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Fully automatic quantitative assessment of emphysema in computed tomography: comparison with pulmonary function testing and normal values

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Abstract

Characterisation and quantification of emphysema are necessary for planning of local treatment and monitoring. Sensitive, easy to measure, and stable parameters have to be established and their relation to the well-known pulmonary function testing (PFT) has to be investigated. A retrospective analysis of 221 nonenhanced thin-section MDCT with a corresponding PFT was carried out, with a subgroup analysis in 102 COPD stage III+IV, 44 COPD stage 0, and 33 investigations into interstitial lung disease (ILD). The in-house YACTA software was used for automatic quantification of lung and emphysema volume [l], emphysema index, mean lung density (MLD [HU]) and 15th percentile [HU]. CT-derived lung volume is significantly smaller in ILD (3.8) and larger in COPD (7.2) than in controls (5.9, p < 0.0001). Emphysema volume and index are significantly higher in COPD than in controls (3.2 vs. 0.5, p < 0.0001, 45% vs. 8%, p < 0.0001). MLD and 15th percentile are significantly smaller in COPD (−877/−985, p < 0.0001) and significantly higher in ILD (−777, p < 0.0006/−914, p < 0.0001) than in controls (−829/−935). A relevant amount of COPD patients apparently do not suffer from emphysema, while controls who do not fulfil PFT criteria for COPD also demonstrate CT features of emphysema. Automatic quantification of thin-section CT delivers convincing parameters and ranges that are able to differentiate among emphysema, control and ILD. An emphysema index of lower 20%, MLD higher than −850, and 15th percentile lower than −950 might be regarded as normal (thin-section, nonenhanced, B40, YACTA). These ranges might be helpful in the judgement of individual measures.

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Abbreviations

6MWT:

six-minute-walk test

COPD:

chronic obstructive pulmonary disease

EI:

emphysema index

EV:

emphysema volume

FEV1 :

forced expiratory volume in 1 s

FVC:

forced vital capacity

ILD:

interstitial lung disease

ITGV:

intrathoracic gas volume

LV:

lung volume

MLD:

mean lung density

NSIP:

nonspecific interstitial pneumonia

PFT:

pulmonary function test

RV:

residual volume

TLC:

total lung capacity

UIP:

usual interstitial pneumonia

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Authors and Affiliations

  1. Thoraxklinik Heidelberg, University Hospital Heidelberg, Amalienstrasse 5, 69126, Heidelberg, Germany

    C. P. Heussel, F. J. F. Herth, J. Kappes, R. Hantusch, S. Hartlieb & R. Eberhardt

  2. Department of Interventional and Diagnostic Radiology, Thoraxklinik Heidelberg, University Hospital Heidelberg, Amalienstrasse 5, 69126, Heidelberg, Germany

    C. P. Heussel, R. Hantusch & S. Hartlieb

  3. Department of Pneumology and Critical Care Medicine, Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Heidelberg, Germany

    F. J. F. Herth, J. Kappes & R. Eberhardt

  4. Department of Interventional and Diagnostic Radiology (Prof. Dr. C. Düber), Johannes Gutenberg University, Langenbeckstrasse 1, 55131, Mainz, Germany

    O. Weinheimer

  5. Department of Diagnostic Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    H. U. Kauczor

Authors
  1. C. P. Heussel
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  2. F. J. F. Herth
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  3. J. Kappes
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  4. R. Hantusch
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  6. O. Weinheimer
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  7. H. U. Kauczor
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  8. R. Eberhardt
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Correspondence to C. P. Heussel.

Additional information

This manuscript includes major parts of the doctoral thesis of Romy Hantusch and Simon Hartlieb.

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Heussel, C.P., Herth, F.J.F., Kappes, J. et al. Fully automatic quantitative assessment of emphysema in computed tomography: comparison with pulmonary function testing and normal values. Eur Radiol 19, 2391–2402 (2009). https://doi.org/10.1007/s00330-009-1437-z

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  • DOI: https://doi.org/10.1007/s00330-009-1437-z

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