Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Clinical Investigations Respiration 2011;81:461–468 DOI: 10.1159/000319580 Multidetector Row Computed Tomography to Assess Changes in Airways Linked to Asthma Control Pierre-Y. Brillet   a Valérie Attali   b Gaëlle Nachbaur   e André Capderou   c, f Marie-H. Becquemin   c Catherine Beigelman-Aubry   d Catalin I. Fetita   g Thomas Similowski   b Marc Zelter   c Philippe A. Grenier   d a  UPRES EA 2363, Service de radiologie, Hôpital Avicenne, Assistance Publique – Hôpitaux de Paris, Université Paris 13, Bobigny, b  Service de pneumologie, c  UPRES 2397, Service d’explorations fonctionnelles respiratoires, d  Institut National de la Santé et de la Recherche médicale U678, Service de radiologie, Hôpital Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Université Pierre et Marie Curie – Paris 6, e  Clinical research department Respirology, GlaxoSmithKline, Paris, f  Centre Chirurgical Marie-Lannelongue, Le Plessis-Robinson, g  ARTEMIS Department, CNRS UMR8145, TELECOM Sud Paris, Evry, France and wall areas (WA) were evaluated at a segmental and sub- segmental level using BronCare software. Lung density was measured at the base of the lung. Baseline and end-of-treat- ment data were compared using the Wilcoxon signed-rank test. Results: After the 12-week treatment period, asthma control was achieved. Airflow obstruction and air trapping decreased as assessed by the changes in FEV 1 (p ! 0.01) and expiratory reserve volume (p ! 0.01). Conversely, LA and WA did not vary significantly. However, a median decrease in LA of 110% was observed in half of the patients with a wide in- tra- and intersubject response heterogeneity. This was con- comitant with a decrease in lung density (p ! 0.02 in the an- teroinferior areas). Conclusions: MDCT is insensitive for demonstrating any decrease in bronchial wall thickness. This is mainly due to changes in bronchial caliber which may be linked to modifications of the elastic properties of the bron- chopulmonary system under treatment. Copyright © 2010 S. Karger AG, Basel Key Words Asthma control  Respiratory mechanics, physiology  Inhaled treatment  Quantitative evaluation  Multidetector row computed tomography Abstract Background: In asthma, multidetector row computed to- mography (MDCT) detects abnormalities that are related to disease severity, including increased bronchial wall thick- ness. However, whether these abnormalities could be relat- ed to asthma control has not been investigated yet. Objec- tive: Our goal was to determine which changes in airways could be linked to disease control. Methods: Twelve patients with poor asthma control were included and received a sal- meterol/fluticasone propionate combination daily for 12 weeks. Patients underwent clinical, functional, and MDCT examinations before and after the treatment period. MDCT examinations were performed using a low-dose protocol at a controlled lung volume (65% TLC). Bronchial lumen (LA) Received: January 19, 2010 Accepted after revision: July 15, 2010 Published online: November 5, 2010 Dr. P.Y. Brillet Service de radiologie, Hôpital Avicenne 125 rue de Stalingrad FR–93009 Bobigny (France) Tel. +33 1 4895 5852, Fax +33 1 4895 5554, E-Mail pierre-yves.brillet  @  avc.aphp.fr © 2010 S. Karger AG, Basel 0025–7931/11/0816–0461$38.00/0 Accessible online at: www.karger.com/res