title: Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity.
abstract: OBJECTIVE
  To perform a quantitative analysis of the airways using automated software, in computed tomography images of patients with cystic fibrosis, correlating the results with spirometric findings.
  
  
  METHODS
  Thirty-four patients with cystic fibrosis were studied-20 males and 14 females; mean age 18 ± 9 years-divided into two groups according to the spirometry findings: group I (n= 21), without severe airflow obstruction (forced expiratory volume in first second [FEV1] > 50% predicted), and group II (n= 13), with severe obstruction (FEV1 ≤ 50% predicted). The following tracheobronchial tree parameters were obtained automatically: bronchial diameter, area, thickness, and wall attenuation.
  
  
  RESULTS
  On average, 52 bronchi per patient were studied. The number of bronchi analyzed was higher in group II. The correlation with spirometry findings, especially between the relative wall thickness of third to eighth bronchial generation and predicted FEV1, was better in group I.
  
  
  CONCLUSIONS
  Quantitative analysis of the airways by computed tomography can be useful for assessing disease severity in cystic fibrosis patients. In patients with severe airflow obstruction, the number of bronchi studied by the method is higher, indicating more bronchiectasis. In patients without severe obstruction, the relative bronchial wall thickness showed a good correlation with the predicted FEV1.
authors.affiliation: PhD, MD, Radiologist, Collaborating Professor at the Center for Imaging Sciences and Medical Physics of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Marcel Koenigkam
authors.initials: MK
authors.lastname: Santos
authors.affiliation: MD, Radiology Specialist at the Center for Imaging Sciences and Medical Physics of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Danilo Lemos
authors.initials: DL
authors.lastname: Cruvinel
authors.affiliation: PhD, MD, Attending Pulmonologist in the Pulmonology Sector of the Department of Clinical Medicine of the Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Marcelo Bezerra
authors.initials: MB
authors.lastname: de Menezes
authors.affiliation: PhD, MD, Attending Radiologist at the Center for Imaging Sciences and Medical Physics of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Sara Reis
authors.initials: SR
authors.lastname: Teixeira
authors.affiliation: PhD, MD, Pulmonologist, Professor in the Pulmonology Sector of the Department of Clinical Medicine of the Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Elcio de Oliveira
authors.initials: EO
authors.lastname: Vianna
authors.affiliation: PhD, MD, Radiologist, Professor at the Center for Imaging Sciences and Medical Physics of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Jorge
authors.initials: J
authors.lastname: Elias Júnior
authors.affiliation: PhD, MD, Pulmonologist, Professor in the Pulmonology Sector of the Department of Clinical Medicine of the Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: José Antonio Baddini
authors.initials: JA
authors.lastname: Martinez
keywords: Airway remodeling/physiology; Cystic fibrosis; Tomography, X-ray computed