RT Journal Article
SR Electronic
T1 Emphysema- and airway-dominant COPD phenotypes defined by standardised quantitative computed tomography
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 92
OP 103
DO 10.1183/13993003.01878-2015
VO 48
IS 1
A1 Deepak R. Subramanian
A1 Sumit Gupta
A1 Dorothe Burggraf
A1 Suzan J. vom Silberberg
A1 Irene Heimbeck
A1 Marion S. Heiss-Neumann
A1 Karl Haeussinger
A1 Chris Newby
A1 Beverley Hargadon
A1 Vimal Raj
A1 Dave Singh
A1 Umme Kolsum
A1 Thomas P. Hofer
A1 Khaled Al-shair
A1 Niklas Luetzen
A1 Antje Prasse
A1 Joachim Müller-Quernheim
A1 Giorgio Benea
A1 Stefano Leprotti
A1 Piera Boschetto
A1 Dorota Gorecka
A1 Adam Nowinski
A1 Karina Oniszh
A1 Wolfgang zu Castell
A1 Michael Hagen
A1 Imre Barta
A1 Balázs Döme
A1 Janos Strausz
A1 Timm Greulich
A1 Claus Vogelmeier
A1 Andreas R. Koczulla
A1 Ivo Gut
A1 Jens Hohlfeld
A1 Tobias Welte
A1 Mahyar Lavae-Mokhtari
A1 Loems Ziegler-Heitbrock
A1 Christopher Brightling
A1 David G. Parr
YR 2016
UL http://erj.ersjournals.com/content/48/1/92.abstract
AB EvA (Emphysema versus Airway disease) is a multicentre project to study mechanisms and identify biomarkers of emphysema and airway disease in chronic obstructive pulmonary disease (COPD). The objective of this study was to delineate objectively imaging-based emphysema-dominant and airway disease-dominant phenotypes using quantitative computed tomography (QCT) indices, standardised with a novel phantom-based approach.441 subjects with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1–3) were assessed in terms of clinical and physiological measurements, laboratory testing and standardised QCT indices of emphysema and airway wall geometry.QCT indices were influenced by scanner non-conformity, but standardisation significantly reduced variability (p<0.001) and led to more robust phenotypes. Four imaging-derived phenotypes were identified, reflecting “emphysema-dominant”, “airway disease-dominant”, “mixed” disease and “mild” disease. The emphysema-dominant group had significantly higher lung volumes, lower gas transfer coefficient, lower oxygen (PO2) and carbon dioxide (PCO2) tensions, higher haemoglobin and higher blood leukocyte numbers than the airway disease-dominant group.The utility of QCT for phenotyping in the setting of an international multicentre study is improved by standardisation. QCT indices of emphysema and airway disease can delineate within a population of patients with COPD, phenotypic groups that have typical clinical features known to be associated with emphysema-dominant and airway-dominant disease.Standardisation of quantitative CT improves delineation of emphysema and airway phenotypes in a multicentre study http://ow.ly/10zjhV