The Role of Chest Computed Tomography in the Evaluation and Management of the Patient with COPD (original) (raw)

2017, American journal of respiratory and critical care medicine

Chronic obstructive pulmonary disease (COPD) exhibits significant heterogeneity in clinical presentation and rate of disease progression, owing at least in part to differing underlying morphologic abnormalities. Symptom assessment and spirometry have traditionally been used to determine disease severity and guide management. However, chest computed tomography (CT) is a widely available and increasingly used imaging modality that can provide additional insight into structural and pathophysiologic pulmonary parameters. While chest CT is not currently recommended as part of the routine evaluation for COPD beyond aiding with advanced therapy decision making in severe disease, the expanding use of CT now demands that clinicians understand how to treat relevant information that becomes available. Emphysema, airway disease, air trapping and pulmonary vascular abnormalities have all been associated with a number of important outcomes, including respiratory symptoms, COPD exacerbations and m...