PMID- 26151081
OWN - NLM
STAT- MEDLINE
DCOM- 20160407
LR  - 20151125
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Linking)
VI  - 277
IP  - 3
DP  - 2015 Dec
TI  - COPD: Do Imaging Measurements of Emphysema and Airway Disease Explain Symptoms 
      and Exercise Capacity?
PG  - 872-80
LID - 10.1148/radiol.2015150037 [doi]
AB  - PURPOSE: To determine the role of imaging measurements of emphysema and airway 
      disease in determining chronic obstructive pulmonary disease (COPD) symptoms and 
      exercise limitation in patients with COPD, particularly in patients with 
      mild-to-moderate disease. MATERIALS AND METHODS: Participants (n = 116) with 
      Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade U 
      (unclassified) or grade I-IV COPD provided informed consent to an ethics 
      board-approved HIPAA-compliant protocol and underwent spirometry and 
      plethysmography, completed the St George's Respiratory Questionnaire (SGRQ), 
      completed a 6-minute walk test for the 6-minute walk distance (6MWD), and 
      underwent hyperpolarized helium 3 ((3)He) magnetic resonance (MR) imaging and 
      computed tomography (CT). Emphysema was estimated by using the MR imaging 
      apparent diffusion coefficient (ADC) and the relative area of the CT attenuation 
      histogram with attenuation of -950 HU or less (RA950). Airway disease was 
      measured by using the CT airway wall thickness of airways with an internal 
      perimeter of 10 mm and total airway count. Ventilation defect percentage at (3)He 
      MR imaging was used to measure ventilation. Multivariable regression models for 
      the 6MWD and SGRQ symptom subscore were used to evaluate the relationships 
      between physiologic and imaging measurements. RESULTS: Multivariate modeling for 
      the 6MWD in 80 patients with GOLD grade U-II COPD showed that ADC (beta = 0.34, P = 
      .04), diffusing capacity of the lung for carbon monoxide (beta = 0.60, P = .0008), 
      and residual volume/total lung capacity (beta = -0.26, P = .02) were significant 
      variables, while forced expiratory volume in 1 second (FEV1) and airway disease 
      measurements were not. In 36 patients with GOLD grade III or IV disease, FEV1 (beta 
      = 0.48, P = .01) was the only significant contributor in a multivariate model for 
      6MWD. MR imaging emphysema measurements also made the greatest relative 
      contribution to symptoms in patients with milder (GOLD grade U-II) COPD (ADC: beta = 
      0.60, P = .005; RA950: beta = -0.52, P = .02; FEV1: beta = -0.45, P = .0002) and in 
      grade III or IV disease (ADC: beta = 0.95, P = .01; RA950: beta = -0.62, P = .07; 
      airway count: beta = -0.49, P = .01). CONCLUSION: In patients with mild-to-moderate 
      COPD, MR imaging emphysema measurements played a dominant role in the expression 
      of exercise limitation, while both CT and MR imaging measurements of emphysema 
      explained symptoms.
FAU - Kirby, Miranda
AU  - Kirby M
AD  - From the James Hogg Research Centre, the University of British Columbia and the 
      Institute of Heart and Lung Health, St Paul's Hospital, Vancouver, BC, Canada 
      (M.K., D.D.S., H.O.C.); Imaging Research Laboratories, Robarts Research Institute 
      (D.P., G.P.), and Department of Medical Biophysics (D.P., G.P.) and Division of 
      Respirology, Department of Medicine (D.G.M.), the University of Western Ontario, 
      1151 Richmond St N, London, ON, Canada N6A 5B7.
FAU - Pike, Damien
AU  - Pike D
AD  - From the James Hogg Research Centre, the University of British Columbia and the 
      Institute of Heart and Lung Health, St Paul's Hospital, Vancouver, BC, Canada 
      (M.K., D.D.S., H.O.C.); Imaging Research Laboratories, Robarts Research Institute 
      (D.P., G.P.), and Department of Medical Biophysics (D.P., G.P.) and Division of 
      Respirology, Department of Medicine (D.G.M.), the University of Western Ontario, 
      1151 Richmond St N, London, ON, Canada N6A 5B7.
FAU - Sin, Don D
AU  - Sin DD
AD  - From the James Hogg Research Centre, the University of British Columbia and the 
      Institute of Heart and Lung Health, St Paul's Hospital, Vancouver, BC, Canada 
      (M.K., D.D.S., H.O.C.); Imaging Research Laboratories, Robarts Research Institute 
      (D.P., G.P.), and Department of Medical Biophysics (D.P., G.P.) and Division of 
      Respirology, Department of Medicine (D.G.M.), the University of Western Ontario, 
      1151 Richmond St N, London, ON, Canada N6A 5B7.
FAU - Coxson, Harvey O
AU  - Coxson HO
AD  - From the James Hogg Research Centre, the University of British Columbia and the 
      Institute of Heart and Lung Health, St Paul's Hospital, Vancouver, BC, Canada 
      (M.K., D.D.S., H.O.C.); Imaging Research Laboratories, Robarts Research Institute 
      (D.P., G.P.), and Department of Medical Biophysics (D.P., G.P.) and Division of 
      Respirology, Department of Medicine (D.G.M.), the University of Western Ontario, 
      1151 Richmond St N, London, ON, Canada N6A 5B7.
FAU - McCormack, David G
AU  - McCormack DG
AD  - From the James Hogg Research Centre, the University of British Columbia and the 
      Institute of Heart and Lung Health, St Paul's Hospital, Vancouver, BC, Canada 
      (M.K., D.D.S., H.O.C.); Imaging Research Laboratories, Robarts Research Institute 
      (D.P., G.P.), and Department of Medical Biophysics (D.P., G.P.) and Division of 
      Respirology, Department of Medicine (D.G.M.), the University of Western Ontario, 
      1151 Richmond St N, London, ON, Canada N6A 5B7.
FAU - Parraga, Grace
AU  - Parraga G
AD  - From the James Hogg Research Centre, the University of British Columbia and the 
      Institute of Heart and Lung Health, St Paul's Hospital, Vancouver, BC, Canada 
      (M.K., D.D.S., H.O.C.); Imaging Research Laboratories, Robarts Research Institute 
      (D.P., G.P.), and Department of Medical Biophysics (D.P., G.P.) and Division of 
      Respirology, Department of Medicine (D.G.M.), the University of Western Ontario, 
      1151 Richmond St N, London, ON, Canada N6A 5B7.
LA  - eng
GR  - CIF 97687/Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150707
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Data Interpretation, Statistical
MH  - Emphysema/pathology/*physiopathology
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Disease, Chronic Obstructive/*physiopathology
MH  - Respiratory Function Tests
MH  - Respiratory Tract Diseases/pathology/*physiopathology
MH  - Surveys and Questionnaires
MH  - Tomography, X-Ray Computed
MH  - Walkers
EDAT- 2015/07/08 06:00
MHDA- 2016/04/08 06:00
CRDT- 2015/07/08 06:00
PHST- 2015/07/08 06:00 [entrez]
PHST- 2015/07/08 06:00 [pubmed]
PHST- 2016/04/08 06:00 [medline]
AID - 10.1148/radiol.2015150037 [doi]
PST - ppublish
SO  - Radiology. 2015 Dec;277(3):872-80. doi: 10.1148/radiol.2015150037. Epub 2015 Jul 
      7.