The University of Southampton
University of Southampton Institutional Repository

Relationship of CT-quantified emphysema, small airways disease and bronchial wall dimensions with physiological, inflammatory and infective measures in COPD

Relationship of CT-quantified emphysema, small airways disease and bronchial wall dimensions with physiological, inflammatory and infective measures in COPD
Relationship of CT-quantified emphysema, small airways disease and bronchial wall dimensions with physiological, inflammatory and infective measures in COPD
Background: COPD is a complex, heterogeneous disease characterised by progressive development of airflow limitation. Spirometry provides little information about key aspects of pathology and is poorly related to clinical outcome, so other tools are required to investigate the disease. We sought to explore the relationships between quantitative CT analysis with functional, inflammatory and infective assessments of disease to identify the utility of imaging to stratify disease to better predict outcomes and disease response.Methods: patients from the AERIS study with moderate-very severe COPD underwent HRCT, with image analysis determining the quantity of emphysema (%LAA<− 950), small airways disease (E/I MLD) and bronchial wall thickening (Pi10). At enrolment subjects underwent lung function testing, six-minute walk testing (6MWT), blood sampling for inflammatory markers and sputum sampling for white cell differential and microbiological culture and PCR.Results: 122 subjects were included in this analysis. Emphysema and small airways disease had independent associations with airflow obstruction (β = − 0.34, p < 0.001 and β = − 0.56, p < 0.001). %LAA<− 950 had independent associations with gas transfer (β = − 0.37, p < 0.001) and E/I MLD with RV/TLC (β = 0.30, p =0.003). The distance walked during the 6MWT was not associated with CT parameters, but exertional desaturation was independently associated with emphysema (β = 0.73, p < 0.001). Pi10 did not show any independent associations with lung function or functional parameters.No CT parameters had any associations with sputum inflammatory cells. Greater emphysema was associated with lower levels of systemic inflammation (CRP β = − 0.34, p < 0.001 and fibrinogen β = − 0.28, p =0.003). There was no significant difference in any of the CT parameters between subjects where potentially pathogenic bacteria were detected in sputum and those where it was not.Conclusions: this study provides further validation for the use of quantitative CT measures of emphysema and small airways disease in COPD as they showed strong associations with pulmonary physiology and functional status. In contrast to this quantitative CT measures showed few convincing associations with biological measures of disease, suggesting it is not an effective tool at measuring disease activity.
COPD, CT, Imaging, phenotyping, emphysema
1465-9921
Ostridge, Kristoffer
d2271bae-b078-4390-8919-8f8c0e20542c
Williams, Nicholas P.
00ee9f78-fdc9-434f-be3e-5ded7a8abe08
Kim, Viktoriya
b7fe2e0f-95b4-4224-96a8-a7e66155625e
Harden, Stephen
f53e511e-df8b-451f-aa1e-e8e80e1a4e46
Bourne, Simon
2b022ba8-a7f2-491d-aa41-038b1c8afccb
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
Aris, Emmanuel
2203e7f8-8fa1-40c0-be30-99f142655835
Mesia-Vela, Sonia
71407f65-ae37-496e-917d-fa0c438d8859
Devaster, Jeanne-Marie
36195bcf-0cae-40cc-8ee2-d389a4a65a13
Tuck, Andrew
90d0a731-080b-4872-8fc0-45cd71db1e2c
Williams, Anthony
973ff46f-46f1-4d7c-b27d-0f53221e4c44
Wootton, Stephen
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Staples, Karl J.
e0e9d80f-0aed-435f-bd75-0c8818491fee
Wilkinson, Tom M.A.
8c55ebbb-e547-445c-95a1-c8bed02dd652
Ostridge, Kristoffer
d2271bae-b078-4390-8919-8f8c0e20542c
Williams, Nicholas P.
00ee9f78-fdc9-434f-be3e-5ded7a8abe08
Kim, Viktoriya
b7fe2e0f-95b4-4224-96a8-a7e66155625e
Harden, Stephen
f53e511e-df8b-451f-aa1e-e8e80e1a4e46
Bourne, Simon
2b022ba8-a7f2-491d-aa41-038b1c8afccb
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
Aris, Emmanuel
2203e7f8-8fa1-40c0-be30-99f142655835
Mesia-Vela, Sonia
71407f65-ae37-496e-917d-fa0c438d8859
Devaster, Jeanne-Marie
36195bcf-0cae-40cc-8ee2-d389a4a65a13
Tuck, Andrew
90d0a731-080b-4872-8fc0-45cd71db1e2c
Williams, Anthony
973ff46f-46f1-4d7c-b27d-0f53221e4c44
Wootton, Stephen
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Staples, Karl J.
e0e9d80f-0aed-435f-bd75-0c8818491fee
Wilkinson, Tom M.A.
8c55ebbb-e547-445c-95a1-c8bed02dd652

