High Resolution CT Findings in Chronic Obstructive Pulmonary Disease (COPD) Patients in Punjab, Pakistan

Authors

  • Mahboob Meer Gujranwala Medical College, Gujranwala, Pakistan.
  • Mian Waheed Ahmad Gujranwala Medical College, Gujranwala, Pakistan.
  • Sidra Gaffar Gujranwala Teaching Hospital ,Gujranwala, Pakistan.
  • Tahira Akhtar Gujranwala Medical College, Gujranwala, Pakistan.
  • Saima Noreen Jinnah Hospital Lahore, Lahore, Pakistan.
  • Rameez Ahmed Gujranwala Medical College & Allied Teaching Hospitals, Gujranwala,Pakistan.

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/044

Keywords:

COPD, High Resolution, CT findings

Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a prevalent, preventable, and treatable chronic respiratory condition that impacts individuals of both genders worldwide. It can be effectively diagnosed using high-resolution computed tomography (HRCT).

OBJECTIVE: To assess the diagnostic characteristics of chronic obstructive pulmonary disease (COPD) through the use of high-resolution computed tomography (HRCT).

MATERIALS AND METHODS: A cohort of 120 individuals with a confirmed diagnosis of chronic obstructive pulmonary disease (COPD) was included in this study. All participants had comprehensive clinical documentation, including results from a 6-minute walk test (6MWT). COPD was defined based on a post-bronchodilator FEV1/FVC ratio below 70%, which is indicative of persistent airflow limitation. The sample size of 120 subjects was selected through convenience sampling. Non-contrast high-resolution computed tomography (HRCT) scans were acquired using a 64-slice CT scanner, with full lung coverage from the lung apex to the diaphragm. Emphysema was evaluated via automated lung segmentation techniques, utilizing emphysema scoring and a density threshold of -950 Hounsfield Units (HU), while excluding central airways from the analysis. Data management and statistical analyses were carried out using SPSS software version 22.

RESULTS: The results of this cross-sectional observational study emphasize the heterogeneous nature of chronic obstructive pulmonary disease (COPD) with respect to its clinical phenotypes and radiological manifestations. Emphysema emerged as the predominant phenotype, particularly among individuals over the age of 50, whereas chronic bronchitis was more frequently observed in patients aged 50 years or younger, suggesting an age-related distribution of COPD subtypes.

CONCLUSION: Computed tomography (CT) proved instrumental in characterizing various patterns of lung involvement, including different forms of emphysema, small airway disease, and incidental findings such as interstitial lung disease and pulmonary mass lesions. Overall, these findings highlight the importance of a comprehensive diagnostic approach that integrates clinical evaluation, pulmonary function testing, and imaging. Accurate phenotyping of COPD through this multimodal assessment is essential for tailoring treatment strategies and ultimately improving patient outcomes.

 

Author Biographies

  • Mahboob Meer, Gujranwala Medical College, Gujranwala, Pakistan.

    Department of Pulmonology and Assistant Professor,

  • Mian Waheed Ahmad, Gujranwala Medical College, Gujranwala, Pakistan.

    Department of Radiology and Associate Professor,

  • Sidra Gaffar, Gujranwala Teaching Hospital ,Gujranwala, Pakistan.

      Department of  Radiology and  Senior Registrar, 

  • Tahira Akhtar, Gujranwala Medical College, Gujranwala, Pakistan.

    Department of Obstetrics and Gynaecology and Assistant Professor 

  • Saima Noreen, Jinnah Hospital Lahore, Lahore, Pakistan.

    Department of Obstetrics and Gynaecology and Senior Registrar, 

  • Rameez Ahmed, Gujranwala Medical College & Allied Teaching Hospitals, Gujranwala,Pakistan.

    PS to Principal

References

1. Momtazmanesh S, Moghaddam SS, Ghamari SH, Rad EM, Rezaei N, Shobeiri P, Aali A, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abdelmasseh M, Abdoun M. Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019. EClinicalMedicine. 2023 May 1;59.

2. Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. The Lancet Respiratory Medicine. 2022 May 1;10(5):447-58.

3. Dos Santos NC, Miravitlles M, Camelier AA, De Almeida VD, Maciel RR, Camelier FW. Prevalence and impact of comorbidities in individuals with chronic obstructive pulmonary disease: a systematic review. Tuberculosis and respiratory diseases. 2022 May 27;85(3):205.

4. Qaid EY, Long I. Asthma unravelled: a comprehensive review of epidemiology, phenotypes, pathophysiology, and emerging therapies. The Egyptian Journal of Bronchology. 2025 Aug 1;19(1):82.

5. Singh S. Respiratory symptoms and signs. Medicine. 2023 Oct 1;51(10):684-92.

6. Uqaili AA, Shah T, Shaikh SN, Abbas U, Shabbir S. Assessment of Environmental Pollutants and their Relationship with Chronic Respiratory Disease Exacerbations in Jamshoro: A Cross-Sectional Study. Pak J Med Dent. 2024;13(4): 108-117. Doi: https://doi.org/10.36283/ziun-pjmd13-4/014.

7. Poto R, Loffredo S, Palestra F, Marone G, Patella V, Varricchi G. Angiogenesis, lymphangiogenesis, and inflammation in chronic obstructive pulmonary disease (COPD): few certainties and many outstanding questions. Cells. 2022 May 23;11(10):1720.

