From the Department of Physics, Toronto Metropolitan University, 350 Victoria St, Kerr Hall South Bldg, Rm KHS-344, Toronto, ON, Canada M5B 2K3 (S.V., M.K.); Center for Heart Lung Innovation, St Paul's Hospital, Vancouver, Canada (W.C.T., J.C.H., C.J.H., M.K.); and McGill University Health Centre, McGill University, Montreal, Canada (J.B.).
Radiology. 2024 Jul;312(1):e233265. doi: 10.1148/radiol.233265.
Background Pre-existing emphysema is recognized as an indicator of future worsening in patients with chronic obstructive pulmonary disease (COPD) when observed through CT imaging. However, it remains uncertain whether additional factors, such as the spatial compactness of CT emphysema, might also serve as predictors of disease progression. Purpose To evaluate the relationship between the compactness of CT emphysema voxels and emphysema progression. Materials and Methods This secondary analysis uses data from the prospective Canadian Cohort Obstructive Lung Disease (CanCOLD) study, examining CT images obtained in participants with and without COPD at baseline and a 3-year follow-up time point (November 2009 to November 2018). Measurements of forced expiratory volume in first second of expiration (FEV) and diffusing capacity of lung for carbon monoxide (DLco) were collected. The normalized join-count (NJC) measurement from baseline CT images and lung density (LD) changes were analyzed. Emphysema progression was defined as an annualized LD change of less than half an SD below the mean of the participants without COPD with no smoking history. Multivariable linear and logistic regression models were used to assess the association between baseline CT NJC measurements and the annualized change in LD, FEV, DLco, and emphysema progression versus nonprogression. Results A total of 524 participants (mean age, 66 years ± 10 [SD]; 293 male) (FEV percent predicted, 88% ± 19; FEV/FVC, 67% ± 9; DLco percent predicted, 105% ± 25) were analyzed, 187 (36%) of whom had COPD. CT NJC was associated with the annualized change in LD ( < .001), FEV ( = .02), and DLco ( = .01). Additionally, CT NJC predicted emphysema progression versus nonprogression (odds ratio, 2.24; 95% CI: 1.37, 3.50; < .001). Conclusion The spatial distribution, or "compactness," of CT emphysema voxels predicted emphysema progression in individuals with and without COPD. ClinicalTrials.gov Identifier: NCT00920348 © RSNA, 2024
背景 通过 CT 成像观察，预先存在的肺气肿被认为是慢性阻塞性肺疾病（COPD）患者未来病情恶化的指标。然而，目前尚不确定 CT 肺气肿的空间紧凑度等其他因素是否也可作为疾病进展的预测因子。目的 评估 CT 肺气肿体素的紧凑度与肺气肿进展之间的关系。材料与方法 本二次分析使用前瞻性加拿大阻塞性肺病队列研究（CanCOLD）的数据，检查基线和 3 年随访时间点（2009 年 11 月至 2018 年 11 月）有和无 COPD 的参与者的 CT 图像。采集用力呼气量第一秒（FEV）和一氧化碳弥散量（DLco）的测量值。分析基线 CT 图像的归一化连接计数（NJC）测量值和肺密度（LD）变化。将 LD 变化的年增长率定义为无吸烟史的无 COPD 参与者 LD 平均值的一半以下作为肺气肿进展。使用多变量线性和逻辑回归模型评估基线 CT NJC 测量值与 LD、FEV、DLco 年增长率以及肺气肿进展与非进展之间的相关性。结果 共分析了 524 名参与者（平均年龄，66 岁±10[标准差]；293 名男性）（FEV%预测值，88%±19；FEV/FVC，67%±9；DLco%预测值，105%±25），其中 187 名（36%）患有 COPD。CT NJC 与 LD 的年增长率呈负相关（ <.001），与 FEV（ =.02）和 DLco（ =.01）的年增长率呈正相关。此外，CT NJC 预测了肺气肿进展与非进展（比值比，2.24；95%置信区间：1.37，3.50； <.001）。结论 CT 肺气肿体素的空间分布（或“紧凑度”）可预测有和无 COPD 个体的肺气肿进展。临床试验.gov 标识符：NCT00920348 © RSNA，2024
