Download European Respiratory Society Annual Congress 2013

European Respiratory Society
Annual Congress 2013
Abstract Number: 1441
Publication Number: P242
Abstract Group: 1.3. Imaging
Keyword 1: COPD - diagnosis Keyword 2: Imaging Keyword 3: No keyword
Title: Airway wall volume: Implications for the CT characterization of airway disease in smokers
Alejandro A. 6411 Diaz [email protected] MD 1, Dr. Raul 6415 San Jose [email protected]
2
, Mr. James C. 6416 Ross [email protected] 2, Yuka 6445 Okajima [email protected] MD 2, Dr.
Juerg 6417 Tschirren [email protected] 3, Meilan K. 6418 Han [email protected] MD 4,
Mark T. 6419 Dransfield [email protected] MD 5, R. Graham 6420 Barr
[email protected] MD 6, Victor 6421 Kim [email protected] MD 7, Joe 6422
Ramsdell [email protected] MD 8, Edwin J.R. 6423 van Beek [email protected] MD 9, Dawn
6426 Demeo [email protected] MD 10, Mr. Jordan A. 6427 Zach [email protected] 11, Joyce D.
6428 Schroeder [email protected] MD 11, Edwin K. 6429 Silverman
[email protected] MD 10, James 6430 Crapo [email protected] MD 12, David A.
6431 Lynch [email protected] MD 11 and George R. 6432 Washko [email protected] MD 1. 1
Medicine, Divsion of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States ; 2 Radiology, Surgical Planning Laboratory, Laboratory of
Mathematics in Imaging, Brigham and Women's Hospital, Boston, MA, United States ; 3 Diagnostics VIDA,
Coralville, IA, United States ; 4 Medicine, Pulmonary and Critical Care, University of Michigan, Ann Arbor,
MI, United States ; 5 Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of
Alabama, Birmingham, AL, United States ; 6 Departments of Medicine and Epidemiology, Columbia
University Medical Center, New York, NY, United States ; 7 Medicine, Division of Pulmonary and Critical
Care Medicine, Temple University School of Medicine, Philadelphia, PA, United States ; 8 Radiology,
University of California San Diego, San Diego, CA, United States ; 9 Clinical Research Imaging Center,
Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom ; 10 Medicine,
Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States ; 11 Radiology, National Jewish Health, Denver, CO, United States and 12 Medicine,
Division of Pulmonary and Critical Care Medicine, National Jewish Health, Denver, CO, United States .
Body: Rationale: Prior studies suggest that smoking results in airway wall thickening which on computed
tomography (CT) manifests as an increase in the wall area percent ([WA%]=wall area/total bronchial
area*100). In the normal lung, the bronchi expand both in length and cross section with inflation. Pathologic
processes such as emphysema and hyperinflation may lead to airway elongation with inflation without
proportionate dilation because of disruption of the airway-parenchyma interdependence. This could result in
an artifactual increase in WA% without a discernable increase in airway wall tissue. Objectives: To
determine if the observed increases in the WA% in smokers is due to a gain of mural tissue or mechanical
deformation of the airways. Methods: We analyzed CT-based airway dimensions including wall volume as
well as lung volume and emphysema measurements along with clinical and lung function data in 7,879
controls, smokers at risk, and smokers with COPD. Results: Airway length increased with COPD severity
and hyperinflation. This was accompanied by reductions in lumen volume with negligible changes in wall
volume.
When examined in cross section this manifested as greater reductions in lumen area than wall area. The
result of which is an increase in the WA%. Conclusion: Increases in WA% on the CT scans of smokers
appears to be due to mechanical deformation of the airway and not a gain of mural tissue.