Comparison of endobronchial ultrasound and high resolution computed tomography as tools for airway wall imaging in asthma and chronic obstructive pulmonary disease. (August 2016)

• Record Type: Journal Article
• Authors: Gorska, Katarzyna; Korczynski, Piotr; Mierzejewski, Michal; Kosciuch, Justyna; Zukowska, Malgorzata; Maskey-Warzechowska, Marta; Krenke, Rafal
• Is Part Of: Respiratory medicine. Volume 117(2016)
• Page Start: 131
• Page End: 138
• Publication Date: 2016-08
• Subjects: Airway remodeling -- Asthma -- COPD -- High resolution computed tomography -- Endobronchial ultrasound -- Bronchial wall thickness; ACT Asthma Control Test -- ATS American Thoracic Society -- BMI body mass index -- BWT bronchial wall thickness -- CAT COPD Assessment Test -- COPD chronic obstructive pulmonary disease -- EBUS endobronchial ultrasound -- ERS European Respiratory Society -- FEV1 forced expiratory volume in the first second -- FVC forced vital capacity -- GOLD Global Initiative for Chronic Obstructive Lung Disease -- HRCT high resolution computed tomography -- OBS1 observer 1 -- OBS2 observer 2 -- PFT pulmonary function testing -- RV residual volume -- TLC total lung capacity; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2016.06.011
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Introduction: Airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) results in bronchial wall thickening. Bronchial wall thickness (BWT) can be assessed in high-resolution computed tomography (HRCT) and endobronchial ultrasound (EBUS). Aims: To compare BWT measured by EBUS and HRCT in patients with mild-to-moderate asthma and COPD, and to evaluate the relationship between the BWT and pulmonary function. Methods: The study included patients with mild-to-moderate asthma (n = 24), COPD (n = 36) and controls (n = 12). Bronchoscopy with EBUS (radial probe) and HRCT were performed to measure the BWT in the segmental bronchus. Results: Good overall agreement between EBUS and HRCT measurements of BWT was demonstrated. Median HRCT-BWT did not reveal any significant differences between individuals with asthma and COPD, and control subjects: 1.56 (1.27–1.70) mm, 1.62 (1.45–1.90) mm, and 1.63 (1.41–1.77) mm, respectively (p = 0.315). In contrast, median BWT measured by EBUS was significantly higher in asthma and COPD groups when compared to controls: 1.20 (1.02–1.41) mm, 1.19 (1.10–1.48) mm, and 0.99 (0.90–1.08) mm, respectively (p = 0.006). There were no differences in BWT in mild-to-moderate asthma and COPD or significant correlations between BWT and the results of pulmonary function tests. Conclusions: The use of EBUS to assess BWT in asthma and COPD is feasible and it shows good compatibility with HRCT. A tendency towards lower BWT values in EBUS when compared to HRCT was observed. The finding that EBUS measurements demonstrated the differences between BWT in patients with obstructive lung diseases and controls, may suggest that EBUS is a more sensitive method to study the BWT than HRCT. Highlights: Bronchial wall thickness (BWT) may be reliably assessed not only in HRCT, but in EBUS as well. This is the first study to assess the utility of EBUS in BWT measurements in mild-to-moderate asthma and COPD patients. There are no differences between the BWT of the segmental bronchi in mild-to-moderate asthma and COPD. Only EBUS measurements could demonstrate the higher BWT in mild-to moderate asthma and COPD compared to controls. EBUS seems to be a more sensitive method to study bronchial wall thickness than HRCT.