO and LAA % at all lung sites; those factors correlated for CPFE only in the upper lobe ( r  = −0.535). In contrast, CPFE had a negative correlation between DL CO and parenchymal density in lower lobes ( r  = −0.453), but COPD showed no correlation in any such sections. In CPFE, no correlation was apparent between LAA in upper lobes and parenchymal density in lower lobes. The annual rate of FVC decline (−169.26 ml/year) in CPFE patients correlated with parenchymal density ( r  = −0.714). Conclusions In CPFE, fibrosis and emphysema apparently existed independently, but both correlate with and likely contribute to the disproportionate reduction in gas exchange. Our study also suggested that pulmonary fibrotic changes may be more important contributors than emphysema for disease progression.</description><identifier>ISSN: 0341-2040</identifier><identifier>EISSN: 1432-1750</identifier><identifier>DOI: 10.1007/s00408-013-9513-1</identifier><identifier>PMID: 24085320</identifier><identifier>CODEN: LUNGD9</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Care and treatment ; Chronic obstructive pulmonary disease ; CT imaging ; Development and progression ; Diagnosis ; Disease Progression ; Emphysema ; Emphysema, Pulmonary ; Female ; Forced Expiratory Volume ; Humans ; Lung - diagnostic imaging ; Lung - physiopathology ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Multidetector Computed Tomography ; Pneumology/Respiratory System ; Predictive Value of Tests ; Prognosis ; Pulmonary Diffusing Capacity ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - diagnostic imaging ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Emphysema - complications ; Pulmonary Emphysema - diagnosis ; Pulmonary Emphysema - diagnostic imaging ; Pulmonary Emphysema - physiopathology ; Pulmonary fibrosis ; Pulmonary Fibrosis - complications ; Pulmonary Fibrosis - diagnosis ; Pulmonary Fibrosis - diagnostic imaging ; Pulmonary Fibrosis - physiopathology ; Respiratory Function Tests ; Retrospective Studies ; Risk factors ; Severity of Illness Index ; Tomography ; Vital Capacity</subject><ispartof>Lung, 2013-12, Vol.191 (6), p.585-591</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>COPYRIGHT 2013 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c710t-1cd876116550acfa537486da9dde3b11d83438618a6080288f33a76261fc13943</citedby><cites>FETCH-LOGICAL-c710t-1cd876116550acfa537486da9dde3b11d83438618a6080288f33a76261fc13943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00408-013-9513-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00408-013-9513-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24085320$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ando, Katsutoshi</creatorcontrib><creatorcontrib>Sekiya, Mitsuaki</creatorcontrib><creatorcontrib>Tobino, Kazunori</creatorcontrib><creatorcontrib>Takahashi, Kazuhisa</creatorcontrib><title>Relationship Between Quantitative CT Metrics and Pulmonary Function in Combined Pulmonary Fibrosis and Emphysema</title><title>Lung</title><addtitle>Lung</addtitle><addtitle>Lung</addtitle><description>Purpose Combined pulmonary fibrosis and emphysema (CPFE) is increasingly recognized, as current reports of its clinical features show. To determine CPFE’s physiologic and radiologic features, we conducted quantitative assessment of computed tomography scans to compare with those of chronic obstructive pulmonary disease (COPD). Methods In 23 patients with CPFE and 42 patients with COPD, we measured the extent of emphysema (LAA %), parenchymal density, and total cross-sectional areas of pulmonary vessels smaller than 5 mm 2 (%CSA &lt;5) and 5–10 mm 2 (%CSA 5–10). Results For CPFE, airflow was better, but diffusing capacity for carbon monoxide (DL CO ) was worse than for COPD, whereas LAA % was similar for both groups. The %CSA &lt;5 was greater but %CSA5–10 was less in CPFE than COPD. COPD involved a negative correlation between DL CO and LAA % at all lung sites; those factors correlated for CPFE only in the upper lobe ( r  = −0.535). In contrast, CPFE had a negative correlation between DL CO and parenchymal density in lower lobes ( r  = −0.453), but COPD showed no correlation in any such sections. In CPFE, no correlation was apparent between LAA in upper lobes and parenchymal density in lower lobes. The annual rate of FVC decline (−169.26 ml/year) in CPFE patients correlated with parenchymal density ( r  = −0.714). Conclusions In CPFE, fibrosis and emphysema apparently existed independently, but both correlate with and likely contribute to the disproportionate reduction in gas exchange. Our study also suggested that pulmonary fibrotic changes may be more important contributors than emphysema for disease progression.