CT scans can help guide treatment in emphysema


11 Sep 2017

The degree of emphysema present on CT scans could help clinicians pinpoint which patients need to be treated, the ERS congress has heard.

Professor MeiLan K Han from Ann Arbour in Michigan in the US told delegates that thoracic imaging was frequently used in people at high risk of COPD yet CT based quantitative measurement of emphysema had not been incorporated into guidelines or clinical decision making.

“The goal of our study was to translate quantitative imaging data into something that has clinical value and can be easily used by practicing physicians by examining the relationship between % emphysema and exacerbations, symptoms and mortality into two separate cohorts,” she explained to delegates.

Using data from the large COPDGene and SPIROMICS studies the researchers found that the presence of  ≥5% emphysema was associated with greater respiratory symptoms, increased exacerbations and higher mortality.

The differences were most pronounced for individuals with airflow obstruction defined by FEV1/FVC <0.70.

Clinicians could consider spirometry for people with emphysema ≥5%  on their scan but no prior diagnosis of COPD, Professor Han told delegates.

Whereas pharmacotherapy may be indicated for people with emphysema  ≥5%  and known COPD.

“Maintenance therapy has been demonstrated to improve symptoms and reduce the risk of future exacerbations,” she added.

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