Radiologic features of COPD exacerbations: quantitative analysis of thorax computerised tomography

Background-aim: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has a negative impact on the prognosis of the disease. Radiological findings might be a helpful assessment tool to predict future exacerbations. Here we identified quantitative computerized tomography (CT) findings in relation to AECOPD. Methods: Thorax CT features of COPD patients who applied to our clinic during the last 5 years were retrospectively evaluated and analyzed based on voxel attenuation. Subjects were divided into two groups according to the presence of acute severe exacerbation during the last 12 months after the date of the CT scan. Thus, groups are named GOLD A-B and GOLD E according to GOLD 2023. Quantitative voxel-based attenuation analysis was done by Myrian® Expert software (Intrasense SA-1231, Montpellier, France). Emphysema was defined as attenuation values<-950 Hounsfield Unit (HU). Results: Of 106, 24 subjects had at least one severe AECOPD in the following year of CT. Emphysema percentage was significantly higher in GOLD E in the GOLD A-B group (3% vs 10%, p=0.001) (Table 1). However, both groups displayed similar values in lung volume and mean attenuation. Conclusion: Higher emphysema percentage might indicate increased AECOPD risk. Quantitative CT analysis could be a helpful assessment tool to evaluate exacerbation risk.