RT Journal Article
SR Electronic
T1 Quantitative CT and visual emphysema scores: association with lung function decline
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00523-2022
DO 10.1183/23120541.00523-2022
A1 Meghan C. Koo
A1 Wan C. Tan
A1 Jim C. Hogg
A1 Jean. Bourbeau
A1 Cameron J. Hague
A1 Jonathon A. Leipsic
A1 Miranda Kirby
YR 2023
UL http://openres.ersjournals.com/content/early/2023/02/09/23120541.00523-2022.abstract
AB Computed tomography (CT) visual emphysema score (VES) is a better predictor of mortality than single quantitative CT emphysema measurements in chronic obstructive pulmonary disease (COPD), but there are numerous CT measurements that reflect COPD-related disease features. The purpose of this study was to determine if linear combinations of quantitative CT measurements by principal component analysis (PCA) have a greater association with FEV1 lower limit of normal (LLN) annualized change (ΔFEV1) than VES in COPD. In this retrospective, longitudinal study, demographic, spirometry, and CT images were acquired. CT VES and quantitative analysis (VIDA Diagnostics Inc.) was performed; the low-attenuation-area-below-950HU (LAA950), and 12 other quantitative CT measurements were investigated. PCA was used for CT feature extraction. Multiple linear regression models for baseline FEV1 LLN and 6-year ΔFEV1 were used to determine associations with VES and CT measurements. A total of 725 participants were analyzed (n=299 never-smoker, n=242 at-risk, n=184 COPD). Quantitative CT measures (LAA950, PCA components) were independently statistically significant (p<0.05) in predicting baseline FEV1 LLN, whereas VES was not statistically significant in any baseline models. When predicting 6-year ΔFEV1, only VES was significant (p<0.05) in models with LAA950 and PCA combination of emphysema measurements. In the model with PCA using all CT measurements predicting 6-year ΔFEV1, VES (p=0.021) along with one PCA component (p=0.004) were statistically significant. PCA with a combination of CT measurements reflecting several different COPD-related disease features independently predicted baseline lung function and increased the relative importance of quantitative CT compared to VES for predicting lung function decline.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of Interest: All authors have nothing to disclose.