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Chest radiography



Chest radiography

Value of chest radiography in phenotyping chronic obstructive pulmonary disease

The  objectives of the  present study were to  reappraise chest radiography for  the diagnosis of emphysema, using computed tomography (CT)  as the  reference standard, and to establish  whether or   not   chest  radiography is   useful  for   phenotyping  chronic  obstructive pulmonary disease  (COPD).
Patients (n5154) who  had undergone posteroanterior and lateral chest radiography and CT for diagnostic purposes were studied. CT data were scored for emphysema using the  picture-grading method. Chest radiographs were examined independently by  five  raters using four  criteria for emphysema that  had been validated against lung  pathology. These criteria were then used to assess the  prevalence of emphysema in 458 COPD patients. Patients with and without evidence of emphysema were compared with  regard to  age, sex, smoking history, body mass  index (BMI), forced  expiratory volume in  one second  (FEV1),  diffusing capacity  of  the   lung   for   carbon monoxide (DL,CO)  and health status.
Chest radiography yielded a sensitivity of 90% and a specificity of 98% for emphysema. Of the
458 COPD  patients, 245 showed radiological evidence of emphysema. Emphysemic patients had a significantly lower  BMI, FEV1 and DL,CO, greater restriction of physical activity and worse quality of life than nonemphysemic patients. There was  no difference across the  two groups with regard to age, sex  or smoking history.
Chest radiography is a simple means of diagnosing moderate-to-severe emphysema. It is useful in phenotyping chronic obstructive pulmonary disease and may  aid  physicians in their choice of treatment