</description><subject>Aged</subject><subject>Care and treatment</subject><subject>Chronic obstructive pulmonary disease</subject><subject>CT imaging</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Disease Progression</subject><subject>Emphysema</subject><subject>Emphysema, Pulmonary</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - physiopathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Multidetector Computed Tomography</subject><subject>Pneumology/Respiratory System</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Pulmonary Diffusing Capacity</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnostic imaging</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary Emphysema - complications</subject><subject>Pulmonary Emphysema - diagnosis</subject><subject>Pulmonary Emphysema - diagnostic imaging</subject><subject>Pulmonary Emphysema - physiopathology</subject><subject>Pulmonary fibrosis</subject><subject>Pulmonary Fibrosis - complications</subject><subject>Pulmonary Fibrosis - diagnosis</subject><subject>Pulmonary Fibrosis - diagnostic imaging</subject><subject>Pulmonary Fibrosis - physiopathology</subject><subject>Respiratory Function Tests</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Severity of Illness Index</subject><subject>Tomography</subject><subject>Vital Capacity</subject><issn>0341-2040</issn><issn>1432-1750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkl2L1DAUhoMo7jj6A7yRgiDedM3pST_mch12VVjxg_U6ZNLTmSxtMiatsv_e1K7SkXFZAgnkPO97DsnL2HPgp8B5-SZwLniVcsB0lccNHrAFCMxSKHP-kC04CkizyJywJyFccw5lAfljdpJFWY4ZX7D9V2pVb5wNO7NP3lL_k8gmXwZle9PHwg9K1lfJR-q90SFRtk4-D23nrPI3ycVg9ShNjE3WrtsYSwdls_EumEl13u13N4E69ZQ9alQb6NntuWTfLs6v1u_Ty0_vPqzPLlNdAu9T0HUVh4Uiz7nSjcqxFFVRq1VdE24A6goFVgVUquAVz6qqQVRlkRXQaMCVwCV7Pfnuvfs-UOhlZ4KmtlWW3BAkiAIQS8QRffkPeu0Gb-N0I8UFIMyprWpJGtu43is9msozgchFKYrsTgrjk0OG0W3J0iPUlix51TpLjYnXB6734ef-p0f4uGrqjD7a4F6CeYdXM8GOVNvvgmuH31E6dL4TnDvCBOqYmuCpkXtvuhgkCVyOcZdT3GWMuxzjLkfNi9ufGzYd1X8Vf_IdgWwCQizZLfnZ1_7X9RcqBgL4</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Ando, Katsutoshi</creator><creator>Sekiya, Mitsuaki</creator><creator>Tobino, Kazunori</creator><creator>Takahashi, Kazuhisa</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Relationship Between Quantitative CT Metrics and Pulmonary Function in Combined Pulmonary Fibrosis and Emphysema</title><author>Ando, Katsutoshi ; 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To determine CPFE’s physiologic and radiologic features, we conducted quantitative assessment of computed tomography scans to compare with those of chronic obstructive pulmonary disease (COPD). Methods In 23 patients with CPFE and 42 patients with COPD, we measured the extent of emphysema (LAA %), parenchymal density, and total cross-sectional areas of pulmonary vessels smaller than 5 mm 2 (%CSA &lt;5) and 5–10 mm 2 (%CSA 5–10). Results For CPFE, airflow was better, but diffusing capacity for carbon monoxide (DL CO ) was worse than for COPD, whereas LAA % was similar for both groups. The %CSA &lt;5 was greater but %CSA5–10 was less in CPFE than COPD. COPD involved a negative correlation between DL CO and LAA % at all lung sites; those factors correlated for CPFE only in the upper lobe ( r  = −0.535). In contrast, CPFE had a negative correlation between DL CO and parenchymal density in lower lobes ( r  = −0.453), but COPD showed no correlation in any such sections. In CPFE, no correlation was apparent between LAA in upper lobes and parenchymal density in lower lobes. The annual rate of FVC decline (−169.26 ml/year) in CPFE patients correlated with parenchymal density ( r  = −0.714). Conclusions In CPFE, fibrosis and emphysema apparently existed independently, but both correlate with and likely contribute to the disproportionate reduction in gas exchange. Our study also suggested that pulmonary fibrotic changes may be more important contributors than emphysema for disease progression.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>24085320</pmid><doi>10.1007/s00408-013-9513-1</doi><tpages>7</tpages></addata></record>
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subjects Aged
Care and treatment
Chronic obstructive pulmonary disease
CT imaging
Development and progression
Diagnosis
Disease Progression
Emphysema
Emphysema, Pulmonary
Female
Forced Expiratory Volume
Humans
Lung - diagnostic imaging
Lung - physiopathology
Male
Medicine
Medicine & Public Health
Middle Aged
Multidetector Computed Tomography
Pneumology/Respiratory System
Predictive Value of Tests
Prognosis
Pulmonary Diffusing Capacity
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - diagnostic imaging
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Emphysema - complications
Pulmonary Emphysema - diagnosis
Pulmonary Emphysema - diagnostic imaging
Pulmonary Emphysema - physiopathology
Pulmonary fibrosis
Pulmonary Fibrosis - complications
Pulmonary Fibrosis - diagnosis
Pulmonary Fibrosis - diagnostic imaging
Pulmonary Fibrosis - physiopathology
Respiratory Function Tests
Retrospective Studies
Risk factors
Severity of Illness Index
Tomography
Vital Capacity
title Relationship Between Quantitative CT Metrics and Pulmonary Function in Combined Pulmonary Fibrosis and Emphysema
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