High Resolution CT Findings in Chronic Obstructive Pulmonary Disease (COPD) Patients in Punjab, Pakistan

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a prevalent, preventable, and treatable chronic respiratory condition that impacts individuals of both genders worldwide. It can be effectively diagnosed using high-resolution computed tomography (HRCT). OBJECTIVE: To assess the diagnostic characteristics of chronic obstructive pulmonary disease (COPD) through the use of high-resolution computed tomography (HRCT). MATERIALS AND METHODS: A cohort of 120 individuals with a confirmed diagnosis of chronic obstructive pulmonary disease (COPD) was included in this study. All participants had comprehensive clinical documentation, including results from a 6-minute walk test (6MWT). COPD was defined based on a post-bronchodilator FEV1/FVC ratio below 70%, which is indicative of persistent airflow limitation. The sample size of 120 subjects was selected through convenience sampling. Non-contrast high-resolution computed tomography (HRCT) scans were acquired using a 64-slice CT scanner, with full lung coverage from the lung apex to the diaphragm. Emphysema was evaluated via automated lung segmentation techniques, utilizing emphysema scoring and a density threshold of -950 Hounsfield Units (HU), while excluding central airways from the analysis. Data management and statistical analyses were carried out using SPSS software version 22. RESULTS: The results of this cross-sectional observational study emphasize the heterogeneous nature of chronic obstructive pulmonary disease (COPD) with respect to its clinical phenotypes and radiological manifestations. Emphysema emerged as the predominant phenotype, particularly among individuals over the age of 50, whereas chronic bronchitis was more frequently observed in patients aged 50 years or younger, suggesting an age-related distribution of COPD subtypes. CONCLUSION: Computed tomography (CT) proved instrumental in characterizing various patterns of lung involvement, including different forms of emphysema, small airway disease, and incidental findings such as interstitial lung disease and pulmonary mass lesions. Overall, these findings highlight the importance of a comprehensive diagnostic approach that integrates clinical evaluation, pulmonary function testing, and imaging. Accurate phenotyping of COPD through this multimodal assessment is essential for tailoring treatment strategies and ultimately improving patient outcomes.