title: Lobar analysis of collapsibility indices to assess functional lung volumes in COPD patients.
abstract: BACKGROUND
  We investigated correlations between lung volume collapsibility indices and pulmonary function test (PFT) results and assessed lobar differences in chronic obstructive pulmonary disease (COPD) patients, using paired inspiratory and expiratory three dimensional (3D) computed tomography (CT) images.
  
  
  METHODS
  We retrospectively assessed 28 COPD patients who underwent paired inspiratory and expiratory CT and PFT exams on the same day. A computer-aided diagnostic system calculated total lobar volume and emphysematous lobar volume (ELV). Normal lobar volume (NLV) was determined by subtracting ELV from total lobar volume, both for inspiratory phase (NLVI) and for expiratory phase (NLVE). We also determined lobar collapsibility indices: NLV collapsibility ratio (NLVCR) (%)=(1-NLVE/NLVI)×100%. Associations between lobar volumes and PFT results, and collapsibility indices and PFT results were determined by Pearson correlation analysis.
  
  
  RESULTS
  NLVCR values were significantly correlated with PFT results. Forced expiratory volume in 1 second, measured as percent of predicted results (FEV1%P) was significantly correlated with NLVCR values for the lower lobes (P<0.01), whereas this correlation was not significant for the upper lobes (P=0.05). FEV1%P results were also moderately correlated with inspiratory, expiratory ELV (ELVI,E) for the lower lobes (P<0.05). In contrast, the ratio of the diffusion capacity for carbon monoxide to alveolar gas volume, measured as percent of predicted (DLCO/VA%P) results were strongly correlated with ELVI for the upper lobes (P<0.001), whereas this correlation with NLVCR values was weaker for upper lobes (P<0.01) and was not significant for the lower lobes (P=0.26).
  
  
  CONCLUSIONS
  FEV1%P results were correlated with NLV collapsibility indices for lower lobes, whereas DLCO/VA%P results were correlated with NLV collapsibility indices and ELV for upper lobes. Thus, evaluating lobar NLV collapsibility might be useful for estimating pulmonary function in COPD patients.
authors.affiliation: Department of Radiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Kitano
authors.affiliation: Department of Radiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Iwano
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Naozumi
authors.initials: N
authors.lastname: Hashimoto
authors.affiliation: Department of Radiology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Radiology, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D021621:Imaging, Three-Dimensional; D001239:Inhalation; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008176:Lung Volume Measurements / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011653:Pulmonary Diffusing Capacity; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
keywords: computed tomography; emphysema; pulmonary function; segmentation