Quantitative CT in Chronic Obstructive Pulmonary Disease: Inspiratory and Expiratory Assessment
|
|
- Bernard Morgan
- 6 years ago
- Views:
Transcription
1 Cardiopulmonary Imaging Original Research kira et al. CT of Chronic Obstructive Pulmonary Disease Cardiopulmonary Imaging Original Research Masanori kira 1 Kazushige Toyokawa 1 Yoshikazu Inoue 2 Toru rai 2 kira M, Toyokawa K, Inoue Y, rai T Keywords: chronic obstructive pulmonary disease (COPD), emphysema, MDCT DOI: /JR Received March 6, 2008; accepted after revision ugust 5, Partially supported by a grant to the Respiratory Failure Research Group from the Ministry of Health Labour and Welfare, Japan, and National Hospital Organization Research Grant, Japan. 1 Department of Radiology, National Hospital Organization, Kinki-Chuo Chest Medical Center, 1180 Nagasonecho, Kita-ku, Sakai City, Osaka , Japan. ddress correspondence to M. kira (kira@kch.hosp.go.jp). 2 Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan. JR 2009; 192: X/09/ merican Roentgen Ray Society Quantitative CT in Chronic Obstructive Pulmonary Disease: Inspiratory and Expiratory ssessment OJECTIVE. The purpose of this study was to determine whether measurements of lung attenuation at inspiration and expiration obtained from 3D lung reconstructions reflect the severity of chronic obstructive pulmonary disease. SUbjects and METHODS. Seventy-six patients with chronic obstructive pulmonary disease underwent MDCT with 3D postprocessing at full inspiration and full expiration. Inspiratory and expiratory mean lung density, percentage of lung volume with attenuation values less than 910 HU and 950 HU at inspiration and expiration, expiratory to inspiratory mean lung density ratio, and fifth and 15th percentiles of the lung attenuation distribution curve at inspiration and expiration were measured. RESULTS. When forced expiratory volume in the first second of expiration ( ) was 50% or greater than predicted value, mean lung density and lower attenuation volume measured from inspiratory MDCT scans correlated better with and ratio of to forced vital capacity (FVC) than did those from expiratory scans. When was less than 50% of predicted value, mean lung density and lower attenuation volume measured from expiratory MDCT scans correlated better with and ratio of residual volume to total lung capacity than did those values from inspiratory scans. Fifth percentile and 15th percentile of the lung attenuation distribution curve at both full inspiration and full expiration correlated well with /FVC and diffusing capacity of the lung for carbon monoxide as a percentage of predicted value but not well with as a percentage of predicted value regardless of. CONCLUSION. Measurements of lung attenuation obtained at inspiration and visual score better reflect abnormal results of pulmonary function tests in patients with less severe chronic obstructive pulmonary disease than do measurements obtained at expiration. Measurements of lung attenuation obtained at expiration better reflect pulmonary function abnormalities in patients with severe chronic obstructive pulmonary disease. T he potential usefulness of CT for identification of regions of pulmonary emphysema and air trapping has been addressed in many investigations [1]. Low-attenuation areas on CT scans in vivo have been found to represent macroscopic and microscopic emphysematous changes in the lungs of patients [2 4]. To objectively quantify pulmonary emphysema with CT, several lung attenuation parameters based on results of histogram analysis of the frequency distribution of the attenuation values of the lung have been developed. The most commonly used methods are based on measurement of mean lung attenuation, the areas of lung occupied by attenuation values lower than predetermined thresholds, and a predetermined percentile of the lung attenuation distribution curve. Many reports have confirmed good correlations of histogram-derived quantitative CT techniques with the results of lung function tests and pathologic evidence of emphysema [1]. The purpose of our study was to determine whether measurements of lung attenuation obtained from 3D lung reconstructions at inspiration and expiration reflect the severity of chronic obstructive pulmonary disease (COPD). We correlated lung function measurements at inspiration and expiration with measurements of lung attenuation on 3D lung reconstructions. We also evaluated the relation between the severity of COPD, reflected by Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage [5], and measurements of lung attenuation on 3D lung reconstructions. JR:192, January
2 kira et al. Subjects and Methods total of 76 smokers were recruited at our institution. The 67 men and nine women (mean age, 67.3 years; range, years) were included because they had a diagnosis of COPD according to the criteria of the merican Thoracic Society [6]. ll subjects were long-term cigarette smokers with an average smoking history of 1,142 ± 592 on the rinkman index (cigarettes/day years). ccording to the GOLD classification [5], six patients had stage 0; two, stage 1; 20, stage 2; 30, stage 3; and 18, stage 4 COPD (Table 1). The study was approved by the ethics committee of our hospital, and informed consent was obtained from each participant. Lung Function Studies ll pulmonary function studies were performed in the same laboratory with methods consistent with merican Thoracic Society recommendations [7] when the patients were in clinically stable condition. The results were compared with predicted values [8]. The pulmonary function tests were performed at the time of 3D lung CT. Lung CT Studies ll CT examinations were performed with a 16- MDCT scanner (HiSpeed Ultra 16, GE Healthcare). The scanner was subject to a weekly quality assessment with a phantom check including uniformity, linearity, and noise. ir and water phantoms were used to calibrate the CT scanner. In addition, an engineering check of spatial and contrast resolution was performed every 3 months and a medical physics check once a year. Scanning voltage was 120 kv and current was 160 m. In each case, CT of the thorax was performed from the lung apices through the level of the adrenal glands at full inspiration and was repeated at full expiration. ll imaging was performed with a collimation of mm, table feed of 30 mm/ rotation, and rotation time of 0.6 second/360 tube rotation with a standard reconstruction algorithm. The mean breath-hold was 7 seconds for one scan. Three-dimensional models of the lungs were reconstructed with analysis software (dvantage Windows 3D, GE Healthcare). Threshold limits of 500 to 1,024 HU were applied to exclude soft tissue surrounding the lung and large vessels within the lung. The 3D model was viewed as a shaded surface display at multiple angles to ensure that the model was valid. The trachea, mainstem bronchi, and gastrointestinal structures were selectively removed manually from the model (Fig. 1). histogram of the model showed the volume, attenuation distribution, mean attenuation, and SD of attenuation of the whole lung. The histogram provided a frequency distribution of voxels TLE 1: Clinical Characteristics ccording to Global Initiative for Chronic Obstructive Lung Disease of Chronic Obstructive Pulmonary Disease Characteristic with special attenuation values in the lung. The percent age of voxels with attenuation values below a specified level was defined as the lower attenuation volume at that threshold. Values for the lower attenuation volume at thresholds of 910 and 950 HU and the fifth and 15th percentiles were measured by moving the boundary line on the histogram. The ratio of expiration to inspiration (E/I) was obtained by dividing the mean lung density at full expiration by that at full inspiration [9]. On hard-copy inspiratory CT images photographed at a window width of 1,200 HU and centered at a level of 700 HU, visual emphysema scores for all axial sections were determined for each patient. Emphysema was identified as areas of