Diagnosing Emphysema and COPD with Medical Imaging

Emphysema is just one of several conditions under the umbrella term “chronic obstructive pulmonary disease.” COPD is a condition that causes the lungs to have difficulty taking in air. COPD includes conditions like emphysema, chronic bronchitis, refractory asthma, and some forms of bronchiectasis. Emphysema is the deadliest of the conditions and we will explore the symptoms and the diagnosis process. In Louisiana alone, more than 7% of the population is affected by COPD.
Source: COPD Foundation (PDF).

Symptoms of Emphysema and COPD

Many patients may have the disease but be unaware of it. Here’s a look at signs you may have the emphysema or COPD:

  • The earliest symptom of emphysema is shortness of breath. Even the slightest activities may tire you out.
  • Wheezing
  • A cough that won’t go away
  • Chest tightness or chest pain

How Doctors Identify Emphysema

What does emphysema look like? To begin, the interior of the lungs are filled with small air sacs called alveoli. These air sacs expand with oxygen when you breathe in and allow oxygen to get into the bloodstream. Emphysema is a condition that causes these air sacs to weaken and ultimately rupture. When they rupture, there is less area for oxygen to be taken in and since emphysema is a chronic condition, these alveoli will continue to weaken and rupture until the lungs are not able to expand and contract on their own.

Emphysema is most notably a result of cigarette or tobacco smoking. The chemicals found in cigarette smoke can total over 7,000 and they are extremely toxic to the entirety of the body, but the lungs take most of the damage. Upon inhalation, the hot smoke and toxic chemicals damage the lung tissue and with an addictive habit like cigarettes, the damage happens multiple times a day for years. With every puff, more lung tissue dies and once it is dead, there is no replacing it. In fact, about 85 to 90 percent of all COPD cases are caused by cigarette smoking in the United States.

If you are a long-term smoker or a former smoker and are over the age of 50, your chances for developing emphysema are much higher. The signs of COPD or emphysema can be confused with other conditions because things like shortness of breath or difficulty catching breath could be misconstrued as part of the aging process or the result of lifestyle choices. You see, as the air sacs are slowly destroyed, air becomes trapped in the lungs and is difficult to expel as well as obtain. Furthermore, if you are experiencing a tightness in the chest that does not seem to pass, these could be the beginning warning signs of COPD and possibly emphysema.

Diagnosing emphysema requires a few different tests. To begin, the doctor will use a physical examination to test things like your vitals and blood pressure. Following a physical, doctors will usually perform a combination of pulmonary function tests to examine the strength and performance of the lungs. Pulmonary function tests include breathing into tubes that can test how much air you are expelling, how fast it is being expelled, and how much air remains after exhalation.

Chest X-Rays and CT Scans

If the results of the pulmonary function test prove conclusive toward symptoms of COPD, doctors will use medical imaging to confirm the diagnosis. A chest x-ray is often performed to see if the lungs have become enlarged because of excess air or if there are structural changes in the lungs. However, diagnosing emphysema cannot be done with a chest x-ray alone. Chest CT scans are also used to diagnose COPD because they can show pockets of air in the lungs which are symptomatic of damage from COPD. All of these procedures are completely painless and require no invasive surgery and yet still provide accurate details and diagnosis.

At Doctors Imaging, we assist doctors in the diagnosis, treatment, and aftercare of sick or injured patients. Our staff offers state of the art medical technology along with decades of professional experience. We have been facing the concerning statistics of lung cancer and lung-related ailments in Louisiana for many years. But we know the importance of lung cancer screenings. We even offer a $99 lung cancer screening for long-time smokers and ex-smokers. Lung cancer screenings are available to each patient annually.

Want to learn more? Find out what to expect during a CT Scan. Ready to make an appointment? You can Request an Appointment online or call Doctors Imaging’s office in Metairie at 504-833-8111 Monday through Friday to speak to a representative.

How Often Should Ex-Smokers Get Lung Cancer Screenings?

A low-dose CT scan of the chest is a good way to detect multiple diseases and disorders, including chronic respiratory diseases and lung cancer.  Early detection of these diseases and disorders is essential to the successful fight against them.  The earlier they are detected, the better chance a patient has at survival.

This brings up a question, though.  If preventative screening is key to catching these diseases early, how often should one get tested?  Let’s take a look at today at one case in particular: a 55-year old ex-smoker who recently stopped smoking.

Our ex-smoker is 55 years old, and has had a history of smoking.  The patient has since stopped. The patient shows lung cancer symptoms now but is worried about an increased chance of developing lung cancer or some other respiratory condition in the future.

Where Public Health Organizations Agree

In August of 2011, the results of the National Lung Screening Trial (NLST) found that screening with low-dose spiral computed tomography (LDCT) scans compared to chest X-ray reduced lung cancer deaths among older heavy smokers by 20%, according to the American Lung Association.

As of December 2013, the U.S. Preventive Services Task Force began recommending “annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.” Further, the USPSTF “concludes with moderate certainty that annual screening for lung cancer with LDCT is of moderate net benefit in asymptomatic persons who are at high risk for lung cancer based on age, total cumulative exposure to tobacco smoke, and years since quitting smoking.”

The American Lung Association is on the same page: Our patient should get tested if they are a current or former smoker aged 55 to 74 years old, has had a history of smoking for at least 30 packs per year and has no history of lung cancer.

Now, if our patient gets tested and the results come back with no signs of lung cancer, are they off the hook for future testing?

No. The patient should still be tested annually.

The goal here is prevention, and the best way to do this is through screening, according to the American Cancer Society. Our patient is likely to develop lung cancer, so preventative screening is the best way to keep them healthy and perhaps save a life.

If you’re looking for preventative screening services (such as a CT scan), come to Doctors Imaging. We’re radiologists concerned about quality patient care. Scheduling is easy, results are available online, our rates are below hospitals, and we accept every major insurance.