Imaging Advances in Chronic Obstructive Pulmonary Disease Insights from the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) Study

被引:105
作者
Bhatt, Surya P. [1 ,2 ]
Washko, George R. [3 ]
Hoffman, Eric A. [6 ]
Newell, John D., Jr. [6 ]
Bodduluri, Sandeep [1 ,2 ]
Diaz, Alejandro A. [3 ]
Galban, Craig J. [7 ,8 ]
Silverman, Edwin K. [4 ]
Estepar, Raul San Jose [5 ]
Lynch, David A. [9 ]
机构
[1] Univ Alabama Birmingham, Sch Med, Div Pulm Allergy & Crit Care Med, UAB Lung Imaging Core, Birmingham, AL USA
[2] Univ Alabama Birmingham, Sch Med, Div Pulm Allergy & Crit Care Med, UAB Lung Hlth Ctr, Birmingham, AL USA
[3] Harvard Med Sch, Brigham & Womens Hosp, Div Pulm & Crit Care Med, Boston, MA USA
[4] Harvard Med Sch, Brigham & Womens Hosp, Channing Div Network Med, Boston, MA USA
[5] Harvard Med Sch, Brigham & Womens Hosp, Dept Radiol, Boston, MA USA
[6] Univ Iowa, Dept Radiol, Carver Coll Med, Iowa City, IA 52242 USA
[7] Univ Michigan, Dept Radiol, Ann Arbor, MI 48109 USA
[8] Univ Michigan, Ctr Mol Imaging, Ann Arbor, MI 48109 USA
[9] Natl Jewish Hlth, Dept Radiol, Denver, CO USA
关键词
chronic obstructive pulmonary disease; lung imaging; computed tomography; QUANTITATIVE COMPUTED-TOMOGRAPHY; INTERSTITIAL LUNG ABNORMALITIES; SMALL-AIRWAY OBSTRUCTION; GENOME-WIDE ASSOCIATION; VISUAL ASSESSMENT; VASCULAR MORPHOLOGY; FLOW OBSTRUCTION; ADIPOSE-TISSUE; VOLUMETRIC CT; EMPHYSEMA;
D O I
10.1164/rccm.201807-1351SO
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) study, which began in 2007, is an ongoing multicenter observational cohort study of more than 10,000 current and former smokers. The study is aimed at understanding the etiology, progression, and heterogeneity of chronic obstructive pulmonary disease (COPD). In addition to genetic analysis, the participants have been extensively characterized by clinical questionnaires, spirometry, volumetric inspiratory and expiratory computed tomography, and longitudinal follow-up, including follow-up computed tomography at 5 years after enrollment. The purpose of this state-of-the-art review is to summarize the major advances in our understanding of COPD resulting from the imaging findings in the COPDGene study. Imaging features that are associated with adverse clinical outcomes include early interstitial lung abnormalities, visual presence and pattern of emphysema, the ratio of pulmonary artery to ascending aortic diameter, quantitative evaluation of emphysema, airway wall thickness, and expiratory gas trapping. COPD is characterized by the early involvement of the small conducting airways, and the addition of expiratory scans has enabled measurement of small airway disease. Computational advances have enabled indirect measurement of nonemphysematous gas trapping. These metrics have provided insights into the pathogenesis and prognosis of COPD and have aided early identification of disease. Important quantifiable extrapulmonary findings include coronary artery calcification, cardiac morphology, intrathoracic and extrathoracic fat, and osteoporosis. Current active research includes identification of novel quantitative measures for emphysema and airway disease, evaluation of dose reduction techniques, and use of deep learning for phenotyping COPD.
引用
收藏
页码:286 / 301
页数:16
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