Systematic review of the relevance of CT densitometry in patients with COPD and AATD

Diana Crossley (Birmingham, United Kingdom), Diana Crossley, Alice Turner

Source: International Congress 2016 – Non-inflammatory assessment of airway disorders
Session: Non-inflammatory assessment of airway disorders
Session type: Thematic Poster
Number: 1021
Disease area: Airway diseases

Congress or journal article abstract

Abstract

IntroductionQuantitatively measuring the severity of emphysema in patients with COPD and AATD by CT densitometry is rapidly being recognised as an accurate and sensitive measure of disease stage and progression. We aim to elucidate the utility and interpretation of densitometry objectively through a new systematic review, and to establish the minimally clinically important difference (MCID) in density decline. An MCID for FEV1 and SGRQ in COPD is already well established, but in AATD specifically, this MCID should indicate those patient with significant net tissue loss and therefore consideration of further therapies.MethodsWe conducted an extensive and robust systematic review adhering to the Cochrane guidelines, with care to include all relevant studies, to eliminate bias and to meta-analyse appropriate results.



ResultsDue to wide variable outcome measures reported in both the measure of density i.e. differing %LAA (low attenuation areas) or the 15th percentile point, a narrative meta-analysis was conducted where necessary. We propose an MCID incorporating important clinical variables such as lung function, and quality of life measures.Conclusion.The MCID of CT quantified density change will provide a useful additional tool in assessing patients with emphysema, and to potentially identify earlier those patients who are rapid decliners.


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Diana Crossley (Birmingham, United Kingdom), Diana Crossley, Alice Turner. Systematic review of the relevance of CT densitometry in patients with COPD and AATD. Eur Respir J 2016; 48: Suppl. 60, 1021

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