Asynchrony in respiratory movements between the pulmonary lobes in patients with COPD: Continuous measurement of lung density by 4-dimensional dynamic-ventilation CT

On behalf of the ACTIve Study Group

Research output: Contribution to journalArticle

6 Citations (Scopus)


Purpose: Four-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density during respiration on the dynamic-ventilation CT. Materials and methods: Thirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during free breathing. CT data were continuously reconstructed every 0.5 sec. Mean lung density (MLD) of the five lobes (right upper [RU], right middle [RM], right lower [RL], left upper [LU], and left lower [LL]) was continuously measured by commercially available software using a fixed volume of volume of interest which was placed and tracked on a single designated point in each lobe. Concordance between the MLD time curves of six pairs of lung lobes (RU-RL, RU-RM, RM-RL, LU-LL, RU-LU, and RL-LL lobes) was expressed by cross-correlation coefficients. The relationship between these cross-correlation coefficients and the forced expiratory volume in one second/forced vital capacity (FEV1.0/FVC) values was assessed by Spearman rank correlation analysis. Results: In all six pairs of the pulmonary lobes, the cross-correlation coefficients of the two MLD curves were significantly positively correlated with FEV1.0/FVC (ρ =0.60–0.73, P<0.001). The mean value of the six coefficients strongly correlated with FEV1.0/FVC (ρ =0.80, P<0.0001). Conclusion: The synchrony of respiratory movements between the pulmonary lobes is limited or lost in patients with more severe airflow limitation.

Original languageEnglish
Pages (from-to)2101-2109
Number of pages9
JournalInternational Journal of COPD
Publication statusPublished - Jul 20 2017



  • Airflow limitation
  • Chronic obstructive pulmonary disease
  • Computed tomography
  • Emphysema
  • Mean lung density

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this