Volumetric HRCT in Stable COPD Patients.
The Role of Volumetric High-Resolution Computed Tomography (HRCT) of the Chest in the Assessment of Patients With Stable Chronic Obstructive Pulmonary Disease (COPD)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Background and Rationale:
Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent respiratory symptoms (such as dyspnea, cough, and sputum production) resulting from airway and/or alveolar abnormalities that cause progressive airflow obstruction. While irreversible airflow obstruction (post-bronchodilator FEV1/FVC < 0.70) measured by spirometry confirms the diagnosis, global spirometric tests lack the spatial resolution required to assess regional parenchymal destruction, emphysema distribution, or peripheral air trapping. Volumetric High-Resolution Computed Tomography (HRCT) enables detailed, three-dimensional quantitative assessment of lung parenchyma and structural alterations in COPD.
Study Objectives:
To quantify emphysema extent, air trapping, and airway wall thickness using volumetric HRCT.
To assess the relationship between quantitative volumetric HRCT findings and clinical measures of COPD severity.
Methods and Procedures:
This cross-sectional observational study is conducted at Mansoura University Hospital (smoking clinic and chest disease general clinic) under ethics approval code MS.25.02.3101. Enrolled participants include patients with stable COPD diagnosed according to GOLD guidelines.
All participants undergo the following assessments:
Clinical Evaluation: Comprehensive history taking (symptoms, smoking status), physical examination, and mMRC Dyspnea Scale grading.
Pulmonary Function Testing & Lung Volumes: Spirometry (FEV1, FVC, FEV1/FVC, MMEF), 6-Minute Walk Test (6MWT), and lung volume measurements (RV, TLC, RV/TLC%).
Laboratory Tests: Complete Blood Count (CBC) with calculation of Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR), and Arterial Blood Gas (ABG) analysis.
HRCT Imaging Protocol: Multidetector HRCT (minimum 64-slice, ≤1,5 mm slice thickness, 512x512 matrix) performed during full inspiratory breath-hold (with optional expiratory scanning for air trapping evaluation). Dedicated high-resolution algorithms and window settings are applied to quantify parenchymal and bronchial changes.
nd bronchial changes.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Kontakter og lokationer
Studiesteder
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Dakahlia Governorate
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Al Mansurah, Dakahlia Governorate, Egypten, 35516
- Mansoura University Hospital (Chest Disease Department)
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:Patients with stable chronic obstructive pulmonary disease (COPD)
Diagnosed according to GOLD criteria (post-bronchodilator FEV1/FVC < 0.70)
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Exclusion Criteria:
- Patient in exacerbation defined as change in the patient's baseline dyspnea, cough, and/or sputum beyond normal day-to-day variations within 14 days . (Ko, Fanny W., et al 2016)
- Connective tissue disease .
- Previously diagnosed Interstitial lung disease
Contraindication to PFT According to ATS (Stanojevic S., et al 2021)
- Recent Myocardial Infarction Within 1 week
- Blood Pressure Instability Severe hypertension or systemic hypotension
- Arrhythmias Significant, uncontrolled atrial or ventricular arrhythmias
- Decompensated heart failure
- Pulmonary Circulation Issues: Uncontrolled pulmonary hypertension, acute cor pulmonale, or clinically unstable pulmonary embolism
- History of Syncope Loss of consciousness related to coughing or forced expiration
- Cerebral Aneurysm
- Recent Brain Surgery: Within 4 weeks
- Concussion: Recent concussion with prolonged symptoms
- Eye Surgery: Recent eye surgery within 1 week
- Pneumothorax: Active or untreated pneumothorax Recent Thoracic Surgery: Within 4 weeks Recent Abdominal Surgery: Within 4 weeks Late-Term Pregnancy
- Contraindicatins of 6MWT according to ATS :
Absolute contraindications
- Unstable Angina Experienced during the previous 1 month.
- Recent Myocardial Infarction : Within the previous 1 month. Relative contraindications
- Resting Tachycardia: Resting heart rate > 120{ bpm}.
Severe Uncontrolled Hypertension:
- Systolic Blood Pressure > 180{ mmHg}
- Diastolic Blood Pressure > 100{ mmHg}
- Symptomatic/Severe Cardiac Conditions: High-degree atrioventricular (AV) block, hypertrophic cardiomyopathy, or symptomatic severe aortic stenosis.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Stable COPD Patients
Stable Chronic Obstructive Pulmonary Disease (COPD) patients undergoing quantitative volumetric High-Resolution Computed Tomography (HRCT) of the chest to evaluate parameters such as air trapping and lung volumes, combined with clinical assessment including mMRC dyspnea scale scoring and laboratory assessment including Cbc abg
|
Multidetector volumetric high-resolution computed tomography (≥64 slices, ≤1.0 mm slice thickness) performed during full inspiratory breath-hold and full expiratory breath-hold to quantitatively measure emphysema percentage (EM%), air trapping percentage (AT%), wall thickness (WT), wall area (WA) ,WA% and WT%
Standardized pulmonary function testing performed according to ATS/ERS standards to measure post-bronchodilator forced expiratory volumes (FEV1, FVC) and static lung volumes (RV/TLC ratio).
