- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07809399
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)
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
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.
Studietyp
Inskrivning (Faktisk)
Kontakter och platser
Studieorter
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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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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Testmetod
Studera befolkning
Beskrivning
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
Hur är studien utformad?
Designdetaljer
Kohorter och interventioner
Grupp / Kohort |
Intervention / Behandling |
|---|---|
|
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).
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Emphysema Percentage (EM%) Across GOLD Stages
Tidsram: 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 (%)
|
Baseline
|
|
Bronchial Wall Thickness (WT) Across GOLD Stages
Tidsram: 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
|
|
Percentage Wall Area (WA%) Across GOLD Stages
Tidsram: 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
|
|
Air Trapping Percentage (AT%) Across GOLD Stages
Tidsram: 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
Tidsram: 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
|
|
Absolute Wall Area (WA) Across GOLD Stages
Tidsram: 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)
|
Baseline
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Correlation Coefficient Between CT Emphysema Percentage (EM%) and Spirometric FEV1/FVC Ratio
Tidsram: 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
Tidsram: 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)
|
Andra resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Correlation Coefficient Between CT Emphysema Percentage (EM%) and Arterial Oxygen Tension (pO2)
Tidsram: 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
|
Samarbetspartners och utredare
Sponsor
Utredare
- Huvudutredare: Nesreen Shalabi, Professor of Chest Diseases
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Patologiska processer
- Kronisk sjukdom
- Sjukdomsegenskaper
- Luftvägssjukdomar
- Lungsjukdomar
- Andningsstörningar
- Lungsjukdomar, obstruktiv
- Andningsinsufficiens
- Patologiska tillstånd, tecken och symtom
- Lungsjukdom, kronisk obstruktiv
- Lungemfysem
- Luftvägshinder
- Diagnostiska tekniker och procedurer
- Diagnos
- Diagnostiska tekniker, andningssystem
- Diagnostiska tekniker, hjärt -kärl
- Andningsfunktionstester
- Pletysmografi
- Spirometri
- Pletyzmografi, helkropp
Andra studie-ID-nummer
- MS.25.02.3101
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