Ostridge, Kristoffer, Williams, Nicholas P., Kim, Viktoriya, Harden, Stephen, Bourne, Simon, Clarke, Stuart C., Aris, Emmanuel, Mesia-Vela, Sonia, Devaster, Jeanne-Marie, Tuck, Andrew, Williams, Anthony, Wootton, Stephen, Staples, Karl J. and Wilkinson, Tom M.A. (2018) Relationship of CT-quantified emphysema, small airways disease and bronchial wall dimensions with physiological, inflammatory and infective measures in COPD. Respiratory Research, 19. (doi:10.1186/s12931-018-0734-y).

Record type: Article

Abstract

Background: COPD is a complex, heterogeneous disease characterised by progressive development of airflow limitation. Spirometry provides little information about key aspects of pathology and is poorly related to clinical outcome, so other tools are required to investigate the disease. We sought to explore the relationships between quantitative CT analysis with functional, inflammatory and infective assessments of disease to identify the utility of imaging to stratify disease to better predict outcomes and disease response.Methods: patients from the AERIS study with moderate-very severe COPD underwent HRCT, with image analysis determining the quantity of emphysema (%LAA<− 950), small airways disease (E/I MLD) and bronchial wall thickening (Pi10). At enrolment subjects underwent lung function testing, six-minute walk testing (6MWT), blood sampling for inflammatory markers and sputum sampling for white cell differential and microbiological culture and PCR.Results: 122 subjects were included in this analysis. Emphysema and small airways disease had independent associations with airflow obstruction (β = − 0.34, p < 0.001 and β = − 0.56, p < 0.001). %LAA<− 950 had independent associations with gas transfer (β = − 0.37, p < 0.001) and E/I MLD with RV/TLC (β = 0.30, p =0.003). The distance walked during the 6MWT was not associated with CT parameters, but exertional desaturation was independently associated with emphysema (β = 0.73, p < 0.001). Pi10 did not show any independent associations with lung function or functional parameters.No CT parameters had any associations with sputum inflammatory cells. Greater emphysema was associated with lower levels of systemic inflammation (CRP β = − 0.34, p < 0.001 and fibrinogen β = − 0.28, p =0.003). There was no significant difference in any of the CT parameters between subjects where potentially pathogenic bacteria were detected in sputum and those where it was not.Conclusions: this study provides further validation for the use of quantitative CT measures of emphysema and small airways disease in COPD as they showed strong associations with pulmonary physiology and functional status. In contrast to this quantitative CT measures showed few convincing associations with biological measures of disease, suggesting it is not an effective tool at measuring disease activity.

Text
Relationship of CT-quantified emphysema, small airways disease and bronchial wall dimensions with physiological, inflammatory and infective measures in COPD - Accepted Manuscript
Available under License Creative Commons Attribution.
Download (135kB)
Text
Relationaship of CT - Version of Record
Available under License Creative Commons Attribution.
Download (617kB)

More information

Accepted/In Press date: 1 February 2018
e-pub ahead of print date: 20 February 2018
Keywords: COPD, CT, Imaging, phenotyping, emphysema

Identifiers

Local EPrints ID: 417817
URI: https://eprints.soton.ac.uk/id/eprint/417817
ISSN: 1465-9921
PURE UUID: 065dc359-317e-4ca5-8571-965a78a0d04b
ORCID for Stuart C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548
ORCID for Karl J. Staples: ORCID iD orcid.org/0000-0003-3844-6457

Catalogue record

Date deposited: 14 Feb 2018 17:31
Last modified: 14 Mar 2019 05:16

Export record

Altmetrics

Contributors

Author: Kristoffer Ostridge
Author: Nicholas P. Williams
Author: Viktoriya Kim
Author: Stephen Harden
Author: Simon Bourne
Author: Emmanuel Aris
Author: Sonia Mesia-Vela
Author: Jeanne-Marie Devaster
Author: Andrew Tuck
Author: Stephen Wootton
Author: Karl J. Staples ORCID iD

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×