Relationship between clinical and radiological signs of bronchiectasis in COPD patients: Results from COSYCONET

• Published in: Respiratory medicine 2020-10, Vol.172, p.106117, Article 106117
• Main Authors: Kahnert, Kathrin, Jörres, Rudolf A., Kauczor, Hans-Ulrich, Biederer, Jürgen, Jobst, Bertram, Alter, Peter, Biertz, Frank, Mertsch, Pontus, Lucke, Tanja, Lutter, Johanna I., Trudzinski, Franziska C., Behr, Jürgen, Bals, Robert, Watz, Henrik, Vogelmeier, Claus F., Welte, Tobias, Stefan, Andreas, Robert, Bals, Jürgen, Behr, Kathrin, Kahnert, Burkhard, Bewig, Bahmer, Thomas, Roland, Buhl, Ralf, Ewert, Beate, Stubbe, Joachim H, Ficker, Manfred, Gogol, Christian, Grohé, Rainer, Hauck, Matthias, Held, Berthold, Jany, Markus, Henke, Felix, Herth, Gerd, Höffken, Hugo A, Katus, Anne-Marie, Kirsten, Henrik, Watz, Rembert, Koczulla, Klaus, Kenn, Juliane, Kronsbein, Cornelia, Kropf-Sanchen, Christoph, Lange, Peter, Zabel, Michael, Pfeifer, Winfried J, Randerath, Werner, Seeger, Michael, Studnicka, Christian, Taube, Helmut, Teschler, Hartmut, Timmermann, Christian, Virchow J., Claus, Vogelmeier, Ulrich, Wagner, Tobias, Welte, Hubert, Wirtz, Lehnert, Doris, Struck, Birte, Krabbe, Lenka, Arikan, Barbara, Tobias, Julia, Spangel, Gina, Teng, Julia, Essen, Ruhrlandklinik gGmbH, Pieper, Jeanette, Gleiniger, Margret, Markworth, Britta, Hinz, Zaklina, Hundack-Winter, Petra, Burmann, Ellen, Wons, Katrin, Rieber, Ulrike, Schaufler, Beate, Seibert, Martina, Schwedler, Katrin, Michalewski, Sabine, Rohweder, Sonja, Kiel, Campus, Berger, Patricia, Schottel, Diana, Klöser, Manuel, Janke, Vivien, Untsch, Rosalie, Graf, Jana, Reichel, Anita, Weiß, Gertraud, Traugott, Erich, Ziss, Barbara, Kietzmann, Ilona, Schrade-Illmann, Michaela, Polte, Beate, Böckmann, Cornelia, Hübner, Gudrun, Sterk, Lena, Wirz, Anne
• Format: Article
• Language: English
• Subjects: Age; Bronchiectasis; Carbon monoxide; Chronic obstructive pulmonary disease; Comorbidity; Computed tomography; COPD; Correlation analysis; Cough; CT scan; Diagnosis; Investigations; Laboratories; Lobes; Lung function; Medical imaging; Physicians; Scanners; Symptoms
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2020.106117

Bronchiectasis (BE) might be frequently present in COPD but masked by COPD symptoms. We studied the relationship of clinical signs of bronchiectasis to the presence and extent of its radiological signs in patients of different COPD severity. Visit 4 data (GOLD grades 1–4) of the COSYCONET cohort was used. Chest CT scans were evaluated for bronchiectasis in 6 lobes using a 3-point scale (0: absence, 1: ≤50%, 2: >50% BE-involvement for each lobe). 1176 patients were included (61%male, age 67.3y), among them 38 (3.2%) with reported physicians’ diagnosis of bronchiectasis and 76 (6.5%) with alpha1-antitrypsin deficiency (AA1D). CT scans were obtained in 429 patients. Within this group, any signs of bronchiectasis were found in 46.6% of patients, whereby ≤50% BE occurred in 18.6% in ≤2 lobes, in 10.0% in 3–4 lobes, in 15.9% in 5–6 lobes; >50% bronchiectasis in at least 1 lobe was observed in 2.1%. Scores ≥4 correlated with an elevated ratio FRC/RV. The clinical diagnosis of bronchiectasis correlated with phlegm and cough and with radiological scores of at least 3, optimally ≥5. In COPD patients, clinical diagnosis and radiological signs of BE showed only weak correlations. Correlations became significant with increasing BE-severity implying radiological alterations in several lobes. This indicates the importance of reporting both presence and extent of bronchiectasis on CT. Further research is warranted to refine the criteria for CT scoring of bronchiectasis and to determine the relevance of radiologically but not clinically detectible bronchiectasis and their possible implications for therapy in COPD patients. •Bronchiectasis (BE) might be frequently present in COPD but masked by COPD symptoms.•In COPD patients diagnosis and radiological signs of BE showed weak correlations.•Correlations became significant with increasing BE-severity.•Importance of reporting both, presence and extent, of bronchiectasis on CT in COPD.