title: Chronic obstructive pulmonary disease: CT quantification of airways disease.
abstract: Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide and results in substantial social and economic burdens. COPD is a heterogeneous disease with both extrapulmonary and pulmonary components. The pulmonary component is characterized by an airflow limitation that is not fully reversible. In the authors' opinion, none of the currently available classifications combining airflow limitation measurements with clinical parameters is sufficient to determine the prognosis and treatment of a particular patient with COPD. With regard to the causes of airflow limitation, CT can be used to quantify the two main contributions to COPD: emphysema, and small airways disease (a narrowing of the airways). CT quantification--with subsequent COPD phenotyping--can contribute to improved patient care, assessment of COPD progression, and identification of severe COPD with increasing risk of mortality. Small airways disease can be quantified through measurements reflecting morphology, quantification of obstruction, and changes in airways walls. This article details these three approaches and concludes with perspectives and directions for further research.
authors.affiliation: Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium.
authors.forename: Maxime
authors.initials: M
authors.lastname: Hackx
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Bankier
authors.forename: Pierre Alain
authors.initials: PA
authors.lastname: Gevenois
mesh_terms: D000403:Airway Resistance; D001980:Bronchi / Q000503:physiopathology*; D006801:Humans; D010641:Phenotype; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*