Radiography Chest In COPD, a radiograph can help exclude alternative diagnoses and evaluate for comorbidities and complications [14]. Wallace et al [15] reported that 14% of chest radiographs ordered during COPD evaluation detected potentially treatable causes of dyspnea other than COPD and lung cancer and that 84% of radiographs assisted management. Chronic Dyspnea-Noncardiovascular Origin CT Chest CT has greater sensitivity and specificity than a chest radiograph in determining the type, extent, and distribution of emphysema and bronchial wall abnormalities [16]. CT is able to identify early changes of COPD in asymptomatic and spirometrically normal smokers [17]. It has shown that visual assessments of emphysema and airway disease are accurate and reproducible [18]. In addition, quantitative CT-derived parameters correlate with pulmonary function tests and can be used as imaging biomarkers to follow disease progression [19-23]. Findings have been shown to correlate with patient-reported measures [24-26] and to predict health status in COPD [27]. CT-based phenotypes have prognostic value in predicting future hospitalization, symptomatic decline, and mortality [28,29]. Expiratory CT has been reported to reflect airflow limitation and correlates well with levels of dyspnea [30]. MRI Chest Numerous MRI techniques are available to evaluate COPD, including hyperpolarized helium, T1 oxygen- enhanced mapping, and equilibrium signal mapping [31-33]. While predominately the subject of research, small studies have shown good correlation with CT-derived measures and provide a rationale for the use of MRI when quantitative imaging measures are needed. US Chest US may have a role in defining pleural or diaphragmatic complications related to COPD, but there is no supporting evidence for its use as a diagnostic technique for this condition. FDG-PET/CT Skull Base to Mid-Thigh There are no primary data to support the use of FDG-PET/CT to diagnose or manage COPD.
Chronic Dyspnea Noncardiovascular Origin. Radiography Chest In COPD, a radiograph can help exclude alternative diagnoses and evaluate for comorbidities and complications [14]. Wallace et al [15] reported that 14% of chest radiographs ordered during COPD evaluation detected potentially treatable causes of dyspnea other than COPD and lung cancer and that 84% of radiographs assisted management. Chronic Dyspnea-Noncardiovascular Origin CT Chest CT has greater sensitivity and specificity than a chest radiograph in determining the type, extent, and distribution of emphysema and bronchial wall abnormalities [16]. CT is able to identify early changes of COPD in asymptomatic and spirometrically normal smokers [17]. It has shown that visual assessments of emphysema and airway disease are accurate and reproducible [18]. In addition, quantitative CT-derived parameters correlate with pulmonary function tests and can be used as imaging biomarkers to follow disease progression [19-23]. Findings have been shown to correlate with patient-reported measures [24-26] and to predict health status in COPD [27]. CT-based phenotypes have prognostic value in predicting future hospitalization, symptomatic decline, and mortality [28,29]. Expiratory CT has been reported to reflect airflow limitation and correlates well with levels of dyspnea [30]. MRI Chest Numerous MRI techniques are available to evaluate COPD, including hyperpolarized helium, T1 oxygen- enhanced mapping, and equilibrium signal mapping [31-33]. While predominately the subject of research, small studies have shown good correlation with CT-derived measures and provide a rationale for the use of MRI when quantitative imaging measures are needed. US Chest US may have a role in defining pleural or diaphragmatic complications related to COPD, but there is no supporting evidence for its use as a diagnostic technique for this condition. FDG-PET/CT Skull Base to Mid-Thigh There are no primary data to support the use of FDG-PET/CT to diagnose or manage COPD.