The utility of quantitative computed tomography in cohort studies of chronic obstructive pulmonary disease: a narrative review

Qi Dai; Xiaoxiao Zhu; Jingfeng Zhang; Zhaoxing Dong; Eugenio Pompeo; Jianjun Zheng; Jingyun Shi

doi:10.21037/jtd-23-1421

The utility of quantitative computed tomography in cohort studies of chronic obstructive pulmonary disease: a narrative review

J Thorac Dis. 2023 Oct 31;15(10):5784-5800. doi: 10.21037/jtd-23-1421. Epub 2023 Oct 27.

Authors

Qi Dai^{1

2}, Xiaoxiao Zhu³, Jingfeng Zhang², Zhaoxing Dong³, Eugenio Pompeo⁴, Jianjun Zheng², Jingyun Shi^{1

5}

Affiliations

¹ School of Medicine, Tongji University, Shanghai, China.
² Department of Radiology, Ningbo No.2 Hospitall, Ningbo, China.
³ Department of Respiratory and Critical Care Medicine, Ningbo No.2 Hospital, Ningbo, China.
⁴ Department of Thoracic Surgery, Policlinico Tor Vergata University, Rome, Italy.
⁵ Department of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

Abstract

Background and objective: Chronic obstructive pulmonary disease (COPD) is a significant contributor to global morbidity and mortality. Quantitative computed tomography (QCT), a non-invasive imaging modality, offers the potential to assess lung structure and function in COPD patients. Amidst the coronavirus disease 2019 (COVID-19) pandemic, chest computed tomography (CT) scans have emerged as a viable alternative for assessing pulmonary function (e.g., spirometry), minimizing the risk of aerosolized virus transmission. However, the clinical application of QCT measurements is not yet widespread enough, necessitating broader validation to determine its usefulness in COPD management.

Methods: We conducted a search in the PubMed database in English from January 1, 2013 to April 20, 2023, using keywords and controlled vocabulary related to QCT, COPD, and cohort studies.

Key content and findings: Existing studies have demonstrated the potential of QCT in providing valuable information on lung volume, airway geometry, airway wall thickness, emphysema, and lung tissue density in COPD patients. Moreover, QCT values have shown robust correlations with pulmonary function tests, and can predict exacerbation risk and mortality in patients with COPD. QCT can even discern COPD subtypes based on phenotypic characteristics such as emphysema predominance, supporting targeted management and interventions.

Conclusions: QCT has shown promise in cohort studies related to COPD, since it can provide critical insights into the pathogenesis and progression of the disease. Further research is necessary to determine the clinical significance of QCT measurements for COPD management.

Keywords: Quantitative computed tomography (QCT); chronic obstructive pulmonary disease (COPD); cohort study.

Publication types

Review