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Emphysema- and airway-dominant COPD phenotypes defined by standardised quantitative computed tomography

: Subramanian, Deepak R.; Gupta, Sumit; Burggraf, Dorothe; Silberberg, Suzan J. vom; Heimbeck, Irene; Heiss-Neumann, Marion S.; Haeussinger, Karl; Newby, Chris; Hargadon, Beverley; Raj, Vimal; Singh, Dave; Kolsum, Umme; Hofer, Thomas P.; Al-Shair, Khaled; Luetzen, Niklas; Prasse, Antje; Müller-Quernheim, Joachim; Benea, Giorgio; Leprotti, Stefano; Boschetto, Piera; Gorecka, Dorota; Nowinski, Adam; Oniszh, Karina; Castell, Wolfgang zu; Hagen, Michael; Barta, Imre; Döme, Balazs; Strausz, Janos; Greulich, Timm; Vogelmeier, Claus; Koczulla, Andreas R.; Gut, Ivo; Hohlfeld, Jens; Welte, Tobias; Lavae-Mokhtari, Mahyar; Ziegler-Heitbrock, Loems; Brightling, Christopher; Parr, David G.


European Respiratory Journal 48 (2016), No.1, pp.92-103
ISSN: 0903-1936
ISSN: 1399-3003
Journal Article
Fraunhofer ITEM ()
obstructive pulmonary disease; Lung densitometry; cluster analysis; Severe asthma; CT metrics; diagnosis; progression; strategy; smoker

EvA (Emphysema versus Airway disease) is a multicentre project to study mechanisms and identify biomarkers of emphysema and airway disease in chronic obstructive pulmonary disease (COPD). The objective of this study was to delineate objectively imaging-based emphysema-dominant and airway disease-dominant phenotypes using quantitative computed tomography (QCT) indices, standardised with a novel phantom-based approach. 441 subjects with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1-3) were assessed in terms of clinical and physiological measurements, laboratory testing and standardised QCT indices of emphysema and airway wall geometry. QCT indices were influenced by scanner non-conformity, but standardisation significantly reduced variability (p<0.001) and led to more robust phenotypes.