8. Leigh LY, Vannelli P, Crow HC, Desai S, Lepore M, Anolik R, Glick M. Diseases of the respiratory tract. Burket's Oral Medicine. 2021 Aug 30:469-504.

9. Szeinuk J, de la Hoz RE. Occupational chronic obstructive pulmonary disease. InModern Occupational Diseases: Diagnosis, Epidemiology, Management and Prevention 2022 Sep 21 (pp. 104-127). Bentham Science Publishers.

10. Ashraf H, Butt M, Akhtar S, Nadeem A, Kareem R, Ashfaq H, Nadeem ZA, Fatima M, Ashraf A, Bhandari J. Asthma incidence, prevalence, and mortality in the United States and worldwide, 1990–2019: Findings from the Global Burden of Disease study. Journal of Asthma. 2025 Mar 21:1-1.

11. Boers E, Barrett M, Su JG, Benjafield AV, Sinha S, Kaye L, Zar HJ, Vuong V, Tellez D, Gondalia R, Rice MB. Global burden of chronic obstructive pulmonary disease through 2050. JAMA Network Open. 2023 Dec 1;6(12):e2346598-.

12. Kaleem Ullah M, Parthasarathi A, Biligere Siddaiah J, Vishwanath P, Upadhyay S, Ganguly K, Anand Mahesh P. Impact of Acute Exacerbation and its phenotypes on the clinical outcomes of Chronic Obstructive Pulmonary Disease in Hospitalized patients: a cross-sectional study. Toxics. 2022 Nov 6;10(11):667.

13. Joshi Y, Saklani S, Bisht S. Prevalence of chronic obstructive pulmonary disease: A global review. Research and Development in Pharmaceutical Science (Volume II)(ISBN: 978-81-953600-6-2). 2021:51.

14. BARUAH D, SABOO SS, BATRA K. Pleura, Diaphragm, and Chest Wall. Textbook of Radiology And Imaging, Volume 1-E-Book. 2023 Aug 31:223.

15. Raoof S, Shah M, Make B, Allaqaband H, Bowler R, Fernando S, Greenberg H, Han MK, Hogg J, Humphries S, Lee KS. Lung imaging in COPD part 1: clinical usefulness. Chest. 2023 Jul 1;164(1):69-84.

16. Gupta PP, Yadav R, Verma M, Gupta KB, Agarwal D. High-resolution computed tomography features in patients with chronic obstructive pulmonary disease. Singapore Med J. 2009;50 (2):193-200.

17. Koshiol J, Rotunno M, Consonni D, Pesatori AC, DeMatteis S, Goldstein AM, etal. Chronic obstructive pulmonary disease and altered risk of lung cancer in a population-based case-control study. PL oS One. 2009 Oct 8;4 (10):e7380

18. Gupta PP, Yadav R, Verma M, Agarwal D, Kumar M. Correlation between high-resolution computed tomography features and patients' characteristics in chronic obstructive pulmonary disease. Ann Thoracic Med. 2008 Jul; 3 (3):87

19. Mehfooz N, Bhargava R, Ahmad Z, Ahmad I,P atigarooSA. HRCT findings in early cases of COPD- an experience. Int J Basic Applied Med Sci. 2013 ;3(3):20-31.

20. Klein JS, Gamsu G, Webb WR, Golden JA, Müller NL. High-resolution CT diagnosis of emphyse main symptomatic patients with normal chest radiograph sand isolated low diffusing capacity. Radiol. 1992 Mar; 182 (3):817-21

21. Singh A, Kumar S, Mishra AK, Kumar M, Kant S, Verma SK, etal. Correlation between clinical characteristics, spirometric in dice sand high resolution computed tomography findings in patients of chronic obstructive pulmonary disease. Lung India: official organ of Indian Chest Society. 2016 Jan; 33 (1):42

22. Brenner DJ. Radiation risks potentially associated with low-dose CT screening of adult smokers for lung cancer. Radiology. 2004 May; 231 (2):440-5.

23. Thurl beck WM, Müller NL. Emphysema: definition, imaging, and quantification. AJR. AmJ Roentgenol.1994Nov;163(5):1017-25

24. Urban T, Sauter AP, Frank M, Willer K, Noichl W, Bast H, Schick R, Herzen J, Koehler T, Gassert FT, Bodden JH. Dark-field chest radiography outperforms conventional chest radiography for the diagnosis and staging of pulmonary emphysema. Investigative Radiology. 2023 Nov 1;58(11):775-81.

25. Al-qaness MA, Zhu J, AL-Alimi D, Dahou A, Alsamhi SH, Abd Elaziz M, Ewees AA. Chest X-ray Images for Lung Disease Detection Using Deep Learning Techniques: A Comprehensive Survey. Archives of Computational Methods in Engineering. 2024 Aug 1;31(6).

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Published

2025-09-29

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How to Cite

1.
Meer M, Ahmad MW, Gaffar S, Akhtar T, Noreen S, Ahmed R. High Resolution CT Findings in Chronic Obstructive Pulmonary Disease (COPD) Patients in Punjab, Pakistan. PJMD [Internet]. 2025 Sep. 29 [cited 2026 Jun. 4];14(4). Available from: https://ojs.zu.edu.pk/pjmd/article/view/4154

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