Emphysema extent on computed tomography is a highly specific index in diagnosing persistent airflow limitation: a real-world study in China

Abstract

Objective

The diagnostic value of emphysema extent in consistent air flow limitation remains controversial. Therefore, we aimed to assess the value of emphysema extent on computed tomography (CT) on the diagnosis of persistent airflow limitation. Furthermore, we developed a diagnostic criterion for further verification.

Materials and methods

We retrospectively enrolled patients who underwent chest CT and lung function test. To be specific, 671 patients were enrolled in the derivation group (Group 1.1), while 479 patients were in the internal validation group (Group 1.2). The percentage of lung volume occupied by low attenuation areas (LAA%) and the percentile of the histogram of attenuation values were calculated.

Results

In patients with persistent airflow limitation, the LAA% was higher and the percentile of the histogram of attenuation values was lower, compared with patients without persistent airflow limitation. Using LAA% with a threshold of −950 HU >1.4% as the criterion, the sensitivity was 44.3% and 47.2%, and the specificity was 95.2% and 95.7%, in Group 1.1 and Group 1.2, respectively. The specificity was influenced by the coexistence of interstitial lung disease, pneumothorax, and post-surgery, rather than the coexistence of pneumonia, nodule, or mass. Multivariable models were also developed.

Conclusion

The emphysema extent on CT is a highly specific marker in the diagnosis of persistent airflow limitation.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2019

Publication date (Electronic): 17 December 2018

Volume: 14

Pages: 13-26

Affiliations

[1 ]Department of Respiratory Medicine, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China, hy_wan2013@ 123456163.com

[2 ]School of Public Health, Fudan University, Shanghai, China

[3 ]Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China, hy_wan2013@ 123456163.com , shiguochao@ 123456hotmail.com

[4 ]Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, shiguochao@ 123456hotmail.com

[5 ]Department of Radiology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Author notes

Correspondence: Huan Ying Wan, Department of Respiratory Medicine, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, No 999, Xiwang Road, Malu Town, Jiading, Shanghai 201801, China, Tel [phone], Fax [phone], Email hy_wan2013@ 123456163.com

Guo Chao Shi, Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No 197, Ruijin Er Road, Huangpu District, Shanghai 200025, China, Email shiguochao@ 123456hotmail.com

Article

Publisher ID: copd-14-013

DOI: 10.2147/COPD.S157141

PMC ID: 6301435

Copyright statement: © 2019 Cheng et al. This work is published and licensed by Dove Medical Press Limited

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Categories

Subject: Original Research