Significance of quantitative radiological phenotype of copd and correlation with bode index

Avinash Jain., Agarwal S.K., Mohit Bhatia., Ashish Verma and Dolly Madan

Background - Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder because of variation in clinical presentation and disease progression. The Role of phenotyping is to identify therapeutic and prognostic characteristics in COPD. Quantitative computed tomography (QHRCT) is non-invasive tool to identify distinct phenotypes in COPD.
Aim-we aimed to evaluate the correlation of Quantitative Radiological Phenotype of COPD with BODE index
Method- 50 COPD subjects meeting Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for COPD with QHRCT analysis were included. Total lung emphysema was measured using the Density Mask Technique with a −950 Hounsfield unit threshold. An visual Semi-Automated Quantification of segmental wall area percentage wall area percentage (WA%) and square root of the wall area of a theoretical airway of 10 mm internal perimeter (Pi10) in 6 segmental bronchi In six segment bronchi. We compared Emphysema severity and Airway Abnormality on Body-Mass Index, Airflow Obstruction, Dyspnea and Exercise Capacity Index measure
Results- Emphysema percentage (LAA950) with BODE score showed positive correlation (r=0.7095, p-value <0.005). Airway dimension segmental wall area percentage (r=0.32, p-value <0.005) and lumenal perimeter (Pi10) (r=0.34, p-value <0.005), also showed positive correlation. Emphysema severity (low attenuation area percentage) was increased with increasing age (r=0.772, p-value<0.005).Emphysema severity (low attenuation area percentage) was increased with increasing number of pack years (r= 0.663, p-value <0.005).
Conclusion -QHRCT is complimentary tool to evaluate progression of COPD. Emphysema and Airway disease both relate to clinically important parameters. Emphysema is a stronger predictor of BODE and Its systemic components MMRC, 6MWT, and BMI than Airway Abnormalities. It is evident that patients with high BODE scores have a much greater burden of emphysema than airway disease.

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