SynthesisAmerican journal of respiratory and critical care medicine2025
The Use of Computed Tomography Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society.
Synthesis in American journal of respiratory and critical care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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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
11 citing papers in PubMed.
- Pulmonary vascular volume heterogeneity in association with emphysema: a multicenter study based on non-contrast chest CT.European radiology · 2026Article
- The clinical relevance of chest computed tomography imaging in pulmonary hypertension associated with lung diseases.Current opinion in pulmonary medicine · 2026Review
- Chest CT imaging toward personalized management of chronic obstructive pulmonary disease, asthma, and bronchiectasis: pulmonologist perspectives.Japanese journal of radiology · 2026Review
- Development and validation of a clinical factor-based nomogram for predicting imaging-defined cardiopulmonary abnormality risk in an asymptomatic screening population.World journal of radiology · 2026Article
- Deep learning-based super-resolution ultrashort echo time MRI for pulmonary nodule detection and longitudinal assessment in emphysema.BMC pulmonary medicine · 2026Article
- Quantitative CT of emphysema, wall thickness and mucus plugs in alpha-1-antitrypsin deficiency: relationship to clinical outcomes.European radiology · 2026Article
- Pulmonary vascular features on chest computed tomography differentially associate with adverse outcomes in smokers in COPDGene.Annals of the American Thoracic Society · 2026Article
- Opportunistic Screening on Chest CT, From theAJR. American journal of roentgenology · 2026Review
- Pathogenesis, Diagnostic Advances, and Therapeutic Management of Chronic Obstructive Pulmonary Disease: A Narrative Review.International journal of chronic obstructive pulmonary disease · 2026Review
- Cluster analysis identifies quantitative CT imaging-based subgroups in COPD subjects with pulmonary artery enlargement.The European respiratory journal · 2025Article
- Age-related lung structure changes by quantitative assessment: a cross-sectional study in a Chinese male cohort.Frontiers in aging · 2025Article
Corrections and comments
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Authors and funding
28 authors.
Funding
Abstract
Emphysema's significant morbidity and mortality underscore the need for reliable outcome metrics in clinical trials. However, commonly accepted chronic obstructive pulmonary disease outcome measures do not adequately capture emphysema severity or progression. Computed tomography (CT) metrics have been validated as accurate indicators of pathological emphysema and predictors of chronic obstructive pulmonary disease progression, exacerbations, and mortality. This position paper reviews the evidence supporting CT densitometry as a biomarker for emphysema, establishes implementation standards, and highlights areas for future research. A systematic literature review addressed three key questions: whether CT densitometry can be used as a diagnostic biomarker of emphysema, whether CT densitometry can be used as a prognostic biomarker, and whether longitudinal change in densitometry can be used as a disease progression monitoring biomarker. Emphysema metrics, such as the percentage of low attenuation areas below -950 Hounsfield units, are validated, highly reproducible diagnostic and prognostic biomarkers. Volume-adjusted lung density is recommended for disease monitoring. Both metrics demonstrate a scan-rescan intraclass correlation coefficient of 0.99 with proper technique. The paper also discusses relevant CT physics, techniques, and sources of variation, including technical factors, physiological changes, and software analysis. Key recommendations for clinical trials include using standardized CT techniques, proper subject selection, and longitudinal evaluation with volume-adjusted lung density.
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Registered trials
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