hypovascular low attenuation and was graded on a 5-point scale based on the percentage of lung involved: 0, no emphysema; 1, up to 25% of lung parenchyma involved; 2, between 26% and 50% of lung parenchyma involved; 3, between 51% and 75% of lung parenchyma involved; and 4, 0 or 1, t Risk or Mild 2, Moderate 3, Severe 4, Very Severe No. of patients ge (y) 62.7 ± ± ± ± 9.3 (% of predicted) 90.2 ± ± ± ± 3.9 /FVC 72.5 ± ± ± ± 5.2 Dl c o (% of predicted) 82.5 ± ± ± ± 21.1 RV/TLC 33.4 ± ± ± ± 11.8 Note FEV = forced expiratory volume in first second of expiration, /FVC = ratio of to forced vital capacity; Dl c o = diffusing capacity of the lung for carbon monoxide, RV/TLC = ratio of residual volume to total lung capacity. Fig year-old man with chronic obstructive pulmonary disease. and, nterior view 3D images reconstructed from inspiratory () and expiratory () MDCT scans. between 76% and 100% of lung parenchyma involved. Grades for the axial images of each lung were added and divided by the number of images evaluated to yield emphysema scores that ranged from 0 to 4 [10]. Statistical nalysis Statistical analysis was performed with SPSS software (version 12.0, SPSS) by comparison of entity to pulmonary function test values with Spearman s correlation coefficients. For evaluation between different COPD levels, the Mann- Whitney U test was used. value of p < 0.05 was considered statistically significant. stepwise procedure was used to identify the subset of independent variables that were good predictors of the pulmonary function measurements. Results Table 2 shows the Spearman s correlation between CT parameters and results of pulmonary 268 JR:192, January 2009
3 CT of Chronic Obstructive Pulmonary Disease TLE 2: Spearman s Correlation Coefficients for Comparison etween CT and Pulmonary Function Data in the Evaluation of Chronic Obstructive Pulmonary Disease (n = 76) CT Parameter function tests. Histogram-derived quantitative CT techniques and visual score had significant good correlation with pulmonary function test results. However, when was 50% of the predicted value or greater (Table 3), mean lung density and lower attenuation volume measured from inspiratory MDCT scans correlated better with and /FVC than did those values on expiratory scans. Fifth percentile at full inspiration and at full expiration and 15th percentile at full inspiration and at full expiration had a strong correlation with /FVC and diffusing capacity of the lung for carbon monoxide (Dl c o) as percentage of predicted value but a much weaker correlation with. E/I correlated well with residual volume (RV)/TLC alone. Visual score correlated well with, /FVC, and Dl c o. In patients with less than 50% of predicted value (Table 4), mean lung density and lower attenuation volume measured from expiratory MDCT scans correlated better with and RV/TLC than did those values from inspiratory scans. Fifth and 15th percentiles at both full inspiration and full expiration correlated well with /FVC, RV/TLC, and Dl c o, but the correlation with was much weaker. E/I correlated well with and (% of Predicted) /FVC RV/TLC RV/TLC. Visual score correlated well with Dlco alone. Figures 2 6 show a variety of CT parameters in relation to GOLD stage of COPD. There were trends for lower attenuation volume, visual score, and E/I to increase with advancing disease stage. Trends were also observed for mean lung density and percentile of the frequency distribution curve to decrease with advancing disease stage. Statistically significant differences in none of CT parameters were found between patients with GOLD stage 0 and those with GOLD stage 1 disease. Statistically significant differences TLE 3: Spearman s Correlation Coefficients for Comparison etween CT and Pulmonary Function Data in the Evaluation of Chronic Obstructive Pulmonary Disease ( 50%, n = 28) CT Parameter (% of Predicted) /FVC RV/TLC Dl c o (% of Predicted) Inspiratory mean lung density a a a Expiratory mean lung density a a Proportion of lung volume with attenuation value less than 910 HU at inspiration a a Proportion of lung volume with attenuation value less than 910 HU at expiration a a Proportion of lung volume with attenuation value less than 950 HU at inspiration a a a Proportion of lung volume with attenuation value less than 950 HU at expiration a a a Fifth percentile of the lung attenuation distribution curve at inspiration a a Fifth percentile of the lung attenuation distribution curve at expiration a a 15th percentile of the lung attenuation distribution curve at inspiration a a 15th percentile of the lung attenuation distribution curve at expiration a a Ratio of expiratory mean lung density to inspiratory mean lung density a Dl c o (% of Predicted) Inspiratory mean lung density Expiratory mean lung density Proportion of lung volume with attenuation value less than 910 HU at inspiration Proportion of lung volume with attenuation value less than 910 HU at expiration Proportion of lung volume with attenuation value less than 950 HU at inspiration Proportion of lung volume with attenuation value less than 950 HU at expiration Fifth percentile of the lung attenuation distribution curve at inspiration Fifth percentile of the lung attenuation distribution curve at expiration th percentile of the lung attenuation distribution curve at inspiration th percentile of the lung attenuation distribution curve at expiration Ratio of expiratory mean lung density to inspiratory mean lung density Visual score Note ll differences are statistically significant. FEV = forced expiratory volume in first second of expiration, /FVC = ratio of to forced vital capacity; RV/TLC = ratio of residual volume to total lung capacity, Dl c o = diffusing capacity of the lung for carbon monoxide. Visual score a a a Note FEV = forced expiratory volume in first second of expiration, /FVC = ratio of to forced vital capacity; RV/TLC = ratio of residual volume to total lung capacity, Dlco = diffusing capacity of the lung for carbon monoxide. a Statistically significant difference. JR:192, January
4 kira et al. TLE 4: Spearman s Correlation Coefficients for Comparison etween CT and Pulmonary Function Data in the Evaluation of Chronic Obstructive Pulmonary Disease ( < 50%, n = 48) Mean Lung Density p = p = p = in inspiratory mean lung density were found from GOLD stage 1 (combined stages 0 and 1) to GOLD stage 4 (Fig. 2). No significant differences in lower attenuation volume measured from inspiratory scans (Fig. 3) or visual score (Fig. 4) were found between patients with GOLD stage 3 and those with GOLD stage 4 disease. Significant differences in expiratory mean lung density (Fig. 2) and lower attenuation volume measured from expiratory scans (Fig. 3) were found between patients with GOLD stage 3 and those with GOLD stage 4 disease, but no significant differences in these values were found between patients with GOLD stages 0 and 1 and those with GOLD stage 2 disease. Significant differences in fifth percentile at full inspiration (Fig. 5), fifth percentile at full expiration (Fig. 5), 15th percentile at full CT Parameter (% of Predicted) /FVC RV/TLC Dl c o (% of Predicted) Inspiratory mean lung density a a Expiratory mean lung density a a a Proportion of lung volume with attenuation value less than 910 HU at inspiration a a Proportion of lung volume with attenuation value less than 910 HU at expiration a a a Proportion of lung volume with attenuation value less than 950 HU at inspiration a a Proportion of lung volume with attenuation value less than 950 HU at expiration a a a Fifth percentile of the lung attenuation distribution curve at inspiration a a a Fifth percentile of the lung attenuation distribution curve at expiration a a a 15th percentile of the lung attenuation distribution curve at inspiration a a a 15th percentile of the lung attenuation distribution curve at expiration a a a Ratio of expiratory mean lung density to inspiratory mean lung density a a Visual score a a Note FEV = forced expiratory volume in first second of