Role of medical and molecular imaging in COPD

Abstract

Chronic obstructive pulmonary disease (COPD) is expected to climb on the podium of the leading causes of mortality worldwide in the upcoming decade. Clinical diagnosis of COPD has classically relied upon detecting irreversible airflow obstruction on pulmonary function testing as a global assessment of pulmonary physiology. However, the outcome is still not favorable to decrease mortality due to COPD. Progress made in both medical and molecular imaging fields are beginning to offer additional tools to address this clinical problem. This review aims to describe medical and molecular imaging modalities used to diagnose COPD and to select patients for appropriate treatments and to monitor response to therapy.

Fig. 1

Bronchial anatomy measurement explanatory diagram

Fig. 2

High resolution CT and hyperpolarized ¹²⁹Xe dissolved-phase MR images in patient with COPD. In order, image reconstructions of gas (top left), tissue (left middle) and red blood cells (bottom left) compartments are presented. The paired color gradient images are fused reconstructions demonstrating relative gas content in the different compartment; tissue/gas, RBC/gas and RBC/tissue. Adapted from [16] with permission

Fig. 3

a Three-dimensional, b axial, and c coronal imaging illustrating the predominantly apical distribution of pulmonary ¹⁸fluorodeoxyglucose ([¹⁸F]-FDG) uptake in a patient with usual chronic obstructive pulmonary disease (COPD). d The color scale gives the spectrum applied to the full range of [¹⁸F]-FDG uptake, so that each color band represents a range of 10% of the maximum signal, with the maximum signal represented by white and the minimum signal by black. (Reprinted from [28] with permission of the American Thoracic Society. Copyright © 2017 American Thoracic Society.)

Fig. 4

In vivo small-animal SPECT/CT imaging of MMP activation. a–c Examples of coronal (left) and transversal (right) views of fused small-animal SPECT/CT images of WT mice injected with RP805 (a) and CC10-IL-13 Tg mice injected with RP805 (b) or its control, amide analog tracer (c). d Small-animal SPECT–derived quantification tracer uptake in lungs. N = 5, 6, 13, and 5, respectively, for WT mice injected with RP805 and CC10-IL-13 Tg mice injected with RP805 or amide, control analog. *P, 0.01. **P, 0.001. cpv 5 counts per voxel; ID 5 injected dose. (This research was originally published in JNM [32]. © by the Society of Nuclear Medicine and Molecular Imaging, Inc.)