Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease:systematic review and meta-analysis

To determine the correlation between CT measurements of emphysema or peripheral airways and airflow obstruction in chronic obstructive pulmonary disease (COPD).PubMed, Embase and Web of Knowledge were searched from 1976 to 2011. Two reviewers independently screened 1,763 citations to identify articles that correlated CT measurements to airflow obstruction parameters of the pulmonary function test in COPD patients, rated study quality and extracted information. Three CT measurements were accessed: lung attenuation area percentage <-950 Hounsfield units, mean lung density and airway wall area percentage. Two airflow obstruction parameters were accessed: forced expiratory volume in the first second as percentage from predicted (FEV1 %pred) and FEV1 divided by the forced volume vital capacity.Seventy-nine articles (9,559 participants) were included in the systematic review, demonstrating different methodologies, measurements and CT airflow obstruction correlations. There were 15 high-quality articles (2,095 participants) in the meta-analysis. The absolute pooled correlation coefficients ranged from 0.48 (95 % CI, 0.40 to 0.54) to 0.65 (0.58 to 0.71) for inspiratory CT and 0.64 (0.53 to 0.72) to 0.73 (0.63 to 0.80) for expiratory CT.CT measurements of emphysema or peripheral airways are significantly related to airflow obstruction in COPD patients. CT provides a morphological method to investigate airway obstruction in COPD.aEuro cent Computed tomography is widely performed in patients with chronic obstructive pulmonary disease (COPD)aEuro cent CT provides quantitative morphological methods to investigate airflow obstruction in COPDaEuro cent CT measurements correlate significantly with the degree of airflow obstruction in COPDaEuro cent Expiratory CT measurements correlate more strongly with airflow obstruction than inspiratory CTaEuro cent Low-dose CT decreases the radiation dose for diagnosis and quantitative emphysema evaluation.