expiration, /FVC = ratio of to forced vital capacity; RV/TLC = ratio of residual volume to total lung capacity, Dlco = diffusing capacity of the lung for carbon monoxide. a Statistically significant difference. Mean Lung Density p = p = p = inspiration, 15th percentile at full expiration, and E/I (Fig. 6) were found only between patients with GOLD stage 2 and those with GOLD stage 3 disease. Stepwise multiple regression analysis revealed that the combination of visual score and mean lung density at full expiration was associated with as percentage of predicted value (r = 0.752, p < 0.001). The following equation was derived: as percentage of predicted value = (0.980 visual score) + (0.291 mean lung density at full expiration). Discussion The chronic airflow limitation characteristic of COPD is caused by a mixture of small airways disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), the Fig. 2 Mean lung density according to Global Initiative for Chronic Obstructive Lung Disease stage in patients with chronic obstructive pulmonary disease., Graph shows results at full inspiration., Graph shows results at full expiration. relative contributions of which vary from person to person [5]. Gelb et al. [11] found a strong negative correlation between diffusing capacity as percentage of predicted value and diffusing capacity per alveolar volume and CT emphysema score only in patients with an of 1 L or more. mong patients with an less than 1 L, however, the correlation was much weaker. In only 10 of 35 patients with an less than 50% of predicted was the CT emphysema score greater than 40, indicating marked emphysema. Those authors concluded that CT visual emphysema score was not predominantly responsible for airflow limitation in COPD and that emphysema did not appear to be primarily responsible for severe expiratory airflow limitation in most patients with severe COPD. Zaporozhan et al. [12] also reported that no differences in inspiratory to 270 JR:192, January 2009
5 CT of Chronic Obstructive Pulmonary Disease Percentage Lung Volume at 950 HU expiratory emphysema index or changes in emphysema index and lung volume were found between patients with GOLD 3 and those with GOLD 4 disease. It remains unsettled whether inspiratory CT or expiratory CT is better for evaluating the severity of COPD. Studies [12 14] showed that the highest correlations between CT findings and physiologic variables consistent with emphysema were observed with CT measurements obtained at full expiration. Visual score correlates closely with morphologic emphysema and has better correlation with Dl c o as a percentage of predicted value. It does not reflect the site of small airways disease. Expiratory quantitative CT parameters are affected by peripheral airway obstruction and air trapping. In our study, mean lung density and lower attenuation volume measured from inspiratory MDCT scans Visual Score p = p = p = p = p = p = Fig. 4 Graph shows visual CT score according to Global Initiative for Chronic Obstructive Lung Disease stage in patients with chronic obstructive pulmonary disease. Percentage Lung Volume at 950 HU p = p = p = better correlated with as a percentage of predicted value and /FVC than did those values from expiratory scans when was 50% of predicted value or greater. In patients with less than 50% of predicted value, mean lung density and lower attenuation volume measured from expiratory MDCT scans better correlated with and RV/TLC than did the values from inspiratory scans. Fifth and 15th percentiles at both full inspiration and full expiration correlated well with /FVC and Dl c o but not well with whether was 50% of predicted value or greater or less than 50% of predicted value. The percentiles also correlated well with RV/TLC when was less than 50% of predicted value. Our study had limitations. The mean effective radiation dose to the chest for volumetric MDCT was 8 msv (range, 6 10 msv). Low-dose CT may be a clinically acceptable and diagnostically adequate technique for CT quantification of emphysema. Comparing standard-dose (effective tube current, ms) and low-radiation-dose (effective tube current, ms) techniques in the CT quantification of emphysema, Gierada et al. [15] found that low- and standard-dose emphysema indexes correlated at all attenuation thresholds. Mean emphysema indexes were higher on the low-dose scans, but the mean difference at all thresholds was less than 3%. Stolk et al. [16] using 4-MDCT imaged 10 patients with emphysema on two occasions 2 weeks apart. Scanning parameters were 140 kv, 20 ms, mm collimation, and effective thickness of 2.5 mm. The repeatability of the 15th percentile and the density-mask value of 910 HU was excellent with an estimated CT dose per examination of 0.7 msv for a chest 30 cm long. Fig. 3 Percentage lung volume at threshold of 950 HU according to Global Initiative for Chronic Obstructive Lung Disease stage in patients with chronic obstructive pulmonary disease., Graph shows results at full inspiration., Graph shows results at full expiration. Our study was different from other studies in materials and method. Zaporozhan et al. [12] obtained paired inspiratory and expiratory MDCT scans of 31 patients who had severe emphysema due to COPD (GOLD stages 3 and 4). They concluded that emphysema volumes measured from expiratory MDCT scans better reflect pulmonary function test abnormalities in patients with severe emphysema than do the values from inspiratory scans. Changes in relative emphysema volume were found between patients with GOLD stages 3 and 4 disease. t expiration, there was a change from the large emphysema cluster (3D volume class 4, > 120 mm 3 ) to the intermediate cluster (class 2, 8 65 mm 3 ; class 3, mm 3 ) and small cluster (class 1, 2 8 mm 3 ). The findings by Zaporozhan et al. were consistent with our findings in patients with GOLD stages 3 and 4 disease. Using paired inspiratory and expiratory volumetric MDCT scans of 36 patients with COPD, Matsuoka et al. [17] determined the attenuation threshold value from the detection and quantification of air trapping in COPD regardless of the degree of emphysema. In that study, a lung volume less than 950 HU was segmented as emphysema and eliminated. Changes in lung volume with attenuation values between 860 and 950 HU at inspiratory and expiratory CT significantly correlated with the results of pulmonary func tion tests, except for Dl c o in the moderate to severe emphysema group. In the minimal or mild emphysema group, all densitometric parameters correlated with pulmonary function test results. Mergo et al. [18] found that 3D volumetric reconstructions of hypoattenuating lung correlated well with pulmonary function test results and that inspiratory and expiratory data also were correlative. JR:192, January
6 kira et al. Fifth Percentile of Lung ttenuation Distribution Curve E/I Ratio , p = p = p = p = p = p = Fig. 6 Graph shows expiratory/inspiratory mean lung density ratio (E/I) according to Global Initiative for Chronic Obstructive Lung Disease stage in patients with chronic obstructive pulmonary disease. Visual score is useful in imaging of patients with less severe COPD. Measurements of lung attenuation obtained from 3D lung reconstructions at inspiration and expiration reflect different aspects of the severity of COPD. Measurements from inspiratory scans better reflect airflow limitation than do measurements from expiratory scans in mild or moderate COPD ( 50%). Measurements from expiratory scans better reflect airflow limitation than do measurements Fifth Percentile of Lung ttenuation Distribution Curve ,000 p = p = p = Fig. 5 Fifth percentile of lung attenuation distribution curve according to Global Initiative for Chronic Obstructive Lung Disease stage in patients with chronic obstructive pulmonary disease., Graph shows results at inspiration., Graph shows results at expiration. from inspiratory scans in severe COPD ( < 50%), apart from a predetermined percentile of the lung attenuation distribution curve. The combination of several measurements including visual score and expiratory measurements may be needed for assessing the severity of COPD. References 1. Coxson HO, Rogers RM. Quantitative computed tomography of chronic obstructive pulmonary disease. cad Radiol 2005; 12: Gevenois P, de Maertelaer V, De Vuyst P, Zanen J, Yernault JC. Comparison of computed density and macroscopic morphometry in pulmonary emphysema. m J Respir Crit Care Med 1995; 152: Gevenois P, De Vuyst P, de Maertelaer V, et al. Comparison of computed density and microscopic morphometry in pulmonary emphysema. m J Respir Crit Care Med 1996; 154: Müller NL, Staples C, Miller RR, bboud RT. Density mask : an objective method to quantitate emphysema using computed tomography. Chest 1988; 94: Global Initiative for Chronic Obstructive Lung Disease (GOLD) Update: GOLD workshop report, global strategy for diagnosis, management, and prevention of COPD. NIH publication GOLD Web site. ccessed May 3, [No authors listed]. