• Carlos H Martinez, Yuka Okajima, Andrew Yen, Diego J Maselli, Pietro Nardelli, Farbord Rahaghi, Kendra Young, Gregory Kinney, Charles Hatt, Craig Galban, George R Washko, MeiLan Han, EstéparRaúl San JoséRSJDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., and Alejandro A Diaz.
• Oaklawn Medical Group, Marshall, Michigan.
• Acad Radiol. 2021 Mar 1; 28 (3): 370-378.

Rationale And ObjectivesBronchiectasis (BE) is associated with chronic obstructive pulmonary disease (COPD), but emphysema and small airways disease, main pathologic features of COPD, have been sparsely studied in BE. We aimed to objectively assess those features in smokers with and without radiographic BE and examine its relationships to airflow obstruction and exercise capacity.Material And MethodsWe measured emphysema and small airways disease on paired inspiratory-expiratory computed tomography (CT) scans with the parametric response map (PRMEMPH and PRMSAD) method in 1184 smokers with and without radiographic BE. PRMSAD and PRMEMPH are expressed as the percentage of lung area. Clinical, spirometry, and exercise capacity data were measured with standardized methods. The differences in PRMSAD and PRMEMPH between subjects with and without radiographic BE were assessed using multivariable linear regression analysis, and their associations with FEV1 and six-minute walk test (6MWT) were assessed with generalized linear models.ResultsOut of 1184 subjects, 383 (32%) had radiographic BE. PRMEMPH but not PRMSAD was higher in subjects with radiographic BE than those without radiographic BE in adjusted models. Subjects with radiographic BE and PRMEMPH (defined as ≥5% on paired CTs) had lower FEV1 (least square mean, 1479 mL vs. 2350 mL p < 0.0001) and 6MWT (372 m vs. 426 m p = 0.0007) than those with radiographic BE alone in adjusted models.ConclusionSmokers with radiographic BE have an increased burden of emphysema on paired CTs, and those with radiographic BE and emphysema have lower airflow and exercise capacity.Copyright © 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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