Visual and Quantitative Assessments of Regional Xenon-Ventilation Using Dual-Energy CT in Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome: A Comparison with Chronic Obstructive Pulmonary Disease

Authors
Hye Jeon Hwang, MD, PhD, Sang Min Lee, MD, PhD, Joon Beom Seo, MD, PhD, Jae Seung Lee, MD, PhD, Namkug Kim, PhD, Sei Won Lee, MD, PhD, and Yeon-Mok Oh, MD, PhD
Journal
Korean Journal of Radiology
Related Product

COPD

Date Published
2020.07
Summary

This study assessed regional ventilation in patients with asthma-COPD overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT) and compared it to COPD patients. Twenty-one ACOS and 46 COPD patients underwent xenon-ventilation DECT. Ventilation abnormalities were visually categorized into four types: peripheral wedge/diffuse defect, diffuse heterogeneous defect, lobar/segmental/subsegmental defect, and no defect. Emphysema index (EI) and airway wall thickness (Pi10) were quantified using Aview software by Coreline Soft on virtual non-contrast (VNC) images. Results showed significant differences in ventilation defect patterns between ACOS and COPD patients. ACOS patients mostly exhibited peripheral wedge/diffuse defects (66.7%), while COPD patients showed diffuse heterogeneous (45.7%) and lobar/segmental/subsegmental defects (43.5%). Quantified ventilation in peripheral lung areas was lower in ACOS patients (p = 0.045), and Pi10 was higher (p = 0.041), but EI was not significantly different between groups. Xenon-ventilation DECT reveals different physiological changes in pulmonary ventilation between ACOS and COPD patients.

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