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Assessment of Regional Progression of Pulmonary Emphysema With CT Densitometry

Bakker, M. Els ; Putter, Hein ; Stolk, Jan ; Shaker, Saher B. ; Piitulainen, Eeva LU ; Russi, Erich W. and Stoel, Berend C. (2008) In Chest 134(5). p.931-937
Abstract
Background: Lung densitometry is an effective method to assess overall progression of emphysema, but generally the location of the progression is not estimated. We hypothesized that progression of emphysema is the result of extension from affected areas toward less affected areas in the lung. To test this hypothesis, a method was developed to assess emphysema severity at different levels in the lungs in order to estimate regional changes. Methods: Fifty subjects with emphysema due to alpha(1)-antitrypsin deficiency (AATD) [AATD deficiency of phenotype PiZZ (PiZ) group] and 16 subjects with general emphysema (general emphysema without phenotype PiZZ [non-.PiZ] group) were scanned with CT at baseline and after 30 months. Densitometry was... (More)
Background: Lung densitometry is an effective method to assess overall progression of emphysema, but generally the location of the progression is not estimated. We hypothesized that progression of emphysema is the result of extension from affected areas toward less affected areas in the lung. To test this hypothesis, a method was developed to assess emphysema severity at different levels in the lungs in order to estimate regional changes. Methods: Fifty subjects with emphysema due to alpha(1)-antitrypsin deficiency (AATD) [AATD deficiency of phenotype PiZZ (PiZ) group] and 16 subjects with general emphysema (general emphysema without phenotype PiZZ [non-.PiZ] group) were scanned with CT at baseline and after 30 months. Densitometry was performed in 12 axial partitions of equal volumes. To indicate predominant location, craniocaudal locallity was defined as the slope in the plot of densities against partitions. Regional progression of emphysema was calculated after volume correction, and its slope identifies the area of predominant progression. The hypothesis was tested by investigating the correlation between predominant location and predominant progression. Results: As expected, the PiZ patients showed more basal emphysema than the non-PiZ group (craniocaudal locality, -40.0 g/L vs -6.2 g/L). Overall progression rate in PiZ patients was lower than in non-PiZ subjects. A significant correlation was found between craniocaudal locality and progression slope in PiZ subjects (R = 0.566, p < 0.001). In the non-PiZ group, no correlation was found. Conclusions: In the PiZ group, the more emphysema is distributed basally, the more progression was found in the basal area. This finding suggests that emphysema due to AATD spreads out from affected areas. (CHEST 2008; 134:931-937) (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
distribution, emphysema, locality, progression, regional, CT, densitometry
in
Chest
volume
134
issue
5
pages
931 - 937
publisher
American College of Chest Physicians
external identifiers
  • wos:000260918500009
  • scopus:55849111903
  • pmid:18625668
ISSN
1931-3543
DOI
10.1378/chest.08-0512
language
English
LU publication?
yes
id
f81ef0ff-e5be-4662-8fcf-bc322b7cccc0 (old id 1283510)
date added to LUP
2016-04-01 12:53:07
date last changed
2022-01-27 08:07:06
@article{f81ef0ff-e5be-4662-8fcf-bc322b7cccc0,
  abstract     = {{Background: Lung densitometry is an effective method to assess overall progression of emphysema, but generally the location of the progression is not estimated. We hypothesized that progression of emphysema is the result of extension from affected areas toward less affected areas in the lung. To test this hypothesis, a method was developed to assess emphysema severity at different levels in the lungs in order to estimate regional changes. Methods: Fifty subjects with emphysema due to alpha(1)-antitrypsin deficiency (AATD) [AATD deficiency of phenotype PiZZ (PiZ) group] and 16 subjects with general emphysema (general emphysema without phenotype PiZZ [non-.PiZ] group) were scanned with CT at baseline and after 30 months. Densitometry was performed in 12 axial partitions of equal volumes. To indicate predominant location, craniocaudal locallity was defined as the slope in the plot of densities against partitions. Regional progression of emphysema was calculated after volume correction, and its slope identifies the area of predominant progression. The hypothesis was tested by investigating the correlation between predominant location and predominant progression. Results: As expected, the PiZ patients showed more basal emphysema than the non-PiZ group (craniocaudal locality, -40.0 g/L vs -6.2 g/L). Overall progression rate in PiZ patients was lower than in non-PiZ subjects. A significant correlation was found between craniocaudal locality and progression slope in PiZ subjects (R = 0.566, p &lt; 0.001). In the non-PiZ group, no correlation was found. Conclusions: In the PiZ group, the more emphysema is distributed basally, the more progression was found in the basal area. This finding suggests that emphysema due to AATD spreads out from affected areas. (CHEST 2008; 134:931-937)}},
  author       = {{Bakker, M. Els and Putter, Hein and Stolk, Jan and Shaker, Saher B. and Piitulainen, Eeva and Russi, Erich W. and Stoel, Berend C.}},
  issn         = {{1931-3543}},
  keywords     = {{distribution; emphysema; locality; progression; regional; CT; densitometry}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{931--937}},
  publisher    = {{American College of Chest Physicians}},
  series       = {{Chest}},
  title        = {{Assessment of Regional Progression of Pulmonary Emphysema With CT Densitometry}},
  url          = {{http://dx.doi.org/10.1378/chest.08-0512}},
  doi          = {{10.1378/chest.08-0512}},
  volume       = {{134}},
  year         = {{2008}},
}