CT in Chronic Obstructive Pulmonary Disease/Pulmonary Emphysema

Abstract

The population of patients suffering from chronic obstructive pulmonary disease (COPD) and asthma is heterogeneous, complicating therapy management and scientifi c analysis. Owing to the rapid technical improvements in imaging techniques in the past years, research has succeeded in gaining further insights into the different manifestations of obstructive pulmonary disease. Whereas the main parameters for differentiation and categorization of the disease in the past were pulmonary function tests and pathologic examinations, computed tomography (CT) has now made it possible to visualize alterations in the airway and parenchymal architecture induced by COPD in vivo and in unprecedented detail. The visual differentiation of COPD is currently given by the two major radiologic phenotypes, namely the airway predominant and the emphysema predominant type of COPD. Further objective and reliable categorization and classifi cation of the different manifestations via computer-aided analysis of pulmonary CT examinations is an important goal of recent research in pulmonary imaging. While much innovation and improvement have already been made, fi nding a conclusive system of parameters that allow for a reliable and quantitative classifi cation of the different imaging features of COPD remains a task to be completed. In this chapter we provide a fundamental insight into the particular imaging patterns and provide a technical basis for the use of CT in COPD. Furthermore, we illustrate the current state-of-the-art technologies in imaging analysis and the results of recent research in typecasting COPD with clinical correlation.