Three-dimensional airway lumen volumetry: comparison with bronchial wall area and parenchymal densitometry in assessment of airway obstruction in pulmonary emphysema.

OBJECTIVES: The purpose of this study was to compare three-dimensional airway lumen volumetry with bronchial wall area and parenchymal densitometry in the assessment of airway obstruction in pulmonary emphysema.

METHODS: 56 patients, who were smokers, underwent CT examination and pulmonary function tests (PFTs). For quantitative assessments, the following parameters were computationally calculated: (1) percentage of voxels -950, -960 and -970 HU in the lung (%LAA(-950), %LAA(-960) and %LAA(-970), respectively); (2) percentage of partial bronchi luminal volumes per total luminal volumes (LV(main), main and distal bronchial volume/total luminal volume; LV(lobe), lobar and distal bronchial volume/total luminal volume); and (3) mean wall area percentages of segmental bronchi of the right apical and left apicoposterior segment (WA%(seg)) and of subsegmental bronchi (WA%(sub)) in the upper lobes. These parameters were correlated with PFTs and statistically compared between a chronic obstructive pulmonary disease (COPD) group [forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)<70] and a non-COPD group.

RESULTS: FEV1, maximum mid-expiratory flow rate and forced expiratory flow at 25% vital capacity had significant correlation with LV(main) (r>0.53, p<0.0001), LV(lobe) (r>0.52, p<0.0001), WA%(seg) (|r|>0.29, p<0.05) and WA%(sub) (|r|>0.31, p<0.05). FEV1/FVC had significant correlation with all parameters (0.27<|r|<0.52, p<0.05). LV(main) and LV(lobe) and WA%(seg) and WA%(sub) were significantly different between the two groups (LV(main) and LV(lobe); p<0.0001, WA%(seg) and WA%(sub); p<0.05).

CONCLUSIONS: Bronchial luminal volumetric assessment better reflected the airflow limitation parameters.

ADVANCES IN KNOWLEDGE: Bronchial luminal volumetric assessment can potentially be used to gauge airflow limitation in pulmonary emphysema.