Emphysema quantification by combining percentage and size distribution of low-attenuation lung regions

Mizuho Nishio, Sumiaki Matsumoto, Hisanobu Koyama, Takeshi Yoshikawa, Naoki Sugihara, Kazuro Sugimura, Yoshiharu Ohno

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10 Citations (Scopus)


OBJECTIVE. The purpose of this study was to investigate efficacy of two types of emphysema quantification: percentage of low-attenuation lung regions (%LA); and size distribution of these regions. On a log-log plot, cumulative frequency-size distribution of low-attenuation lung regions can be fitted by a straight line whose slope (D) has been reported to reflect diffusing capacity. In this study, % LA and D were compared with pulmonary function test (PFT) parameters, especially with ratio of diffusing capacity of carbon monoxide to effective alveolar ventilation (i.e., DLCO/VA). MATERIALS AND METHODS. Thin-section unenhanced CT images were acquired from 30 patients (25 men, five women; mean [SD] age, 70.1 ± 12.1 years), of whom 25 had received diagnosis of COPD, and %LA and D were calculated at 20 thresholds, ranging from -995 to -900 HU. To determine utility of % LA and D, we used Pearson's correlation for emphysema quantification and PFT. Significance of the coefficients was determined with Bonferroni correction ( p < 0.0025). Finally, the relationships between emphysema quantification and DL CO/VA were examined by linear models and Akaike information criterion (AIC). RESULTS. The correlation coefficients for %LA and DLCO/VA were statistically significant at all the thresholds (optimal coefficient, -0.761). The correlation coefficients for D and DLCO/VA were statistically significant at the thresholds from -945 to -900 HU (optimal coefficient, -0.646). AIC values showed that the most accurate prediction of DLCO/VA was obtained by the model incorporating both %LA and D. CONCLUSION. Both %LA and D showed significant correlation with DL CO/VA. Combining %LA and D resulted in more accurate evaluation of DLCO/VA than did using % LA or D alone.

Original languageEnglish
Pages (from-to)W453-W458
JournalAmerican Journal of Roentgenology
Issue number5
Publication statusPublished - 05-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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