Imaging of COPD

Although imaging of patient with COPD in not recommended in clinical practice, many researches and drug trial include imaging studies in evaluation of COPD. In particular, thin-section volumetric CT covering the whole lung with following quantitative assessment has been accepted one of the essential components of studies. This chapter encompasses the whole aspect of CT in COPD, including basic CT physics, radiation dose consideration, diagnosis and visual assessment of COPD, fundamentals of quantitative assessment of emphysema, airway wall thickening, and air trapping and its clinical values. Assessment of other components of COPD includes chest wall changes, vascular changes, osteoporosis, and so on. In addition, new emerging imaging methods such as MRI, dual-energy CT, PET, and optical imaging to evaluate not only morphologic but also functional aspects of lung in COPD will be introduced. Functional imaging includes direct visualization of ventilation, perfusion, chest wall motion, and inflammation. The promising results of early studies will be introduced, highlighting the potential of imaging approach for the future studies.