ROLE OF CHEST COMPUTED TOMOGRAPHY IN EVALUATION AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Chronic obstructive pulmonary disease (COPD) exhibits significant heterogeneity in its clinical presentation and rate of disease progression among affected individuals, owing at least in part to differing pulmonary morphologic abnormalities. Symptom assessment, spirometric evaluation, and frequency of respiratory exacerbations have traditionally been used to determine disease severity and guide management. ChestComputed Tomography (CT) scanning provides clear and exact in vivo assessments of organs, and from these data, we can extract subjective and objective features such as parenchymal remodeling, airway dilatation, and vascular calcification. These features can be used to detect the extent of the disease, its severity and also predict its clinical course. However, despite the increasing use and widespread availability of chest CT scans, the wealth of information from Chest CT scans is not consistently used in routine practice and has not yet been incorporated into clinical guidelines for COPD diagnosis, management or prognosis.This article reviews the role of CT in differentiating different phenotypes of Chronic Obstructive Pulmonary Disease (COPD), its clinical implications of emphysema, airway disease, air trapping, and pulmonary vasculature and, highlight the potential value of assessing nonpulmonary structures such as coronary arteries and vertebral bone to provide better comprehensive care for patients with COPD.