GOLD-Grade Specific Disease Characterization and Phenotyping of COPD Using Quantitative Computed Tomography in the Nationwide COSYCONET Multicenter Trial in Germany.

Autor:	Konietzke P; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Weinheimer O; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Triphan SMF; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Nauck S; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Wuennemann F; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Konietzke M; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Jobst BJ; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Jörres RA; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University, Munich, Germany.; Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany., Vogelmeier CF; Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), University Medical Center Giessen and Marburg, Giessen, Germany., Heussel CP; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Kauczor HU; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany., Biederer J; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Faculty of Medicine, University of Latvia, Riga, Latvia.; Faculty of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany., Wielpütz MO; Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.; Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic at University of Heidelberg, Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Respiration; international review of thoracic diseases [Respiration] 2024 Aug 22, pp. 1-17. Date of Electronic Publication: 2024 Aug 22.
DOI:	10.1159/000540781
Abstrakt:	Introduction: The aim of this study was to apply quantitative computed tomography (QCT) for GOLD-grade specific disease characterization and phenotyping of air-trapping, emphysema, and airway abnormalities in patients with chronic obstructive pulmonary disease (COPD) from a nationwide cohort study. Methods: As part of the COSYCONET multicenter study, standardized CT in ex- and inspiration, lung function assessment (FEV1/FVC), and clinical scores (BODE index) were prospectively acquired in 525 patients (192 women, 327 men, aged 65.7 ± 8.5 years) at risk for COPD and at GOLD1-4. QCT parameters such as total lung volume (TLV), emphysema index (EI), parametric response mapping (PRM) for emphysema (PRMEmph) and functional small airway disease (PRMfSAD), total airway volume (TAV), wall percentage (WP), and total diameter (TD) were computed using automated software. Results: TLV, EI, PRMfSAD, and PRMEmph increased incrementally with each GOLD grade (p < 0.001). Aggregated WP5-10 of subsegmental airways was higher from GOLD1 to GOLD3 and lower again at GOLD4 (p < 0.001), whereas TD5-10 was significantly dilated only in GOLD4 (p < 0.001). Fifty-eight patients were phenotyped as "non-airway non-emphysema type," 202 as "airway type," 96 as "emphysema type," and 169 as "mixed type." FEV1/FVC was best in "non-airway non-emphysema type" compared to other phenotypes, while "mixed type" had worst FEV1/FVC (p < 0.001). BODE index was 0.56 ± 0.72 in the "non-airway non-emphysema type" and highest with 2.55 ± 1.77 in "mixed type" (p < 0.001). Conclusion: QCT demonstrates increasing hyperinflation and emphysema depending on the GOLD grade, while airway wall thickening increases until GOLD3 and airway dilatation occur in GOLD4. QCT identifies four disease phenotypes with implications for lung function and prognosis. (© 2024 S. Karger AG, Basel.)
Databáze:	MEDLINE
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