ArticleChest2015
How Common Is Airflow Limitation in Patients With Emphysema on CT Scan of the Chest?
Article in Chest, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 46 citations in OpenAlex.
- Chronic obstructive pulmonary disease prevalence and prediction in a high-risk lung cancer screening population.BMC pulmonary medicine · 2020Trial
- Year in Review: Pulmonary Function Testing.Respiratory care · 2025Review
- The Emerging Biomarkers in Chronic Obstructive Pulmonary Disease: A Narrative Review.Diagnostics (Basel, Switzerland) · 2025Review
- The Role of Pulmonary Function Testing in the Diagnosis and Management of COPD.Respiratory care · 2023Review
- Affordable, portable and self-administrable electrical impedance tomography enables global and regional lung function assessment.Scientific reports · 2022Article
- Bullous Parametric Response Map for Functional Localization of COPD.Journal of digital imaging · 2022Article
- Mortality and Exacerbation Risk by Body Mass Index in Patients with COPD in TIOSPIR and UPLIFT.Annals of the American Thoracic Society · 2022Article
- Defining Resilience to Smoking-related Lung Disease: A Modified Delphi Approach from SPIROMICS.Annals of the American Thoracic Society · 2021Article
- Abnormal pulmonary flow is associated with impaired right ventricular coupling in patients with COPD.The international journal of cardiovascular imaging · 2021Article
- Prediction of lung emphysema in COPD by spirometry and clinical symptoms: results from COSYCONET.Respiratory research · 2021Article
- Early chronic obstructive pulmonary disease: A new perspective.Chronic diseases and translational medicine · 2021Review
- Role of the Emphysema Index Combined with the Chronic Obstructive Pulmonary Disease Assessment Test Score in the Evaluation of Chronic Obstructive Pulmonary Disease.Canadian respiratory journal · 2021Article
- Optimization of pulmonary emphysema quantification on CT scans of COPD patients using hybrid iterative and post processing techniques: correlation with pulmonary function tests.Insights into imaging · 2019Article
- Quantitative computed tomography for predicting cardiopulmonary complications after lobectomy for lung cancer in patients with chronic obstructive pulmonary disease.General thoracic and cardiovascular surgery · 2019Article
- Associations of airway tree to lung volume ratio on computed tomography with lung function and symptoms in chronic obstructive pulmonary disease.Respiratory research · 2019Observational
- The role of CAT in evaluating the response to treatment of patients with AECOPD.International journal of chronic obstructive pulmonary disease · 2018Article
- Asthma and Chronic Obstructive Pulmonary Disease Overlap: The Effect of Definitions on Measures of Burden.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2017Article
- Usefulness of the desaturation-distance ratio from the six-minute walk test for patients with COPD.International journal of chronic obstructive pulmonary disease · 2017Article
- TwoInternational journal of chronic obstructive pulmonary disease · 2017Article
- Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCOPD has traditionally been defined by the presence of irreversible airflow limitation on spirometry using either the GOLD (Global Initiative for Chronic Obstructive Lung Disease) or American Thoracic Society/European Respiratory Society criteria (lower limit of normal [LLN]). We have observed that some patients with clinical COPD and emphysema on chest CT scan have no obstruction on spirometry. The purpose of this study was to assess the prevalence of obstruction by GOLD and LLN criteria in patients with emphysema on CT scan and determine which radiographic criteria were associated with a clinical diagnosis of COPD.
methodsWe retrospectively analyzed the clinical records and spirometry of all patients who had radiographically defined emphysema on chest CT scans completed at the University of Vermont in 2011. We compared spirometric criteria and CT scan factors with the presence of clinical COPD based on chart review.
resultsWe identified 274 patients with CT scan-defined emphysema. GOLD criteria detected obstruction in 228 patients (83%), and LLN detected obstruction in 206 patients (75%). However, GOLD failed to correctly identify 19 patients (6.9%) and LLN failed to identify 38 patients (13.9%) (average 10.4%) who had radiographic emphysema and a clinical diagnosis of COPD. Obese patients had a lower prevalence of obstruction whether classified by LLN or GOLD. Among patients with spirometric obstruction, there were greater degrees of emphysema and more severely increased airway wall thickness. Factors that were independently associated with clinical COPD were lower FVC % predicted, lower FEV1/FVC ratio, and increasing airway wall thickness.
conclusionsSpirometry missed 10.4% of patients with clinical COPD who have significant emphysema on chest CT scan.
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