Pulmonary emphysema: histopathologic correlation with minimum intensity projection imaging, high-resolution computed tomography, and pulmonary function test results

J Comput Assist Tomogr. 2008 Jul-Aug;32(4):576-82. doi: 10.1097/RCT.0b013e31814b276a.

Abstract

Objective: To prospectively evaluate the use of minimum-intensity projection (minIP) imaging, high-resolution (HR) computed tomography (CT), and pulmonary function tests for quantifying emphysema with histopathologic examination.

Methods: MinIP and HRCT imaging data (n = 23) were obtained, and relative areas of the lung with attenuation values below thresholds from -940 to -1000 Hounsfield units (HU) and first to 13th percentiles were calculated for both data. Pulmonary function tests were performed before lung resection. These parameters were compared with mean alveolar perimeters measured on resected samples.

Results: Strongest correlations with mean alveolar perimeter were obtained at -990 HU and the fifth percentile by minIP, -1000 HU and the seventh percentile by HRCT, and diffusion capacity. The correlation between the mean alveolar perimeter and relative areas below -990 HU by minIP showed significantly higher extension (0%-51%) than those below -1000 HU by HRCT (1%-21%).

Conclusions: MinIP imaging is more than 2(1/2) times more predictive for quantifying emphysema than HRCT, although diffusion capacity of lung for carbon monoxide is also a valid index.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Lung / diagnostic imaging
  • Lung / physiopathology
  • Lung / surgery
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Emphysema / diagnosis*
  • Pulmonary Emphysema / physiopathology
  • Radiographic Image Interpretation, Computer-Assisted / methods
  • Reproducibility of Results
  • Respiratory Function Tests / methods
  • Respiratory Function Tests / statistics & numerical data
  • Respiratory Mechanics
  • Tomography, Spiral Computed / methods*
  • X-Ray Intensifying Screens*