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. merican Thoracic Society. m J Respir Crit Care Med 1995; 152[suppl]:S77 S83 7. [No authors listed]. Standardization of spirometry: 1987 update statement of the merican Thoracic Society. m Rev Respir Dis 1987; 136: Japanese Society of Chest Diseases. Standards of pulmonary function tests for Japanese. Jpn J Thorac Dis 1993; 31:appendix 9. Eda S, Kubo K, Fujimoto K, Matsuzawa Y, Sekiguchi M, Sakai F. The relations between expiratory chest CT using helical CT and pulmonary function tests in emphysema. m J Respir Crit Care Med 1997; 155: Park KJ, ergin CJ, Clausen JL. Quantitation of emphysema with three-dimensional CT densitometry: comparison with two-dimensional analysis, visual emphysema scores, and pulmonary function test results. Radiology 1999; 211: Gelb F, Hogg JC, Müller NL, et al. Contribution of emphysema and small airways in COPD. Chest 1996; 109: Zaporozhan J, Ley S, Eberhardt R, et al. Paired inspiratory/expiratory volumetric thin-slice CT scan for emphysema analysis. Chest 2005; 128: O Donnell R, Peebles C, Ward J, et al. Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD. Thorax 2004; 59: Camiciottoli G, artolucci M, Maluccio NM, et al. Spirometrically gated high-resolution CT findings in COPD: lung attenuation vs lung function and dyspnea severity. Chest 2006; 129: Gierada DS, Pilgram TK, Whiting R, et al. Comparison of standard- and low-radiation-dose CT for quantification of emphysema. JR 2007; 188: Stolk J, Dirksen, van der Lugt, et al. Repeatability of lung density measurements with low-dose computed tomography in subjects with alpha-1-antitrypsin deficiency-associated emphysema. Invest Radiol 2001; 36: Matsuoka S, Kurihara Y, Yagihashi K, Hoshino M, Watanabe N, Nakajima Y. Quantitative assessment of air trapping in chronic obstructive pulmonary disease using inspiratory and expiratory volumetric MDCT. JR 2008; 190: Mergo PJ, Williams WF, Gonzalez-Rothi R, et al. Three-dimensional volumetric assessment of abnormally low attenuation of the lung from routine helical CT: inspiratory and expiratory quantification. JR 1998; 170: JR:192, January 2009
Quantitative Assessment of Air Trapping in Chronic Obstructive Pulmonary Disease Using Inspiratory and Expiratory Volumetric MDCT
Chest Imaging Original Research Matsuoka et al. MDCT of Air Trapping in COPD Chest Imaging Original Research Shin Matsuoka 12 Yasuyuki Kurihara 1 Kunihiro Yagihashi 1 Makoto Hoshino 3 Naoto Watanabe 3
More informationSang Min Lee, M.D., Jin Hur, M.D., Tae Hoon Kim, M.D., Sang Jin Kim, M.D., Hyung Jung Kim, M.D. 2
Quantitative Assessment of Lung Volumes using Multidetector Row Computed Tomography (MDCT) in Patients with Chronic Obstructive Pulmonary Disease (COPD) 1 Sang Min Lee, M.D., Jin Hur, M.D., Tae Hoon Kim,
More informationCopyright 2008 Society of Photo Optical Instrumentation Engineers. This paper was published in Proceedings of SPIE, vol. 6915, Medical Imaging 2008:
Copyright 2008 Society of Photo Optical Instrumentation Engineers. This paper was published in Proceedings of SPIE, vol. 6915, Medical Imaging 2008: Computer Aided Diagnosis and is made available as an
More informationChapter 11. Summary and general discussion
Chapter 11 Summary and general discussion Low Dose Computed Tomography of the Chest: Applications and Limitations INTRODUCTION The introduction of spiral, multidetector-row computed tomography (CT) has
More informationNormal Range of Emphysema and Air Trapping on CT in Young Men
Cardiopulmonary Imaging Original Research Mets et al. CT of Emphysema and Air Trapping Cardiopulmonary Imaging Original Research Onno M. Mets 1 Robert A. van Hulst 2,3 Colin Jacobs 4,5 Bram van Ginneken
More informationC hronic obstructive pulmonary disease (COPD) develops
837 CHRONIC OBSTRUCTIVE PULMONARY DISEASE Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD R A O Donnell, C Peebles, J A Ward, A Daraker, G
More informationComputed Tomography-Based Centrilobular Emphysema Subtypes Relate with Pulmonary Function
Send Orders of Reprints at reprints@benthamscience.net 54 The Open Respiratory Medicine Journal, 213, 7, 54-59 Computed Tomography-Based Centrilobular Emphysema s Relate with Pulmonary Function Mamoru
More informationThree Cuts Method for Identification of COPD
ORIGINAL REPORT Three Cuts Method for Identification of COPD Mohammad-Parsa Hosseini 1,2, Hamid Soltanian-Zadeh 2,3, and Shahram Akhlaghpoor 4 1 Department of Electrical & Computer Engineering, Wayne State
More informationHRCT Versus Volume Rendering (Three Colors, Three Densities Lung Images) in Diagnosis of Small Airway Disease: A Comparative Study
Med. J. Cairo Univ., Vol. 84, No. 1, March: 359-364, 2016 www.medicaljournalofcairouniversity.net HRCT Versus Volume Rendering (Three Colors, Three Densities Lung Images) in Diagnosis of Small Airway Disease:
More informationExpiratory and inspiratory chest computed tomography and pulmonary function tests in cigarette smokers
Eur Respir J 1999; 13: 252±256 Printed in UK ± all rights reserved Copyright ERS Journals Ltd 1999 European Respiratory Journal ISSN 0903-1936 Expiratory and inspiratory chest computed tomography and pulmonary
More informationParametric response mapping
Parametric response mapping Utility of a novel imaging biomarker in pulmonary disease Dharshan Vummidi MD, Lama VN MD, Yanik G MD, Kazerooni EA MD, Meilan Han MD, Galban C PhD Radiology, Pulmonary & Critical
More informationSupplementary Online Content
Supplementary Online Content Regan EA, Lynch DA, Curran-Everett D, et al; Genetic Epidemiology of COPD (COPDGene) Investigators. Clinical and radiologic disease in smokers with normal spirometry. Published
More informationRadiologic characterization of emphysema's pattern of distribution - a subjective approach
Radiologic characterization of emphysema's pattern of distribution - a subjective approach Poster No.: C-0866 Congress: ECR 2014 Type: Educational Exhibit Authors: J. Praia, C. Maciel, J. Pereira, J. Albuquerque,
More informationCT Densitometry as a Predictor of Pulmonary Function in Lung Cancer Patients
Send Orders of Reprints at bspsaif@emirates.net.ae The Open Respiratory Medicine Journal, 2012, 6, 139-144 139 CT Densitometry as a Predictor of Pulmonary Function in Lung Cancer Patients Fiachra Moloney
More informationDetection and Severity Scoring of Chronic Obstructive Pulmonary Disease Using Volumetric Analysis of Lung CT Images ABSTRACT
chest imaging Iran J Radiol. 2012;9(1):22-27. DOI: 10.5812/iranjradiol.6759 Iranian Journal of RADIOLOGY RADIOLOGYwww.iranjradiol.com Detection and Severity Scoring of Chronic Obstructive Pulmonary Disease
More informationThe relationship between lung function impairment and quantitative computed tomography in chronic obstructive pulmonary disease
Eur Radiol (2012) 22:120 128 DOI 10.1007/s00330-011-2237-9 COMPUTED TOMOGRAPHY The relationship between lung function impairment and quantitative computed tomography in chronic obstructive pulmonary disease
More informationWhat do pulmonary function tests tell you?
