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)
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
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.
研究の種類
研究の種類
入学 (実際)
入学
連絡先と場所
研究場所
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Dakahlia Governorate
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Al Mansurah、Dakahlia Governorate、エジプト、35516
- Mansoura University Hospital (Chest Disease Department)
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参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
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.
研究計画
研究はどのように設計されていますか?
デザインの詳細
グループ/コホートの数
コホートと介入
グループ/コホートグループ/コホート |
介入・治療介入・治療 |
|---|---|
|
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
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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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この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Emphysema Percentage (EM%) Across GOLD Stages
時間枠: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
時間枠: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
時間枠:Baseline
|
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 (%)
|
Baseline
|
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Air Trapping Percentage (AT%) Across GOLD Stages
時間枠: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 (%)
|
Baseline
|
|
Percentage Wall Thickness (WT%) Across GOLD Stages
時間枠: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
時間枠: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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二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Correlation Coefficient Between CT Emphysema Percentage (EM%) and Spirometric FEV1/FVC Ratio
時間枠:Baseline (same day or within 1 week of HRCT scan)
|
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
時間枠: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)
|
その他の成果指標
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Correlation Coefficient Between CT Emphysema Percentage (EM%) and Arterial Oxygen Tension (pO2)
時間枠:Baseline
|
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
|
協力者と研究者
捜査官
捜査官
- 主任研究者:Nesreen Shalabi、Professor of Chest Diseases
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (実際)
一次修了
研究の完了 (実際)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- MS.25.02.3101
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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