CT Indexes of Emphysema and Airways in Healthy Volunteers: Normal Values; Relations With Gender, Height and Weight

Overview

Various indexes have been proposed to quantify both pulmonary emphysema and airways disease on chest CT scans. It is unknown whether these indexes should be consider in absolute values or as compared to predicted normal values. The purposes of the present study is thus : a) to measure these indexes at CT in healthy volunteers; b) to investigate their relations with gender, height and weight.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: June 2011

Detailed Description

87 healthy volunteers performed consecutively a low-dose chest CT scan and pulmonary function tests: 1. On chest CT scans, indexes reflecting pulmonary emphysema and airways measurements have been computed by using dedicated softwares. Each of our three readers performed two reading sessions. Relative area of lung parenchyma with attenuation value less than -960 Hounsfield Units; luminal area and wall thickness in third and fourth generations airways were recorded. 2. Pulmonary function tests were performed: vital capacity, forced vital capacity , functional residual capacity, total lung capacity, residual volume, forced expiratory volume in one second, and diffusion lung capacity for carbon monoxide were recorded (either in absolute values and percentage of predicted values). CT indexes were compared with gender, height and weight.

Interventions

  • Radiation: Low-dose chest CT scans
    • Supine chest CT scan after full inspiration. Acquisition parameters: (Topogram 35 mA 120 kV 512 mm length) 35 quality ref mAs with care-dose ON 120 kV Pitch 1.4 Rotation time 0.33 s Acquired images 64 x 0.6 mm

Arms, Groups and Cohorts

  • Healthy Volunteers
    • Inclusion criteria: Aged 18 or more. Never smoked. No respiratory infection in the 4 weeks before the begin of the study. No history of pulmonary resection. No active malignancy or malignancy of any organ system within the past 5 years.

Clinical Trial Outcome Measures

Primary Measures

  • CT index – RA960 (%)
    • Time Frame: 4 hours
    • From acquired data, images were reconstructed using a soft algorithm. On these soft images, the relative area of lung parenchyma with attenuation value less than -960 Hounsfield Units was computed (expressed in %), as an index representative of pulmonary emphysema extent.
  • CT index – LA3rd (mm2)
    • Time Frame: 4 hours
    • From acquired data, images were reconstructed using a high resolution algorithm. On these high-resolution images, the airway lumen was measured in third generations of airways (expressed in mm2).
  • CT index – LA4th (mm2)
    • Time Frame: 4 hours
    • From acquired data, images were reconstructed using a high resolution algorithm. On these high-resolution images, the airway lumen was measured in fourth generations of airways (expressed in mm2).
  • CT index – WT3rd (mm)
    • Time Frame: 4 hours
    • From acquired data, images were reconstructed using a high resolution algorithm. On these high-resolution images, the airway wall was measured in third generations of airways (expressed in mm).
  • CT index – WT4th (mm)
    • Time Frame: 4 hours
    • From acquired data, images were reconstructed using a high resolution algorithm. On these high-resolution images, the airway wall was measured in fourth generations of airways (expressed in mm).

Secondary Measures

  • Pulmonary function tests – VC (l)
    • Time Frame: 4 hours
    • Vital capacity was measured (expressed in l).
  • Pulmonary function tests – FVC (l)
    • Time Frame: 4 hours
    • Forced vital capacity was measured (expressed in l).
  • Pulmonary function tests – FRC (l)
    • Time Frame: 4 hours
    • Functional residual capacity capacity was measured (expressed in l).
  • Pulmonary function tests – TLC (l)
    • Time Frame: 4 hours
    • Total lung capacity was measured (expressed in l).
  • Pulmonary function tests – RV (l)
    • Time Frame: 4 hours
    • Residual volume was measured (expressed in l).
  • Pulmonary function tests – FEV1 (l)
    • Time Frame: 4 hours
    • Forced expiratory volume in one second was measured (expressed in l).
  • Pulmonary function tests – DLCO (ml/min/ mmHg)
    • Time Frame: 4 hours
    • Diffusion lung capacity for carbon monoxide was measured (expressed in ml/min/ mmHg)

Participating in This Clinical Trial

Inclusion Criteria

  • Never smoked. – No respiratory infection in the 4 weeks before the begin of the study. – No history of pulmonary resection. – No active malignancy or malignancy of any organ system within the past 5 years. Exclusion Criteria:

  • no exclusion criteria

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Erasme University Hospital
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Pierre Alain GEVENOIS, MD, PhD, Study Director, Erasme University Hospital

References

Madani A, Zanen J, de Maertelaer V, Gevenois PA. Pulmonary emphysema: objective quantification at multi-detector row CT–comparison with macroscopic and microscopic morphometry. Radiology. 2006 Mar;238(3):1036-43. doi: 10.1148/radiol.2382042196. Epub 2006 Jan 19.

Madani A, De Maertelaer V, Zanen J, Gevenois PA. Pulmonary emphysema: radiation dose and section thickness at multidetector CT quantification–comparison with macroscopic and microscopic morphometry. Radiology. 2007 Apr;243(1):250-7. doi: 10.1148/radiol.2431060194.

Hackx M, Bankier AA, Gevenois PA. Chronic obstructive pulmonary disease: CT quantification of airways disease. Radiology. 2012 Oct;265(1):34-48. doi: 10.1148/radiol.12111270.

Hackx M, Gyssels E, Severo Garcia T, De Meulder I, Alard S, Bruyneel M, Van Muylem A, Ninane V, Gevenois PA. Chronic Obstructive Pulmonary Disease: CT Quantification of Airway Dimensions, Numbers of Airways to Measure, and Effect of Bronchodilation. Radiology. 2015 Dec;277(3):853-62. doi: 10.1148/radiol.2015140949. Epub 2015 May 19.

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