Pulmonary Function Testing Michael Wert, MD Assistant Professor Clinical Department of Internal Medicine Division of Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Wexner Medical
More informationDifference Between The Slow Vital Capacity And Forced Vital Capacity: Predictor Of Hyperinflation In Patients With Airflow Obstruction
ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 4 Number 2 Difference Between The Slow Vital Capacity And Forced Vital Capacity: Predictor Of Hyperinflation In Patients With Airflow Obstruction
More informationQuantitative evaluation by high resolution computed tomography (HRCT) of patients with asthma and emphysema
19 Evaluation by HRCT in asthma and emphysema Quantitative evaluation by high resolution computed tomography (HRCT) of patients with asthma and emphysema Fumihiro Mitsunobu, Takashi Mifune, Kozo Ashida,
More informationPulmonary emphysema is a chronic obstructive pulmonary disease and worldwide the sixth and 12th most common cause of mortality and morbidity, respecti
ORIGINAL RESEARCH THORACIC IMAGING Afarine Madani, MD Viviane De Maertelaer, PhD Jacqueline Zanen, PhD Pierre Alain Gevenois, MD, PhD Pulmonary Emphysema: Radiation Dose and Section Thickness at Multidetector
More informationPatient selection for lung volume reduction surgery. Patient Selection for Lung Volume Reduction Surgery*
Patient Selection for Lung Volume Reduction Surgery* An Objective Model Based on Prior Clinical Decisions and Quantitative CT Analysis David S. Gierada, MD; Roger D. Yusen, MD; Ian A. Villanueva, BS; Thomas
More informationPFT Interpretation and Reference Values
PFT Interpretation and Reference Values September 21, 2018 Eric Wong Objectives Understand the components of PFT Interpretation of PFT Clinical Patterns How to choose Reference Values 3 Components Spirometry
More informationDivision of Medicine, "Division of Rehabilitation, Misasa Medical Center, Okayama University Medical and Dental School
35 Low attenation area in asthma and Difference in low attenuation area (LAA) of the lungs on high resolution computed tomography (HRCT) between asthma and in relation to cigarette smoking Fumihiro Mitsunobu,
More informationKey words: bronchodilation; diffusing capacity; high-resolution CT; lung volumes; spirometry
Assessment of Emphysema in COPD* A Functional and Radiologic Study Isa Cerveri, MD; Roberto Dore, MD; Angelo Corsico, MD, PhD; Maria C. Zoia, MD; Riccardo Pellegrino, MD; Vito Brusasco, MD; and Ernesto
More informationNormal variance in emphysema index measurements in 64 multidetector-row computed tomography
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 14, NUMBER 4, 2013 Normal variance in emphysema index measurements in 64 multidetector-row computed tomography Bruno Hochhegger, 1 Klaus L. Irion, 2
More informationResearch Protocol: Project summary
Research Protocol: First clinical study with AiDA on patients as presented in the manuscript Can a single-breath nanoaerosol inhalation detect emphysema? A case-control study Project summary Nanoparticles
More informationCT-Densitometry A structure-based quantitative analysis of lung-ct in emphysema
CT-Densitometry A structure-based quantitative analysis of lung-ct in emphysema R.A. Blechschmidt and U. Lörcher Department of Radiology, Deutsche Klinik für Diagnostik Aukammallee 33, 65191 Wiesbaden,
More informationAPSR RESPIRATORY UPDATES
APSR RESPIRATORY UPDATES Volume 4, Issue 7 Newsletter Date: July 2012 APSR EDUCATION PUBLICATION Inside this issue: Quantitative imaging of airways Small-Airway Obstruction and Emphysema in Chronic Obstructive
More informationKerstin Cederlund, MD, PhD; Ulf Tylén, MD, PhD; Lennart Jorfeldt, MD, PhD; and Peter Aspelin, MD, PhD
Classification of Emphysema in Candidates for Lung Volume Reduction Surgery* A New Objective and Surgically Oriented Model for Describing CT Severity and Heterogeneity Kerstin Cederlund, MD, PhD; Ulf Tylén,
More informationFractal analysis of low attenuation clusters on computed tomography in chronic obstructive pulmonary disease
Tanabe et al. BMC Pulmonary Medicine (2018) 18:144 https://doi.org/10.1186/s12890-018-0714-5 RESEARCH ARTICLE Open Access Fractal analysis of low attenuation clusters on computed tomography in chronic
More informationPulmonary Nodule Volumetric Measurement Variability as a Function of CT Slice Thickness and Nodule Morphology
CT of Pulmonary Nodules Chest Imaging Original Research Myria Petrou 1 Leslie E. Quint 1 in Nan 2 Laurence H. aker 3 Petrou M, Quint LE, Nan, aker LH Keywords: chest, lung disease, MDCT, oncologic imaging,
More informationVisual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in The COPDGene Study
88 Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation Original Research. Visual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in The COPDGene Study
More informationFunctional Impairment in Emphysema: Contribution of Airway Abnormalities and Distribution of Parenchymal Disease
Functional Impairment in Emphysema Chest Imaging Original Research Zelena A. Aziz 1 Athol U. Wells 2 Sujal R. Desai 3 Stephen M. Ellis 4 Amanda E. Walker 5 Sharyn MacDonald 6 David M. Hansell 1 Aziz ZA,
More informationCT-quantified emphysema in male heavy smokers: association with lung function decline
See Editorial, p 741 < Additional data are published online only. To view these files please visit the journal online (http://thorax.bmj.com). 1 Division of Heart and Lungs, Department of Respiratory Medicine,
More informationCopyright 2009 Society of Photo Optical Instrumentation Engineers. This paper was published in Proceedings of SPIE, vol. 7260, Medical Imaging 2009:
Copyright 2009 Society of Photo Optical Instrumentation Engineers. This paper was published in Proceedings of SPIE, vol. 7260, Medical Imaging 2009: Computer Aided Diagnosis and is made available as an
More informationTeacher : Dorota Marczuk Krynicka, MD., PhD. Coll. Anatomicum, Święcicki Street no. 6, Dept. of Physiology
Title: Spirometry Teacher : Dorota Marczuk Krynicka, MD., PhD. Coll. Anatomicum, Święcicki Street no. 6, Dept. of Physiology I. Measurements of Ventilation Spirometry A. Pulmonary Volumes 1. The tidal
More informationQuantitative assessment of emphysema distribution in smokers and patients with a 1 -antitrypsin deficiency
Respiratory Medicine (2006) 100, 94 100 Quantitative assessment of emphysema distribution in smokers and patients with a 1 -antitrypsin deficiency Trine Stavngaard, Saher B. Shaker, Asger Dirksen Department
More informationPULMONARY FUNCTION TESTING. Purposes of Pulmonary Tests. General Categories of Lung Diseases. Types of PF Tests
PULMONARY FUNCTION TESTING Wyka Chapter 13 Various AARC Clinical Practice Guidelines Purposes of Pulmonary Tests Is lung disease present? If so, is it reversible? If so, what type of lung disease is present?
