Abstract
Introduction Patients referred to the pulmonology department and diagnosed with COPD often obtain an initial CT scan. COPD contains different phenotypes and presents a risk for lung malignancy. CT scanning may therefore contribute to the initial management of these patients, however its value is largely unknown.
Objectives This raises an interest to determine the value of CT scans in all referred COPD patients irrespective of lung function values.
Methods After diagnosis of COPD is made based on GOLD criteria, thoracic high resolution CT scans (HRCT), using advanced reconstruction methods with emphysema quantification software, are applied.
Results While inclusion is ongoing, of the 72 referred patients we currently observed 76% being truly diagnosed with COPD. Of the included and examined patients 48% showed emphysema at the cut-off level of 5%, comprising mostly GOLD stage III. In contrast, emphysema quantification below the cut-off level was mostly seen in patients classified as GOLD stage II. 10,8% of the HRCT scans showed an intrapulmonary density suspected for a malignancy, half of which initially not detected on a recent chest X-ray. Scans also presented a great variety of extra pulmonary abnormal findings such as aortic aneurysms, liver, renal and adrenal abnormalities. A total of 35% of the findings were recommended for further investigation.
Conclusion Patients which were referred and truly diagnosed with COPD showed software calculated emphysema to some extent, however not all >5%, but with additional findings. Of these findings 10,8% were suspected for malignancy, of which a part not detected on chest X-rays and a total of 35% were recommended for further investigation and treatment.
- Copyright ©the authors 2017