Present and future utility of CT scanning in the assessment and management of COPD

Abstract

Computed Technology (CT) is the modality of choice for imaging the thorax and lung structure. In COPD it used to recognise the key morphological features of emphysema, bronchial wall thickening and gas trapping. Despite this its place in the investigation and management of COPD is yet to be determined and it is not routinely recommended. However, lung CT already has important clinical applications where it can be used to diagnose concomitant pathology and determine which patients with severe emphysema
are appropriate for lung volume reduction procedures. Furthermore novel quantitative analysis techniques permit objective measurements of pulmonary and extra-pulmonary manifestations of the disease. These techniques can give important insights into COPD and help explore the heterogeneity and underlying mechanisms of the condition. In time it is hoped that these techniques can be used in clinical trials to help develop disease specific therapy and ultimately as a clinical tool in identifying patients who would benefit most from new and existing treatments. This review discusses the current clinical applications for CT imaging in COPD and quantification techniques and its potential future role in stratifying disease for optimal
outcome.

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