More information11.3 RESPIRATORY SYSTEM DISORDERS
11.3 RESPIRATORY SYSTEM DISORDERS TONSILLITIS Infection of the tonsils Bacterial or viral Symptoms: red and swollen tonsils, sore throat, fever, swollen glands Treatment: surgically removed Tonsils: in
More informationRESPIRATORY PHYSIOLOGY Pre-Lab Guide
RESPIRATORY PHYSIOLOGY Pre-Lab Guide NOTE: A very useful Study Guide! This Pre-lab guide takes you through the important concepts that where discussed in the lab videos. There will be some conceptual questions
More informationPulmonary Function Testing: Concepts and Clinical Applications. Potential Conflict Of Interest. Objectives. Rationale: Why Test?
Pulmonary Function Testing: Concepts and Clinical Applications David M Systrom, MD Potential Conflict Of Interest Nothing to disclose pertinent to this presentation BRIGHAM AND WOMEN S HOSPITAL Harvard
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Hunninghake GM, Hatabu H, Okajima Y, et al. MUC5B promoter
More informationSGRQ Questionnaire assessing respiratory disease-specific quality of life. Questionnaire assessing general quality of life
SUPPLEMENTARY MATERIAL e-table 1: Outcomes studied in present analysis. Outcome Abbreviation Definition Nature of data, direction indicating adverse effect (continuous only) Clinical outcomes- subjective
More informationInterobserver Variability in the Determination of Upper Lobe- Predominant Emphysema*
CHEST Interobserver Variability in the Determination of Upper Lobe- Predominant Emphysema* Original Research Craig P. Hersh, MD, MPH; George R. Washko, MD; Francine L. Jacobson, MD, MPH; Ritu Gill, MBBS;
More informationcollapse in patients with tracheobronchomalacia,
J. Zhang 1,2 I. Hasegawa 1,3 H. Hatabu 1,3 D. Feller-Kopman 1,3 P. M. Boiselle 1,3 Received June 5, 2003; accepted after revision July 23, 2003. 1 Department of Radiology, Beth Israel Deaconess Medical
More informationPediatric High-Resolution Chest CT
Pediatric High-Resolution Chest CT Alan S. Brody, MD Professor of Radiology and Pediatrics Chief, Thoracic Imaging Cincinnati Children s s Hospital Cincinnati, Ohio, USA Pediatric High-Resolution CT Short
More informationLUNG VOLUME REDUCTION SURGERY IN PATIENTS WITH COPD
LUNG VOLUME REDUCTION SURGERY IN PATIENTS WITH COPD Walter WEDER, Ilhan INCI, Michaela TUTIC Division of Thoracic Surgery University Hospital, Zurich, Switzerland e-mail: walter.weder@usz.ch INTRODUCTION
More informationFactors influencing the decline in lung density in a Danish lung cancer screening cohort
Eur Respir J 2012; 40: 1142 1148 DOI: 10.1183/09031936.00207911 CopyrightßERS 2012 Factors influencing the decline in lung density in a Danish lung cancer screening cohort Saher B. Shaker*, Asger Dirksen*,
More informationLow Grade Coal Worker's Pneumoconiosis
Acta Radiologica ISSN: 0284-181 (Print) 1600-04 (Online) Journal homepage: https://www.tandfonline.com/loi/iard20 Low Grade Coal Worker's Pneumoconiosis P. A. Gevenois, E. Pichot, F. Dargent, S. Dedeire,
More informationChapter 6. Hester Gietema Cornelia Schaefer-Prokop Willem Mali Gerard Groenewegen Mathias Prokop. Accepted for publication in Radiology
Chapter 6 Interscan variability of semiautomated volume measurements in intraparenchymal pulmonary nodules using multidetector-row computed tomography: Influence of inspirational level, nodule size and
More informationPulmonary Function Testing The Basics of Interpretation
Pulmonary Function Testing The Basics of Interpretation Jennifer Hale, M.D. Valley Baptist Family Practice Residency Objectives Identify the components of PFTs Describe the indications Develop a stepwise
More informationclinical investigations Preoperative Severity of Emphysema Predictive of Improvement After Lung Volume Reduction Surgery* Use of CT Morphometry
clinical investigations Preoperative Severity of Emphysema Predictive of Improvement After Lung Volume Reduction Surgery* Use of CT Morphometry Robert M. Rogers, MD, FCCP; Harvey O. Coxson, PhD; Frank
More informationInterpreting pulmonary function tests: Recognize the pattern, and the diagnosis will follow
REVIEW FEYROUZ AL-ASHKAR, MD Department of General Internal Medicine, The Cleveland Clinic REENA MEHRA, MD Department of Pulmonary and Critical Care Medicine, University Hospitals, Cleveland PETER J. MAZZONE,
More informationUltralow Dose Chest CT with MBIR
Ultralow Dose Chest CT with MBIR Ella A. Kazerooni, M.D. Professor & Director Cardiothoracic Radiology Associate Chair for Clinical Affairs University of Michigan Disclosures Consultant: GE Healthcare
More informationComputed tomography-quantified emphysema distribution is associated with lung function decline
Eur Respir J 2012; 40: 844 850 DOI: 10.1183/09031936.00186311 CopyrightßERS 2012 Computed tomography-quantified emphysema distribution is associated with lung function decline Firdaus A.A. Mohamed Hoesein*,
More informationInvestigation of airways using MDCT for visual and quantitative assessment in COPD patients
REVIEW Investigation of airways using MDCT for visual and quantitative assessment in COPD patients Pierre-Yves Brillet 1 Catalin I Fetita 2 Amaury Saragaglia 2 Anne-Laure Brun 3 Catherine Beigelman-Aubry
