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Regional bronchodilator response assessed by computed tomography in chronic obstructive pulmonary disease

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Title: Regional bronchodilator response assessed by computed tomography in chronic obstructive pulmonary disease
Other Titles: Regional bronchodilation assessed by CT
Authors: Shimizu, Kaoruko Browse this author →KAKEN DB
Makita, Hironi Browse this author →KAKEN DB
Hasegawa, Masaru Browse this author
Kimura, Hirokazu Browse this author
Fuke, Satoshi Browse this author
Nagai, Katsura Browse this author →KAKEN DB
Yoshida, Takayuki Browse this author →KAKEN DB
Suzuki, Masaru Browse this author →KAKEN DB
Konno, Satoshi Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author →KAKEN DB
Nishimura, Masaharu Browse this author →KAKEN DB
Keywords: Bronchodilation
Pulmonary function
Salmeterol/fluticasone propionate combination
Computed tomography
Issue Date: Jun-2015
Publisher: Elsevier
Journal Title: European journal of radiology
Volume: 84
Issue: 6
Start Page: 1196
End Page: 1201
Publisher DOI: 10.1016/j.ejrad.2015.02.022
PMID: 25805332
Abstract: Background and objective: The reliability of CT assessment of regional bronchodilation is not universally accepted. In this study, using our proprietary 3D-CT software, we first examined airway inner luminal area (Ai) before and after inhalation of SFC in a group of COPD patients and then evaluated the same parameters for two sets of CT data obtained from clinically stable subjects with no intervention. Methods: We conducted CT at deep inspiration and pulmonary function tests before and one week after inhalation of SFC in 23 COPD patients. As a non-intervention group, we used two sets of CT data obtained with one-year interval in another group of subjects who demonstrated stable pulmonary function (n = 8). We measured Ai at the mid-portions of 3rd to 6th generation in 8 bronchi of the right lung, a total of 32 identical sites before and after intervention. Results: The average bronchodilation at all sites (ΔAi%: 28.2 ± 4.1 (SE)%) (r = 0.65, p < 0.001) and that of each generation significantly correlated with % improvement of FEV1 (ΔFEV1%), which increased from 1.40 ± 0.10 L to 1.58 ± 0.10 L. When subjects were classified into two groups in terms of mean ΔFEV1%, even the poor responders (ΔFEV1% <14% above baseline, n = 13) displayed significantly larger ΔAi% compared with the non-intervention group (19.1 ± 4.6% versus 2.1 ± 3.9%). Inter-observer variability for overall ΔAi% was within acceptable levels. Conclusions: CT can reliably detect the regional bronchodilation in 3rd to 6th generation airways when ΔFEV1 is as small as 180 ml on average. This study was registered in the UMIN Clinical Trials Registry (UMIN-CTR) system (http://www.umin.ac.jp/. No. UMIN 000002668).
Rights: © 2015, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/61986
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 清水 薫子

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