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. 1992 Nov;47(11):914–921. doi: 10.1136/thx.47.11.914

Regional structure-function correlations in chronic obstructive lung disease measured with positron emission tomography.

L H Brudin 1, C G Rhodes 1, S O Valind 1, P D Buckingham 1, T Jones 1, J M Hughes 1
PMCID: PMC464094  PMID: 1465748

Abstract

BACKGROUND: Positron emission tomography, performed with isotopes of very short half life, can be used to relate local lung tissue density to local ventilation and to the ventilation:perfusion ratio. This method has been used in 10 patients with severe chronic airflow obstruction and differing values for carbon monoxide transfer factor (TLCO) and transfer coefficient (KCO). METHODS: Ventilation (VA) and the ventilation:perfusion ratio (V/Q), lung density, and blood volume were measured regionally in a single transaxial section at mid-heart level with the patients in a supine position. Alveolar volume, extravascular tissue lung density, and perfusion (Q) were derived. Twenty five regions with abnormalities in the ventilation images were analysed. RESULTS: Tissue density showed a negative correlation with the ratio V/Q (r = 0.55) and a positive correlation with Q (r = 0.59) and blood volume (r = 0.65). In four patients with a low carbon monoxide transfer factor (TLCO) and transfer coefficient (KCO) < 50% predicted many regions with low VA had low tissue density and normal or high V/Q. On the other hand, in four patients with TLCO and KCO > 50% predicted many regions with low VA had normal or high tissue density and low values of V/Q. The other two patients had patterns between these two extremes. Individual ratios between mean values of tissue density and V/Q had a positive correlation with KCO (% pred; r = 0.79). CONCLUSIONS: These findings link structural differences with distinctive functional patterns; they reinforce the view that bronchial inflammation or oedema predominate in some patients with chronic airflow obstruction, whereas alveolar destruction is the major feature in others.

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Selected References

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  1. Bergin C., Müller N., Nichols D. M., Lillington G., Hogg J. C., Mullen B., Grymaloski M. R., Osborne S., Paré P. D. The diagnosis of emphysema. A computed tomographic-pathologic correlation. Am Rev Respir Dis. 1986 Apr;133(4):541–546. doi: 10.1164/arrd.1986.133.4.541. [DOI] [PubMed] [Google Scholar]
  2. Brudin L. H., Rhodes C. G., Valind S. O., Wollmer P., Hughes J. M. Regional lung density and blood volume in nonsmoking and smoking subjects measured by PET. J Appl Physiol (1985) 1987 Oct;63(4):1324–1334. doi: 10.1152/jappl.1987.63.4.1324. [DOI] [PubMed] [Google Scholar]
  3. Brudin L. H., Valind S. O., Rhodes C. G. Error analysis of combined measurements of regional ventilation and V/Q ratio using positron emission tomography. Phys Med Biol. 1992 May;37(5):1077–1093. doi: 10.1088/0031-9155/37/5/005. [DOI] [PubMed] [Google Scholar]
  4. Brudin L. H., Valind S. O., Rhodes C. G., Turton D. R., Hughes J. M. Regional lung hematocrit in humans using positron emission tomography. J Appl Physiol (1985) 1986 Apr;60(4):1155–1163. doi: 10.1152/jappl.1986.60.4.1155. [DOI] [PubMed] [Google Scholar]
  5. Burrows B., Fletcher C. M., Heard B. E., Jones N. L., Wootliff J. S. The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in London and Chicago. Lancet. 1966 Apr 16;1(7442):830–835. doi: 10.1016/s0140-6736(66)90181-4. [DOI] [PubMed] [Google Scholar]
  6. Gould G. A., MacNee W., McLean A., Warren P. M., Redpath A., Best J. J., Lamb D., Flenley D. C. CT measurements of lung density in life can quantitate distal airspace enlargement--an essential defining feature of human emphysema. Am Rev Respir Dis. 1988 Feb;137(2):380–392. doi: 10.1164/ajrccm/137.2.380. [DOI] [PubMed] [Google Scholar]
  7. Morrison N. J., Abboud R. T., Ramadan F., Miller R. R., Gibson N. N., Evans K. G., Nelems B., Müller N. L. Comparison of single breath carbon monoxide diffusing capacity and pressure-volume curves in detecting emphysema. Am Rev Respir Dis. 1989 May;139(5):1179–1187. doi: 10.1164/ajrccm/139.5.1179. [DOI] [PubMed] [Google Scholar]
  8. Müller N. L., Staples C. A., Miller R. R., Abboud R. T. "Density mask". An objective method to quantitate emphysema using computed tomography. Chest. 1988 Oct;94(4):782–787. doi: 10.1378/chest.94.4.782. [DOI] [PubMed] [Google Scholar]
  9. Petty T. L., Silvers G. W., Stanford R. E. Mild emphysema is associated with reduced elastic recoil and increased lung size but not with air-flow limitation. Am Rev Respir Dis. 1987 Oct;136(4):867–871. doi: 10.1164/ajrccm/136.4.867. [DOI] [PubMed] [Google Scholar]
  10. Rhodes C. G., Valind S. O., Brudin L. H., Wollmer P. E., Jones T., Buckingham P. D., Hughes J. M. Quantification of regional V/Q ratios in humans by use of PET. II. Procedure and normal values. J Appl Physiol (1985) 1989 Apr;66(4):1905–1913. doi: 10.1152/jappl.1989.66.4.1905. [DOI] [PubMed] [Google Scholar]
  11. Rhodes C. G., Wollmer P., Fazio F., Jones T. Quantitative measurement of regional extravascular lung density using positron emission and transmission tomography. J Comput Assist Tomogr. 1981 Dec;5(6):783–791. doi: 10.1097/00004728-198112000-00001. [DOI] [PubMed] [Google Scholar]
  12. Valind S. O., Rhodes C. G., Jonson B. Quantification of regional ventilation in humans using a short-lived radiotracer--theoretical evaluation of the steady-state model. J Nucl Med. 1987 Jul;28(7):1144–1154. [PubMed] [Google Scholar]
  13. Wagner P. D., Dantzker D. R., Dueck R., Clausen J. L., West J. B. Ventilation-perfusion inequality in chronic obstructive pulmonary disease. J Clin Invest. 1977 Feb;59(2):203–216. doi: 10.1172/JCI108630. [DOI] [PMC free article] [PubMed] [Google Scholar]

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