Objectives. Diagnostic guidelines for chronic obstructive pulmonary disease (COPD) are based on spirometry and clinical criteria.\nHowever, this does not address the pathophysiological complexity of the disease sufficiently. Until now, inspiratory chest\ncomputed tomography (CT) has been considered as the preferred imaging method in these patients. We hypothesized that\nexpiratory CTmay be superior to demonstrate pathophysiological changes. The aim of this prospective study was to systematically\ncompare lung function tests with quantified CT parameters in inspiration and expiration. Materials and Methods. Forty-six\npatients with diagnosed COPD underwent spirometry, body plethysmography, and dose-optimized CT in maximal inspiration\nand expiration. Four quantified CT parameters were acquired in inspiration, expiration, and their calculated delta values. These\nparameters were correlated with seven established lung function parameters. Results. For inspiratory scans, a weak-to-moderate\ncorrelation with the lung function parameters was found. These correlations significantly improved when adding the expiratory\nscan (p<0.05). Moreover, some parameters showed a significant correlation only in expiratory datasets. Calculated delta values\nshowed even stronger correlation with lung function testing. Conclusions. Expiratory quantified CT and calculated delta values\nsignificantly improve the correlation with lung function parameters. Thus, an additional expiratory CTmay improve image-based\nphenotyping of patients with COPD.
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