More informationQuantitative assessment of cross-sectional area of. small pulmonary vessels in patients with COPD. using inspiratory and expiratory MDCT
Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT ( 慢性閉塞性肺疾患における吸気呼気 CT を用いた 肺末梢血管面積の定量的評価 ) 千葉大学大学院医学薬学府環境健康科学専攻 (
More informationAirway wall thickness associated with forced expiratory volume in 1 second decline and development of airflow limitation
ERJ Express. Published on January 22, 2015 as doi: 10.1183/09031936.00020714 ORIGINAL ARTICLE IN PRESS CORRECTED PROOF Airway wall thickness associated with forced expiratory volume in 1 second decline
More informationCardiac CT - Coronary Calcium Basics Workshop II (Basic)
Cardiac CT - Coronary Calcium Basics Workshop II (Basic) J. Jeffrey Carr, MD, MSCE Dept. of Radiology & Public Health Sciences Wake Forest University School of Medicine Winston-Salem, NC USA No significant
More informationHigh resolution computed tomography (HRCT) assessment of β 2 -agonist induced bronchodilation in chronic obstructive pulmonary disease patients
European Review for Medical and Pharmacological Sciences High resolution computed tomography (HRCT) assessment of β 2 -agonist induced bronchodilation in chronic obstructive pulmonary disease patients
More informationBasic approach to PFT interpretation. Dr. Giulio Dominelli BSc, MD, FRCPC Kelowna Respiratory and Allergy Clinic
Basic approach to PFT interpretation Dr. Giulio Dominelli BSc, MD, FRCPC Kelowna Respiratory and Allergy Clinic Disclosures Received honorarium from Astra Zeneca for education presentations Tasked Asked
More informationDIAGNOSTIC NOTE TEMPLATE
DIAGNOSTIC NOTE TEMPLATE SOAP NOTE TEMPLATE WHEN CONSIDERING A DIAGNOSIS OF IDIOPATHIC PULMONARY FIBROSIS (IPF) CHIEF COMPLAINT HISTORY OF PRESENT ILLNESS Consider IPF as possible diagnosis if any of the
More informationRespiratory System Mechanics
M56_MARI0000_00_SE_EX07.qxd 8/22/11 3:02 PM Page 389 7 E X E R C I S E Respiratory System Mechanics Advance Preparation/Comments 1. Demonstrate the mechanics of the lungs during respiration if a bell jar
More informationIdentification of Chronic Obstructive Pulmonary Disease in Lung Cancer Screening Computed Tomographic Scans JAMA. 2011;306(16):
ORIGINAL CONTRIBUTION Identification of Chronic Obstructive Pulmonary Disease in Lung Cancer Screening Computed Tomographic Scans Onno M. Mets, MD Constantinus F. M. Buckens, MD Pieter Zanen, MD, PhD Ivana
More informationChapter 3. Pulmonary Function Study Assessments. Mosby items and derived items 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 3 Pulmonary Function Study Assessments 1 Introduction Pulmonary function studies are used to: Evaluate pulmonary causes of dyspnea Differentiate between obstructive and restrictive pulmonary disorders
More informationWe recruited participants from a local tertiary care center and through advertisement. Briefly,
RSNA, 2016 10.1148/radiol.2015151484 Appendix E1 Materials and Methods Study Subjects We recruited participants from a local tertiary care center and through advertisement. Briefly, inclusion criteria
More informationGender Differences in the Severity of CT Emphysema in COPD*
Original Research COPD Gender Differences in the Severity of CT Emphysema in COPD* Mark T. Dransfield, MD; George R. Washko, MD; Marilyn G. Foreman, MD, FCCP; Raul San Jose Estepar, PhD; John Reilly, MD,
More informationDensitometry for assessment of effect of Lung Volume Reduction. Surgery for emphysema
ERJ Express. Published on March 1, 2007 as doi: 10.1183/09031936.00056206 Densitometry for assessment of effect of Lung Volume Reduction Surgery for emphysema 1 Jan Stolk, 2 Michel I.M. Versteegh, 1 Leon
More informationRespiratory Physiology In-Lab Guide
Respiratory Physiology In-Lab Guide Read Me Study Guide Check Your Knowledge, before the Practical: 1. Understand the relationship between volume and pressure. Understand the three respiratory pressures
More informationX-Ray & CT Physics / Clinical CT
Computed Tomography-Basic Principles and Good Practice X-Ray & CT Physics / Clinical CT INSTRUCTORS: Dane Franklin, MBA, RT (R) (CT) Office hours will be Tuesdays from 5pm to 6pm CLASSROOM: TIME: REQUIRED
More informationPreoperative risk assessment with computed tomography in patients undergoing lung cancer surgery
Original Article Preoperative risk assessment with computed tomography in patients undergoing lung cancer surgery Kazuhiro Ueda, Junichi Murakami, Toshiki Tanaka, Masataro Hayashi, Kazunori Okabe, Kimikazu
More informationDifferential diagnosis
Differential diagnosis The onset of COPD is insidious. Pathological changes may begin years before symptoms appear. The major differential diagnosis is asthma, and in some cases, a clear distinction between
More informationAfter the Chest X-Ray:
After the Chest X-Ray: What To Do Next Alan S. Brody Professor of Radiology and Pediatrics Chief of Thoracic Imaging Cincinnati Children s Hospital Cincinnati, Ohio USA What Should We Do Next? CT scan?
