Imaging Might Improve Treatment Of COPD Patients

Computed tomography (CT) and magnetic resonance imaging (MRI) provide relevant information about the symptoms and exercise capabilities of those suffering with mild-to-moderate chronic obstructive pulmonary disease (COPD), a finding that was recently published in the Radiology journal that could lead to new and better treatments for COPD patients.

COPD, a progressive disease of the lungs, affects almost 65 million people in the world according to the World Health Organization. Diagnosis includes spirometry tests to assess lung function that produces a figure called the forced expiratory volume in one second (FEV1), but this test has been shown to have limitations.

“COPD is a very heterogeneous disease. Patients are classified based on spirometry, but patients with the same air flow may have different symptoms and significant variation in how much regular activity they can perform, such as walking to their car or up the stairs in their home,” noted the study’s co-author Grace Parraga from the Robarts Research Institute in London, Ontario, Canada.

The researchers went on to explain that the FEV1 test might not offer physicians and imaging professionals the entire picture of the lungs, while emphysema and airways disease can be directly measured with imaging. Dr. Parraga and team performed conventional CT and inhaled noble gas MRI on 116 COPD patients with COPD (80 with a milder form of the disease). Patients also responded to a questionnaire and took a 6-minute walk so that their exercise tolerance could be measured.

Results revealed that in patients with mild-to-moderate COPD and with modestly abnormal FEV1, the MRI measurements of emphysema were correlated with exercise limitation, and CT and MRI helped to explain symptoms.

“FEV1 doesn’t tell the whole story. With lung imaging, we can look at patients with mild disease much more carefully and change treatment if necessary,” Parraga said in a press release.

There is no cure for emphysema but there are measures to mitigate symptoms. Emphysema, one of the diseases included in COPD, is under-recognized, which might be causing suboptimal treatment for that patients.

“One in four hospital beds in Canada is occupied by a COPD patient, and many of them return to a hospital because they’re not being optimally treated. Our study shows that when COPD symptoms and exercise limitations are discordant with FEV1 measurements, we should consider using lung imaging to provide a deeper understanding of the patient’s disease and to help improve their quality of life,” she concluded.