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Title: The Role of CT Scanning in Multidimensional Phenotyping of COPD
Authors: Bafadhel, Mona
Umar, Imran
Gupta, Sumit
Raj, J. Vimal
Vara, Dhiraj D.
Entwisle, James J.
Pavord, Ian D.
Brightling, Christopher E.
Siddiqui, Salman
First Published: Sep-2011
Publisher: American College of Chest Physicians (ACCP)
Citation: Chest, 2011, 140 (3), pp. 634-642
Abstract: Background: COPD is a heterogeneous disease characterized by airflow obstruction and diagnosed by lung function. CT imaging is emerging as an important, noninvasive tool in phenotyping COPD. However, the use of CT imaging in defining the disease heterogeneity above lung function is not fully known. Methods: Seventy-five patients with COPD (58 men, 17 women) were studied with CT imaging and with measures of airway inflammation. Airway physiology and health status were also determined. Results: The presence of emphysema (EM), bronchiectasis (BE), and bronchial wall thickening (BWT) was found in 67%, 27%, and 27% of subjects, respectively. The presence of EM was associated with lower lung function (mean difference % FEV[subscript 1] , -20%; 95% CI, -28 to -11; P<.001). There was no difference in airway inflammation, exacerbation frequency, or bacterial load in patients with EM alone or with BE and/or BWT±EM. The diffusing capacity of the lung for carbon monoxide/alveolar volume ratio was the most sensitive and specific parameter in identifying EM (area under the receiver operator characteristic curve, 0.87; 95% CI, 0.79-0.96). Physiologic cluster analysis identified three clusters, two of which were EM predominant and the third characterized by a heterogeneous combination of EM and BE. Conclusions: The application of CT imaging can be useful as a tool in the multidimensional approach to phenotyping patients with COPD.
DOI Link: 10.1378/chest.10-3007
ISSN: 0012-3692
eISSN: 1931-3543
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2011 American College of Chest Physicians. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Information for commercial entities is available online (
Appears in Collections:Published Articles, Dept. of Infection, Immunity and Inflammation

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