More informationLUNGS. Requirements of a Respiratory System
Respiratory System Requirements of a Respiratory System Gas exchange is the physical method that organisms use to obtain oxygen from their surroundings and remove carbon dioxide. Oxygen is needed for aerobic
More informationHRCT in CHILDREN. strengths and weaknesses in practice: Dr Catherine Owens BSc MBBS MRCP FRCR. Great Ormond Street Hospital for Children NHS Trust
HRCT in CHILDREN strengths and weaknesses in practice: Dr Catherine Owens BSc MBBS MRCP FRCR Great Ormond Street Hospital for Children NHS Trust London WC1N 3JH Telephone 02074059200 Ext. 0493 or 5072
More informationRelationship of emphysema and airway disease assessed by CT to exercise capacity in COPD
Respiratory Medicine (2010) 104, 1145e1151 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed Relationship of emphysema and airway disease assessed by CT to exercise capacity
More informationCIRCULAR INSTRUCTION REGARDING ESTABLISHMENT OF IMPAIRMENT DUE TO OCCUPATIONAL LUNG DISEASE FOR THE PURPOSES OF AWARDING PERMANENT DISABLEMENT
Circular Instruction 195 CIRCULAR INSTRUCTION REGARDING ESTABLISHMENT OF IMPAIRMENT DUE TO OCCUPATIONAL LUNG DISEASE FOR THE PURPOSES OF AWARDING PERMANENT DISABLEMENT COMPENSATION FOR OCCUPATIONAL INJURIES
More informationE. Senéterre*, F. Paganin**, J.M. Bruel*, F.B. Michel**, J. Bousquet**
Eur Respir J, 1994, 7, 596 6 DOI: 1.1183/931936.94.73596 Printed in UK - all rights reserved Copyright ERS Journals Ltd European Respiratory Journal ISSN 93-1936 TECHNICAL NOTE Measurement of the internal
More informationContent Indica c tion Lung v olumes e & Lung Indica c tions i n c paci c ties
Spirometry Content Indication Indications in occupational medicine Contraindications Confounding factors Complications Type of spirometer Lung volumes & Lung capacities Spirometric values Hygiene &
More informationA VIRTUAL TRAINING SYSTEM FOR CHEST RADIOGRAM INTERPRETATIONS USING ANATOMICAL HUMAN STRUCTURES IN HIGH-RESOLUTION CT IMAGES
A VIRTUAL TRAINING SYSTEM FOR CHEST RADIOGRAM INTERPRETATIONS USING ANATOMICAL HUMAN STRUCTURES IN HIGH-RESOLUTION CT IMAGES T. Hara*, X. Zhou*, H. Fujita*, I. Kurimoto*, T. Kiryu**, R. Yokoyama**, H.
More informationImproved image quality of low-dose thoracic CT examinations with a new postprocessing software*
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 11, NUMBER 3, Summer 2010 Improved image quality of low-dose thoracic CT examinations with a new postprocessing software* Anne Catrine Traegde Martinsen,
More informationChapter 10 The Respiratory System
Chapter 10 The Respiratory System Biology 2201 Why do we breathe? Cells carry out the reactions of cellular respiration in order to produce ATP. ATP is used by the cells for energy. All organisms need
More informationTo assess the pulmonary impairment in treated pulmonary tuberculosis patients using spirometry
Original Research Article To assess the pulmonary impairment in treated pulmonary tuberculosis patients using spirometry Dhipu Mathew 1, Kirthana G 2, Krishnapriya R 1, Srinivasan R 3 1 Assistant Professor,
More informationCoexistence of confirmed obstruction in spirometry and restriction in body plethysmography, e.g.: COPD + pulmonary fibrosis
Volumes: IRV inspiratory reserve volume Vt tidal volume ERV expiratory reserve volume RV residual volume Marcin Grabicki Department of Pulmonology, Allergology and Respiratory Oncology Poznań University
More informationDOES SMOKING MARIJUANA INCREASE THE RISK OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE?
DOES SMOKING MARIJUANA INCREASE THE RISK OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE Pubdate: Tue, 14 Apr 2009 Source: Canadian Medical Association Journal (Canada) Copyright: 2009 Canadian Medical Association
More informationQuantitative CT Measurement of Cross-sectional Area of Small Pulmonary Vessel in COPD:
Quantitative CT Measurement of Cross-sectional Area of Small Pulmonary Vessel in COPD: Correlations with Emphysema and Airflow Limitation Shin Matsuoka, MD, PhD, George R. Washko, MD, Mark T. Dransfield,
More informationResponses to inhaled long-acting beta-agonist and corticosteroid according to COPD subtype *
Respiratory Medicine (2010) 104, 542e549 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed Responses to inhaled long-acting beta-agonist and corticosteroid according to
More informationTORCH: Salmeterol and Fluticasone Propionate and Survival in COPD
TORCH: and Propionate and Survival in COPD April 19, 2007 Justin Lee Pharmacy Resident University Health Network Outline Overview of COPD Pathophysiology Pharmacological Treatment Overview of the TORCH
More information4D PET: promises and limitations
4D PET: promises and limitations Tinsu Pan, Ph.D. M.D. Anderson Cancer Center The University of Texas Background Outlines Gating techniques: Deep inspiration breath hold 4D PET/CT Non-gating techniques
More informationPulmonary Function Testing
In the Clinic Pulmonary Function Testing Hawa Edriss MD, Gilbert Berdine MD The term PFT encompasses three different measures of lung function: spirometry, lung volumes, and diffusion capacity. In this
More informationCOPD or not COPD, that is the question.
COPD or not COPD, that is the question. Asthma-COPD Overlap Syndrome: ACOS Do we really need this? Michelle Harkins Disclosure Slide Slide help - William Busse, MD Organizational Interests ATS, ACCP, ACP
More informationFVC to Slow Inspiratory Vital Capacity Ratio* A Potential Marker for Small Airways Obstruction
Original Research PSYCHOLOGICAL TESTING FVC to Slow Inspiratory Vital Capacity Ratio* A Potential Marker for Small Airways Obstruction Judith Cohen, MD; Dirkje S. Postma, MD, PhD; Karin Vink-Klooster;
More informationNational COPD Audit Programme
National COPD Audit Programme Planning for every breath National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme: Primary care audit (Wales) 2015 17 Data analysis and methodology Section 2:
More informationASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss?
ASTHMA-COPD OVERLAP SYNDROME 2018: What s All the Fuss? Randall W. Brown, MD MPH AE-C Association of Asthma Educators Annual Conference July 20, 2018 Phoenix, Arizona FACULTY/DISCLOSURES Randall Brown,
More informationHow does COPD really work?
How does COPD really work? by Alex Goodell View online Where does COPD fit in the mix of respiratory diseases? I ve made a map of the major pathologies outlined in Robbins and First Aid (obviously these
More informationPathophysiology of COPD 건국대학교의학전문대학원
Pathophysiology of COPD 건국대학교의학전문대학원 내과학교실 유광하 Rate per 100 0,000 population 550 500 450 400 350 300 250 200 150 100 50 0 Heart disease Cancer Stroke 1970 1974 1978 1982 1986 1990 1994 1998 2002 Year of
More informationPrapaporn Pornsuriyasak, M.D. Pulmonary and Critical Care Medicine Ramathibodi Hospital
Prapaporn Pornsuriyasak, M.D. Pulmonary and Critical Care Medicine Ramathibodi Hospital Only 20-30% of patients with lung cancer are potential candidates for lung resection Poor lung function alone ruled
More informationof the right B 10 fourth, r = 0.476, p < ; B 10
Yamashiro et al. CT of Chronic Obstructive Pulmonary Disease Cardiopulmonary Imaging Original Research Tsuneo Yamashiro 1,2 Shin Matsuoka 3 Raúl San José Estépar 4 Mark T. Dransfield 5 Alejandro Diaz 6,7
More information3. Which statement is false about anatomical dead space?
Respiratory MCQs 1. Which of these statements is correct? a. Regular bronchioles are the most distal part of the respiratory tract to contain glands. b. Larynx do contain significant amounts of smooth
More information