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Quantitative assessment of mucociliary clearance in smokers with mild-to-moderate chronic obstructive pulmonary disease and chronic bronchitis from planar radionuclide imaging using the change in penetration index

Quantitative assessment of mucociliary clearance in smokers with mild-to-moderate chronic obstructive pulmonary disease and chronic bronchitis from planar radionuclide imaging using the change in penetration index
Quantitative assessment of mucociliary clearance in smokers with mild-to-moderate chronic obstructive pulmonary disease and chronic bronchitis from planar radionuclide imaging using the change in penetration index

Background: Mucociliary clearance (MCC) rate from the lung has been shown to be reduced in chronic obstructive pulmonary disease (COPD). This study compared the use of change in penetration index (PI) with conventional whole lung clearance in assessing MCC in mild-to-moderate disease. Methods: Measurement of lung MCC using planar gamma camera imaging was performed in three groups: (1) healthy nonsmoking controls (n = 9), (2) smoking controls who were current smokers with normal lung function (n = 10), and (3) current smokers with mild-to-moderate COPD and bronchitis (n = 15). The mean (±standard deviation) forced expiratory volume at 1 second (FEV1) for the three groups was 109 (±18), 94 (±5), and 78 (±12), respectively. Following inhalation of a technetium-99m labeled aerosol, planar imaging was performed over 4 hours and then at 24 hours. Total lung clearance and tracheobronchial clearance (TBC; normalized to 24-hour clearance) were calculated. A novel parameter, the normalized change in PI (NOCHIP), was also evaluated. PI is the ratio of counts between outer and inner lung zones normalized to lung volume. Results: More aerosol was deposited in central airways in COPD compared to nonsmoking controls, using 24-hour clearance measurements (p < 0.001). Smoking controls had intermediate values. The optimal endpoint for MCC assessment was chosen to be 3 hours, when intersubject variability was minimal, while preserving a measure of early clearance. There was no statistical difference between the three groups in mean total lung clearance, or TBC, at 3 hours. NOCHIP at 3 hours was reduced significantly, compared to nonsmoking controls, in both smoking controls (p = 0.007) and COPD (p < 0.0001). It also correlated with FEV1 (p = 0.003). A higher proportion of smoking control subjects had NOCHIP values in the nonsmoking control range than in the COPD group. Conclusions: NOCHIP was a more sensitive measure of MCC than whole lung clearance and TBC in mild-to-moderate COPD.

2D imaging, COPD, human lung, mucociliary clearance
1941-2711
175-188
Fleming, John S.
9a23102d-6740-430a-ac74-89938b328ec3
Conway, Joy
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06
Bennett, Michael J.
6df5585a-3d93-4870-8797-389759fc82c7
Tossici-Bolt, Livia
a9bd79ee-18c7-40c0-a1a8-2d826e4be759
Guy, Matthew
a0a4b3bc-2ca1-4ab3-a428-3dd20435e4c8
Blé, François Xavier
f5330548-dcc2-4a34-a5b5-1d3e6caa4c3b
McCrae, Christopher
905349d4-6151-412b-b146-7f1481d8472b
Carlsson, Mats
7797d75a-9558-4da7-9dc5-6dd8461f5778
Bondesson, Eva
ed20fdd1-cc5e-4189-8a79-87cfd4bd7091
Fleming, John S.
9a23102d-6740-430a-ac74-89938b328ec3
Conway, Joy
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06
Bennett, Michael J.
6df5585a-3d93-4870-8797-389759fc82c7
Tossici-Bolt, Livia
a9bd79ee-18c7-40c0-a1a8-2d826e4be759
Guy, Matthew
a0a4b3bc-2ca1-4ab3-a428-3dd20435e4c8
Blé, François Xavier
f5330548-dcc2-4a34-a5b5-1d3e6caa4c3b
McCrae, Christopher
905349d4-6151-412b-b146-7f1481d8472b
Carlsson, Mats
7797d75a-9558-4da7-9dc5-6dd8461f5778
Bondesson, Eva
ed20fdd1-cc5e-4189-8a79-87cfd4bd7091

Fleming, John S., Conway, Joy, Bennett, Michael J., Tossici-Bolt, Livia, Guy, Matthew, Blé, François Xavier, McCrae, Christopher, Carlsson, Mats and Bondesson, Eva (2019) Quantitative assessment of mucociliary clearance in smokers with mild-to-moderate chronic obstructive pulmonary disease and chronic bronchitis from planar radionuclide imaging using the change in penetration index. Journal of Aerosol Medicine and Pulmonary Drug Delivery, 32 (4), 175-188. (doi:10.1089/jamp.2017.1441).

Record type: Article

Abstract

Background: Mucociliary clearance (MCC) rate from the lung has been shown to be reduced in chronic obstructive pulmonary disease (COPD). This study compared the use of change in penetration index (PI) with conventional whole lung clearance in assessing MCC in mild-to-moderate disease. Methods: Measurement of lung MCC using planar gamma camera imaging was performed in three groups: (1) healthy nonsmoking controls (n = 9), (2) smoking controls who were current smokers with normal lung function (n = 10), and (3) current smokers with mild-to-moderate COPD and bronchitis (n = 15). The mean (±standard deviation) forced expiratory volume at 1 second (FEV1) for the three groups was 109 (±18), 94 (±5), and 78 (±12), respectively. Following inhalation of a technetium-99m labeled aerosol, planar imaging was performed over 4 hours and then at 24 hours. Total lung clearance and tracheobronchial clearance (TBC; normalized to 24-hour clearance) were calculated. A novel parameter, the normalized change in PI (NOCHIP), was also evaluated. PI is the ratio of counts between outer and inner lung zones normalized to lung volume. Results: More aerosol was deposited in central airways in COPD compared to nonsmoking controls, using 24-hour clearance measurements (p < 0.001). Smoking controls had intermediate values. The optimal endpoint for MCC assessment was chosen to be 3 hours, when intersubject variability was minimal, while preserving a measure of early clearance. There was no statistical difference between the three groups in mean total lung clearance, or TBC, at 3 hours. NOCHIP at 3 hours was reduced significantly, compared to nonsmoking controls, in both smoking controls (p = 0.007) and COPD (p < 0.0001). It also correlated with FEV1 (p = 0.003). A higher proportion of smoking control subjects had NOCHIP values in the nonsmoking control range than in the COPD group. Conclusions: NOCHIP was a more sensitive measure of MCC than whole lung clearance and TBC in mild-to-moderate COPD.

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e-pub ahead of print date: 8 March 2019
Published date: 1 August 2019
Keywords: 2D imaging, COPD, human lung, mucociliary clearance

Identifiers

Local EPrints ID: 436849
URI: http://eprints.soton.ac.uk/id/eprint/436849
ISSN: 1941-2711
PURE UUID: 4d4c8593-1453-4c94-8655-7c82442d5345
ORCID for Joy Conway: ORCID iD orcid.org/0000-0001-6464-1526

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Date deposited: 10 Jan 2020 17:35
Last modified: 20 Mar 2020 17:32

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Contributors

Author: John S. Fleming
Author: Joy Conway ORCID iD
Author: Michael J. Bennett
Author: Livia Tossici-Bolt
Author: Matthew Guy
Author: François Xavier Blé
Author: Christopher McCrae
Author: Mats Carlsson
Author: Eva Bondesson

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