Pulmonary emphysema: Comparison of preoperative quantitative CT and physiologic index values with clinical outcome after lung-volume reduction surgery

David S. Gierada, Richard M. Slone, Kyongtae T. Bae, Roger D. Yusen, Stephen S. Lefrak, Joel D. Cooper

Research output: Contribution to journalArticle

87 Scopus citations

Abstract

PURPOSE: To compare quantitative computed tomographic (CT) and preoperative physiologic values in emphysema with outcome after lung-volume reduction surgery. MATERIALS AND METHODS: In 46 patients, emphysema was quantified by measuring lung attenuation on preoperative CT scans. Quantitative CT and preoperative physiologic values and postoperative outcomes (1-second forced expiratory volume, PaO2, and 6-minute walk distance) were compared. RESULTS: Moderately strong correlations were found between several quantitative CT and preoperative physiologic values (/r/ = .29-.58, P < .05) and several quantitative CT and outcome measures (/r/ = .31-.47, P < .05). With stratification, postoperative outcome was better with mean lung attenuation greater than -900 HU; 75% or greater of upper lung below -900 HU (emphysema index); greater than 25% of lung below -960 HU (severe emphysema index); ratio of upper- and lower-lung emphysema indexes 1.5 or greater; volume of normally attenuated lung (-850 to -701 HU) greater than 1 L; and full width at half maximum of attenuation-frequency distribution 80 HU or less. Differences in outcome measures between groups stratified with quantitative CT values were often two- to threefold; patients with greater numbers of favorable quantitative CT values had better outcome. Correlations between preoperative physiologic measures and outcome were few. CONCLUSION: In emphysema, quantitative CT values correlate with outcome. Quantitative assessment of emphysema in candidates for lung-volume reduction surgery is potentially useful.

Original languageEnglish
Pages (from-to)235-242
Number of pages8
JournalRadiology
Volume205
Issue number1
DOIs
StatePublished - Oct 1997

Keywords

  • Computed tomography (CT), quantitative
  • Emphysema, pulmonary
  • Lung, CT
  • Lung, surgery

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