International Journal of COPD (Jun 2023)

Inspiratory and Expiratory Computed Tomography Imaging Clusters Reflect Functional Characteristics in Chronic Obstructive Pulmonary Disease

  • Matsuo Y,
  • Ogawa E,
  • Tsunoda Y,
  • Yamazaki A,
  • Kawashima S,
  • Uchida Y,
  • Nakagawa H,
  • Kinose D,
  • Yamaguchi M,
  • Nakano Y

Journal volume & issue
Vol. Volume 18
pp. 1047 – 1055

Abstract

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Yumiko Matsuo,1,2 Emiko Ogawa,1,2 Yoko Tsunoda,1 Akio Yamazaki,1 Satoru Kawashima,1 Yasuki Uchida,1 Hiroaki Nakagawa,1 Daisuke Kinose,1 Masafumi Yamaguchi,1 Yasutaka Nakano1 1Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan; 2Health Administration Center, Shiga University of Medical Science, Otsu, Shiga, JapanCorrespondence: Emiko Ogawa, Health Administration Center, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan, Tel/Fax +81-77-548-2212, Email [email protected]: Disease probability measure (DPM) is a useful voxel-wise imaging assessment of gas-trapping and emphysematous lesions in patients with chronic obstructive pulmonary disease (COPD). To elucidate the progression of COPD, we performed a cluster analysis using the following DPM parameters: normal (DPMNormal), gas-trapping (DPMGasTrap), and emphysematous lesions (DPMEmph). Our findings revealed the characteristics of each cluster and the 3-year disease progression using imaging parameters.Patients and Methods: Inspiratory and expiratory chest computed tomography (CT) images of 131 patients with COPD were examined, of which 84 were followed up for 3 years. The percentage of low attenuation volume (LAV%) and the square root of the wall area of a hypothetical airway with an internal perimeter of 10 mm (√Aaw at Pi10) were quantitatively measured using inspiratory chest CT. A hierarchical cluster analysis was performed using the DPM parameters at baseline. Five clusters were named according to the dominant DPM parameters: normal (NL), normal-GasTrap (NL-GT), GasTrap (GT), GasTrap-Emphysema (GT-EM), and Emphysema (EM).Results: Women were predominantly diagnosed with GT. Forced expiratory volume in 1 s gradually decreased in the following order: NL, NL-GT, GT, GT-EM, and EM. DPMEmph correlated well with LAV%. Four clusters other than NL showed significantly higher values of √Aaw at Pi10 than NL; however, no significant differences were observed among them. In all clusters, DPMEmph increased after 3 years. DPMNormal only increased in the GT cluster.Conclusion: Clusters using DPM parameters may reflect the characteristics of COPD and help understand the pathophysiology of the disease.Keywords: cluster analysis, computed tomography, COPD, DPM, gas-trapping, emphysema

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