The comparison of quantitative CT features of COPD and pre-COPD: results from a real-life study

AbstractBackground:&nbsp;Although fixed airway obstruction on spirometry is crucial for COPD diagnosis, it might be insufficient to identify subjects with pre-COPD. Quantitative computerized tomography (CT) measurements might be helpful to distinguish the subjects with pre-COPD. Thus, we aimed to compare quantitative CT findings of subjects with pre-COPD and COPD.Methods:&nbsp;Subjects who were admitted to our clinic with chronic respiratory symptoms and were evaluated for COPD as a pre-diagnosis were included in the study. Subjects were categorized as COPD and pre-COPD groups according to the FEV1/FVC ratio. Thorax CT voxel-based attenuation analysis was performed by Myrian® Expert software(Intrasense SA-1231, Montpellier, France). Attenuation values lower than -950 Hounsfield Units (HU) were defined as emphysema.Results:&nbsp;Of 163, 106 COPD and 57 pre-COPD cases were included. COPD group had significantly higher lung volume (5683 ml vs 4921 ml,&nbsp;p=0.001) and lower mean attenuation value (-830.0 HU vs -808.2 HU,&nbsp;p&lt;0.001) than the pre-COPD group. Moreover, the COPD group had a higher emphysema percentage than the pre-COPD group (3.87% vs 0.28%,&nbsp;p&lt;0.001).Conclusion:&nbsp;Quantitative CT of pre-COPD demonstrated radiologic findings that might help to corroborate COPD diagnosis, which was also associated with the severity of the airflow obstruction and be an alternative method for COPD diagnosis when it is difficult to reach spirometry." data-icon-position="" data-hide-link-title="0" style="-webkit-font-smoothing: antialiased; margin: 0px; padding: 8px; border: none; outline-style: initial; outline-width: 0px; vertical-align: baseline; font-style: inherit; font-variant: inherit; font-stretch: inherit; font-size: 0.857rem; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; color: rgb(0, 85, 148); display: block; box-shadow: rgba(0, 0, 0, 0.15) 0px 2px 10px 0px; background: rgb(255, 255, 255);">" data-icon-position="" data-hide-link-title="0" style="-webkit-font-smoothing: antialiased; margin: 0px; padding: 8px; border: none; outline-style: initial; outline-width: 0px; vertical-align: baseline; font-style: inherit; font-variant: inherit; font-stretch: inherit; font-size: 0.857rem; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; color: rgb(0, 85, 148); display: block; box-shadow: rgba(0, 0, 0, 0.15) 0px 2px 10px 0px; background: rgb(255, 255, 255);">" data-icon-position="" data-hide-link-title="0" style="-webkit-font-smoothing: antialiased; margin: 0px; padding: 8px; border: none; outline-style: initial; outline-width: 0px; vertical-align: baseline; font-style: inherit; font-variant: inherit; font-stretch: inherit; font-size: 0.857rem; line-height: inherit; font-family: inherit; font-optical-sizing: inherit; font-kerning: inherit; font-feature-settings: inherit; font-variation-settings: inherit; color: rgb(0, 85, 148); display: block; box-shadow: rgba(0, 0, 0, 0.15) 0px 2px 10px 0px; background: rgb(255, 255, 255);"></div

Pelvis Magnetic Resonance Imaging to Diagnose Familial Partial Lipodystrophy

Context The diagnosis of familial partial lipodystrophy (FPLD) is currently made based on clinical judgment. Objective There is a need for objective diagnostic tools that can diagnose FPLD accurately. Methods We have developed a new method that uses measurements from pelvic magnetic resonance imaging (MRI) at the pubis level. We evaluated measurements from a lipodystrophy cohort (n = 59; median age [25th-75th percentiles]: 32 [24-44]; 48 females and 11 males) and age- and sex-matched controls (n = 29). Another dataset included MRIs from 289 consecutive patients. Results Receiver operating characteristic curve analysis revealed a potential cut-point of = 2.5 (based on a receiver operating characteristic curve) provided 96.67% (95% CI, 82.78-99.92) sensitivity and 91.38% (95% CI, 81.02-97.14) specificity in the overall cohort and 100.00% (95% CI, 87.23-100.00) sensitivity and 90.00% (95% CI, 76.34-97.21) specificity in females for the diagnosis of FPLD. When this approach was tested in a larger dataset of random patients, FPLD was differentiated from subjects without lipodystrophy with 96.67% (95% CI, 82.78-99.92) sensitivity and 100.00% (95% CI, 98.73-100.00) specificity. When only women were analyzed, the sensitivity and the specificity was 100.00% (95% CI, 87.23-100.00 and 97.95-100.00, respectively). The performance of gluteal fat thickness and pubic/gluteal fat thickness ratio was comparable to readouts performed by radiologists with expertise in lipodystrophy. Conclusion The combined use of gluteal fat thickness and pubic/gluteal fat ratio from pelvic MRI is a promising method to diagnose FPLD that can reliably identify FPLD in women. Our findings need to be tested in larger populations and prospectively

Radiologic features of COPD exacerbations: quantitative analysis of thorax computerised tomography

AbstractBackground-aim:&nbsp;Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has a negative impact on the prognosis of the disease. Radiological findings might be a helpful assessment tool to predict future exacerbations. Here we identified quantitative computerized tomography (CT) findings in relation to AECOPD.Methods:&nbsp;Thorax CT features of COPD patients who applied to our clinic during the last 5 years were retrospectively evaluated and analyzed based on voxel attenuation. Subjects were divided into two groups according to the presence of acute severe exacerbation during the last 12 months after the date of the CT scan. Thus, groups are named GOLD A-B and GOLD E&nbsp;according to&nbsp;GOLD 2023. Quantitative voxel-based attenuation analysis was done by Myrian® Expert software (Intrasense SA-1231, Montpellier, France). Emphysema was defined as attenuation values&lt;-950 Hounsfield Unit (HU).Results:&nbsp;Of 106, 24 subjects had at least one severe AECOPD in the following year of CT. Emphysema percentage was significantly higher in GOLD E in the GOLD A-B group (3% vs 10%,&nbsp;p=0.001) (Table 1). However, both groups displayed similar values in lung volume and mean attenuation.Conclusion:&nbsp;Higher emphysema percentage might indicate increased AECOPD risk. Quantitative CT analysis could be a helpful assessment tool to evaluate exacerbation risk.</p