Table7_Quantitative CT parameters correlate with lung function in chronic obstructive pulmonary disease: A systematic review and meta-analysis.docx

ObjectiveThis study aimed to analyze the correlation between quantitative computed tomography (CT) parameters and airflow obstruction in patients with COPD.
MethodsPubMed, Embase, Cochrane and Web of Knowledge were searched by two investigators from inception to July 2022, using a combination of pertinent items to discover articles that investigated the relationship between CT measurements and lung function parameters in patients with COPD. Five reviewers independently extracted data, and evaluated it for quality and bias. The correlation coefficient was calculated, and heterogeneity was explored. The following CT measurements were extracted: percentage of lung attenuation area <−950 Hounsfield Units (HU), mean lung density, percentage of airway wall area, air trapping index, and airway wall thickness. Two airflow obstruction parameters were extracted: forced expiratory volume in the first second as a percentage of prediction (FEV1%pred) and FEV1 divided by forced expiratory volume lung capacity.
ResultsA total of 141 studies (25,214 participants) were identified, which 64 (6,341 participants) were suitable for our meta-analysis. Results from our analysis demonstrated that there was a significant correlation between quantitative CT parameters and lung function. The absolute pooled correlation coefficients ranged from 0.26 (95% CI, 0.18 to 0.33) to 0.70 (95% CI, 0.65 to 0.75) for inspiratory CT and 0.56 (95% CI, 0.51 to 0.60) to 0.74 (95% CI, 0.68 to 0.80) for expiratory CT.
ConclusionsResults from this analysis demonstrated that quantitative CT parameters are significantly correlated with lung function in patients with COPD. With recent advances in chest CT, we can evaluate morphological features in the lungs that cannot be obtained by other clinical indices, such as pulmonary function tests. Therefore, CT can provide a quantitative method to advance the development and testing of new interventions and therapies for patients with COPD.

研究目的 本研究旨在分析慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease, COPD）患者的定量计算机断层扫描（Computed Tomography, CT）参数与气流阻塞的相关性。
研究方法 由两名研究者以建库至2022年7月为检索时限，在PubMed、Embase、Cochrane及Web of Knowledge数据库中，联合使用相关检索词，检索探讨COPD患者CT测量指标与肺功能参数相关性的文献。由5名评价者独立提取数据，并对研究质量与偏倚风险进行评估。计算相关系数并探索异质性来源。本次提取的CT测量指标包括：肺衰减面积<−950亨氏单位（Hounsfield Units, HU）占比、平均肺密度、气道壁面积占比、空气潴留指数及气道壁厚度。提取的气流阻塞参数包括：第一秒用力呼气容积占预计值百分比（FEV1%pred）及第一秒用力呼气容积与用力肺容积的比值。
研究结果 共检索到141项研究，合计纳入25214名受试者，其中64项研究（6341名受试者）符合本荟萃分析的纳入标准。分析结果显示，定量CT参数与肺功能指标存在显著相关性。吸气相CT的合并绝对相关系数范围为0.26（95%置信区间[CI]：0.18~0.33）至0.70（95%CI：0.65~0.75），呼气相CT的合并绝对相关系数范围为0.56（95%CI：0.51~0.60）至0.74（95%CI：0.68~0.80）。
研究结论 本分析结果表明，COPD患者的定量CT参数与肺功能指标存在显著相关性。随着胸部CT技术的不断进步，我们可通过CT评估其他临床检测手段（如肺功能试验）无法获取的肺部形态学特征。因此，CT可为COPD患者新型干预措施与治疗方案的研发及疗效评估提供定量检测方法。