Variability of CT Airways Measurements in COPD Patients Between Morning and Afternoon

Publication date: Available online 20 March 2018
Source:Academic Radiology
Author(s): Maxime Hackx, Elodie Gyssels, Tiago Severo Garcia, Isabelle De Meulder, Marie Bruyneel, Alain Van Muylem, Vincent Ninane, Pierre Alain Gevenois
Rationale and ObjectivesComputed tomography (CT) airways measurements can be used as surrogates to spirometric measurements for assessing bronchodilation in a particular patient with chronic obstructive pulmonary disease. Although spirometric measurements show variations within the opening hours of a hospital department, we aimed to compare the variability of CT airways measurements between morning and afternoon in patients with chronic obstructive pulmonary disease to that of spirometric measurements.Materials and MethodsTwenty patients had pulmonary function tests and CT around 8 am and 4 pm. Luminal area (LA) and wall thickness (WT) of third and fourth generation airways were measured twice by three readers. The percentage of airway area occupied by the wall (WA%) and the square root of wall area at an internal perimeter of 10 mm (√WAPi10) were calculated. The effects of examination time, reader, and measurement session on CT airways measurements were assessed, and the variability of these measurements was compared to that of spirometric measurements.ResultsVariability of LA^3rd and LA^4th was greater than that of spirometric measurements (P values ranging from <.001 to .033). There was no examination time effect on √WAPi10, WT^3rd, LA^4th, or WA%^4th (P values ranging from .102 to .712). There was a reader effect on all CT airways measurements (P values ranging from <.001 to .028), except in WT^3rd (P > .999). There was no effect of measurement session on any CT airway measurement (P values ranging from .535 to >.999).ConclusionAs the variability of LA^3rd and LA^4th is greater than that of spirometric measurements, clinical studies should include cohorts with larger numbers of patients when considering LA than when considering spirometric measurements as end points.



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