Table of Contents Author Guidelines Submit a Manuscript
Canadian Respiratory Journal
Volume 2018, Article ID 9493504, 9 pages
Research Article

Time to Exhale: Additional Value of Expiratory Chest CT in Chronic Obstructive Pulmonary Disease

1Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
2Department of Medicine (Cardiology, Angiology, Pulmonary, and Intensive Care), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
3Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
4DZHK (German Center for Cardiovascular Research), Partner Site Mannheim, Berlin, Germany

Correspondence should be addressed to Frederik Trinkmann; ed.mmu@nnamknirt.kirederf

Received 2 September 2017; Revised 23 December 2017; Accepted 31 December 2017; Published 4 March 2018

Academic Editor: Jörg D. Leuppi

Copyright © 2018 Joshua Gawlitza et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Diagnostic guidelines for chronic obstructive pulmonary disease (COPD) are based on spirometry and clinical criteria. However, this does not address the pathophysiological complexity of the disease sufficiently. Until now, inspiratory chest computed tomography (CT) has been considered as the preferred imaging method in these patients. We hypothesized that expiratory CT may be superior to demonstrate pathophysiological changes. The aim of this prospective study was to systematically compare lung function tests with quantified CT parameters in inspiration and expiration. Materials and Methods. Forty-six patients with diagnosed COPD underwent spirometry, body plethysmography, and dose-optimized CT in maximal inspiration and expiration. Four quantified CT parameters were acquired in inspiration, expiration, and their calculated delta values. These parameters were correlated with seven established lung function parameters. Results. For inspiratory scans, a weak-to-moderate correlation with the lung function parameters was found. These correlations significantly improved when adding the expiratory scan (). Moreover, some parameters showed a significant correlation only in expiratory datasets. Calculated delta values showed even stronger correlation with lung function testing. Conclusions. Expiratory quantified CT and calculated delta values significantly improve the correlation with lung function parameters. Thus, an additional expiratory CT may improve image-based phenotyping of patients with COPD.