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COPD

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Multislice CT

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by persistent airflow limitation associated with an enhanced chronic inflammatory response to noxious particles or gases in the lungs and airways. Airflow limitation that characterizes COPD is caused by a combination of emphysema-induced loss of elastic recoil and small airway chronic inflammation and remodeling. Their contribution to the disease largely varies among patients, and current spirometric criteria are inadequate to assess the predominant contributor. In this context imaging plays an essential role. Chest radiography is a simple tool for diagnosing moderate-to-severe emphysema, and it can be suitable for phenotyping COPD in severe cases. Multidetector CT (MDCT) is currently the most widely available and precise imaging method for diagnosing and characterizing the morphological phenotypes of COPD, also in the early stage. MDCT allows the automatic quantification of the presence and percentage of emphysematous lung, the lobar and zonal distribution of the low-attenuation areas, the changes in airway wall and luminal caliber, and the severity of air trapping due to small airway involvement. MDCT provides information on significant concomitant pulmonary and extrapulmonary diseases and can be employed to plan interventional procedures in patients with severe disease. Imaging quantitative measurements of COPD phenotype have also been associated with exacerbation frequency and risk of lung cancer. In the future imaging quantitative analysis will enable the identification and stratification of patients with certain disease features for clinical trials focused on targeted treatments, thus improving patient management.

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Authors and Affiliations

  1. Diagnostic Imaging, Catholic University of the Sacred Heart, Policlinico A. Gemelli Foundation, Largo A. Gemelli, 8, 00168, Rome, Italy

    Anna Rita Larici MD, Paola Franchi, Giuseppe Cicchetti & Lorenzo Bonomo

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  1. Anna Rita Larici MD
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  2. Paola Franchi
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  3. Giuseppe Cicchetti
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  4. Lorenzo Bonomo
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Correspondence to Anna Rita Larici MD .

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  1. Department of Radiology, Universitätsklinikum Tübingen, Tübingen, Baden-Württemberg, Germany

    Konstantin Nikolaou

  2. Department of Diagnostic and Interventional Radiology, University of Freiburg, Freiburg, Germany

    Fabian Bamberg

  3. Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza” – University of Rome, Rome, Italy

    Andrea Laghi

  4. Department of Radiology, Duke University School of Medicine, Durham, NC, USA

    Geoffrey D. Rubin

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Larici, A.R., Franchi, P., Cicchetti, G., Bonomo, L. (2017). COPD. In: Nikolaou, K., Bamberg, F., Laghi, A., Rubin, G.D. (eds) Multislice CT. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2017_10

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