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Emphysema Percentage (EM%) Across GOLD Stages
Tidsramme: Baseline
|
Volumetric CT assessment quantifying the percentage of low-attenuation lung areas below -950 Hounsfield Units (%LAA-950) across post-bronchodilator GOLD grades (GOLD 1 to 4).
Unit of Measure: Percentage (%)
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Baseline
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Bronchial Wall Thickness (WT) Across GOLD Stages
Tidsramme: Baseline
|
Volumetric CT quantitative measurement of airway wall thickness evaluated in segmental and subsegmental bronchi across post-bronchodilator GOLD grades (GOLD 1 to 4).Unit of measurements millimeter (mm).
|
Baseline
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Percentage Wall Area (WA%) Across GOLD Stages
Tidsramme: Baseline
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Volumetric CT quantitative measurement of bronchial wall area expressed as a percentage of total bronchial cross-sectional area across post-bronchodilator GOLD grades (GOLD 1 to 4).
Unit of Measure: Percentage (%)
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Baseline
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Air Trapping Percentage (AT%) Across GOLD Stages
Tidsramme: Baseline
|
Volumetric CT assessment evaluating the percentage of low-attenuation lung areas on paired expiratory CT scans (%LAA-856 or expiratory/inspiratory ratio) across post-bronchodilator GOLD grades (GOLD 1 to 4).
Unit of Measure: Percentage (%)
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Baseline
|
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Percentage Wall Thickness (WT%) Across GOLD Stages
Tidsramme: Baseline
|
Volumetric CT quantitative measurement of bronchial wall thickness expressed as a percentage of total bronchial outer diameter evaluated in segmental and subsegmental bronchi across post-bronchodilator GOLD grades (GOLD 1 to 4).
Unit of Measure: Percentage (%)
|
Baseline
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Absolute Wall Area (WA) Across GOLD Stages
Tidsramme: Baseline
|
Volumetric CT quantitative measurement of absolute bronchial wall cross-sectional area evaluated in segmental and subsegmental bronchi across post-bronchodilator GOLD grades (GOLD 1 to 4).
Unit of Measure: Millimeter (mm)
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Baseline
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Correlation Coefficient Between CT Emphysema Percentage (EM%) and Spirometric FEV1/FVC Ratio
Tidsramme: Baseline (same day or within 1 week of HRCT scan)
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Pearson's or Spearman's correlation coefficient evaluating the relationship between quantitative CT-derived emphysema percentage (%LAA-950) and post-bronchodilator FEV1/FVC ratio measured by spirometry. Unit of Measure: Correlation coefficient (r) |
Baseline (same day or within 1 week of HRCT scan)
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Correlation Coefficient Between CT Air Trapping Percentage (AT%) and Plethysmographic RV/TLC Ratio
Tidsramme: Baseline (same day or within 1 week of HRCT scan)
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Pearson's or Spearman's correlation coefficient evaluating the relationship between quantitative expiratory CT air trapping percentage (%LAA-856) and plethysmographic Residual Volume to Total Lung Capacity ratio (RV/TLC expressed as % predicted). Unit of Measure: Correlation coefficient (r) |
Baseline (same day or within 1 week of HRCT scan)
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Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Correlation Coefficient Between CT Emphysema Percentage (EM%) and Arterial Oxygen Tension (pO2)
Tidsramme: Baseline
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Pearson's or Spearman's correlation coefficient evaluating the relationship between quantitative CT-derived emphysema percentage (%LAA-950) and arterial blood gas oxygen tension (pO2 measured in mmHg). Unit of Measure: Correlation coefficient (r) |
Baseline
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Nesreen Shalabi, Professor of Chest Diseases
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Patologiske processer
- Kronisk sygdom
- Sygdomsegenskaber
- Luftvejssygdomme
- Lungesygdomme
- Respirationsforstyrrelser
- Lungesygdomme, obstruktiv
- Respiratorisk insufficiens
- Patologiske tilstande, tegn og symptomer
- Lungesygdom, kronisk obstruktiv
- Lungeemfysem
- Luftvejsobstruktion
- Diagnostiske teknikker og procedurer
- Diagnose
- Diagnostiske teknikker, åndedrætssystem
- Diagnostiske teknikker, kardiovaskulær
- Respiratorisk funktionstest
- Plethysmografi
- Spirometri
- Pletysmografi, hele kroppen
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- MS.25.02.3101
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