Quantitative CT parameters correlate with lung function in chronic obstructive pulmonary disease: A systematic review and meta-analysis

Yan Wang; Limin Chai; Yuqian Chen; Jin Liu; Qingting Wang; Qianqian Zhang; Yuanjie Qiu; Danyang Li; Huan Chen; Nirui Shen; Xiangyu Shi; Jian Wang; Xinming Xie; Manxiang Li

doi:10.3389/fsurg.2022.1066031

Quantitative CT parameters correlate with lung function in chronic obstructive pulmonary disease: A systematic review and meta-analysis

Front Surg. 2023 Jan 4:9:1066031. doi: 10.3389/fsurg.2022.1066031. eCollection 2022.

Authors

Yan Wang¹, Limin Chai¹, Yuqian Chen¹, Jin Liu¹, Qingting Wang¹, Qianqian Zhang¹, Yuanjie Qiu¹, Danyang Li¹, Huan Chen¹, Nirui Shen¹, Xiangyu Shi¹, Jian Wang¹, Xinming Xie¹, Manxiang Li¹

Affiliation

¹ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Abstract

Objective: This study aimed to analyze the correlation between quantitative computed tomography (CT) parameters and airflow obstruction in patients with COPD.

Methods: PubMed, Embase, Cochrane and Web of Knowledge were searched by two investigators from inception to July 2022, using a combination of pertinent items to discover articles that investigated the relationship between CT measurements and lung function parameters in patients with COPD. Five reviewers independently extracted data, and evaluated it for quality and bias. The correlation coefficient was calculated, and heterogeneity was explored. The following CT measurements were extracted: percentage of lung attenuation area <-950 Hounsfield Units (HU), mean lung density, percentage of airway wall area, air trapping index, and airway wall thickness. Two airflow obstruction parameters were extracted: forced expiratory volume in the first second as a percentage of prediction (FEV₁%pred) and FEV₁ divided by forced expiratory volume lung capacity.

Results: A total of 141 studies (25,214 participants) were identified, which 64 (6,341 participants) were suitable for our meta-analysis. Results from our analysis demonstrated that there was a significant correlation between quantitative CT parameters and lung function. The absolute pooled correlation coefficients ranged from 0.26 (95% CI, 0.18 to 0.33) to 0.70 (95% CI, 0.65 to 0.75) for inspiratory CT and 0.56 (95% CI, 0.51 to 0.60) to 0.74 (95% CI, 0.68 to 0.80) for expiratory CT.

Conclusions: Results from this analysis demonstrated that quantitative CT parameters are significantly correlated with lung function in patients with COPD. With recent advances in chest CT, we can evaluate morphological features in the lungs that cannot be obtained by other clinical indices, such as pulmonary function tests. Therefore, CT can provide a quantitative method to advance the development and testing of new interventions and therapies for patients with COPD.

Keywords: COPD; airway obstruction; meta-analysis; quantitative CT; systematic review.

Publication types

Review