Journal article
Pulmonary Emphysema Subtypes on Computed Tomography: The MESA COPD Study
The American journal of medicine, Vol.127(1), pp.94.e7-94.e23
01/2014
DOI: 10.1016/j.amjmed.2013.09.020
PMCID: PMC3882898
PMID: 24384106
Abstract
Pulmonary emphysema is divided into 3 major subtypes at autopsy: centrilobular, paraseptal, and panlobular emphysema. These subtypes can be defined by visual assessment on computed tomography (CT); however, clinical characteristics of emphysema subtypes on CT are not well defined. We developed a reliable approach to visual assessment of emphysema subtypes on CT and examined if emphysema subtypes have distinct characteristics.
The Multi-Ethnic Study of Atherosclerosis COPD Study recruited smokers with chronic obstructive pulmonary disease (COPD) and controls ages 50-79 years with ≥10 pack-years. Participants underwent CT following a standardized protocol. Definitions of centrilobular, paraseptal, and panlobular emphysema were obtained by literature review. Six-minute walk distance and pulmonary function were performed following guidelines.
Twenty-seven percent of 318 smokers had emphysema on CT. Interrater reliability of emphysema subtype was substantial (K: 0.70). Compared with participants without emphysema, individuals with centrilobular or panlobular emphysema had greater dyspnea, reduced walk distance, greater hyperinflation, and lower diffusing capacity. In contrast, individuals with paraseptal emphysema were similar to controls, except for male predominance. Centrilobular, but not panlobular or paraseptal, emphysema was associated with greater smoking history (+21 pack-years P <.001). Panlobular, but not other types of emphysema, was associated with reduced body mass index (−5 kg/m2; P = .01). Other than for dyspnea, these findings were independent of the forced expiratory volume in 1 second. Seventeen percent of smokers without COPD on spirometry had emphysema, which was independently associated with reduced walk distance.
Emphysema subtypes on CT are common in smokers with and without COPD. Centrilobular and panlobular emphysema, but not paraseptal emphysema, have considerable symptomatic and physiological consequences.
Details
- Title: Subtitle
- Pulmonary Emphysema Subtypes on Computed Tomography: The MESA COPD Study
- Creators
- Benjamin M Smith - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NYJohn H.M Austin - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NYJohn D Newell - Department of Radiology, University of Iowa Carver College of Medicine, Iowa CityBelinda M D'Souza - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NYAnna Rozenshtein - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NYEric A Hoffman - Department of Radiology, University of Iowa Carver College of Medicine, Iowa CityFiras Ahmed - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NYR. Graham Barr - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
- Resource Type
- Journal article
- Publication Details
- The American journal of medicine, Vol.127(1), pp.94.e7-94.e23
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjmed.2013.09.020
- PMID
- 24384106
- PMCID
- PMC3882898
- ISSN
- 0002-9343
- eISSN
- 1555-7162
- Grant note
- US Environmental Protection Agency NIH National Institutes of Health (NIH) NIH and Siemens Healthcare Alpha-1 Foundation American Lung Association
- Language
- English
- Date published
- 01/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984051551902771
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