Updates in computed tomography assessment of emphysema using computed tomography lung analysis

Abstract

CT lung analysis is a new CT technique that allows assessment of emphysema in quantitative pattern to avoid subjective analysis.

Objectives: To assess the role of new CT lung analysis in quantitative assessment of pulmonary emphysema.

Patients and Methods: Thirty patients with emphysema were included who presented to the Chest department- Ain Shams University for follow up. All patients underwent full history taking, clinical examination, spirometry and body plethysmography then referred to the Radiology department to do non contrast CT chest followed by lung volume analysis. Four patients of them were followed up before and after medical volume reduction therapy.

Results: There was a direct relation between the CT lung volume, the percentage of low attenuation area (% LAA) as well as the total lung capacity (TLC) measured with Body plethysmography. Twelve cases were found to be grade I by Goddard score with 9 of them found to be GOLD I and 3 of them found to be GOLD II. Fifteen cases were found to be grade II by Goddard score with 12 of them found to be GOLD II and 3 of them found to be GOLD III/IV. Three cases were found to be grade III by Goddard score with all of them found to be GOLD III/IV. The maximum site for distribution of the cluster according to their number was in the left upper lobe while according to the cluster volume was in the right upper lobe. CT lung analysis guided the site of injection in four patient underwent volume reduction therapy. Conclusion: CT lung analysis is a new technique that allows quantitative assessment of emphysema, important for categorization, follow-up and treatment strategies. It must be added as a routine study accompanied with spirometric function.