Management of COPD: Is there a role for quantitative imaging?

•Multicentre studies with CT are enabling a better understanding of COPD phenotypes.•New pulmonary MRI techniques have emerged that provide sensitive COPD biomarkers.•OCT is the only imaging modality that can directly quantify the small airways.•Imaging may identify phenotypes for effective COPD management to improve outcomes.

While the recent development of quantitative imaging methods have led to their increased use in the diagnosis and management of many chronic diseases, medical imaging still plays a limited role in the management of chronic obstructive pulmonary disease (COPD). In this review we highlight three pulmonary imaging modalities: computed tomography (CT), magnetic resonance imaging (MRI) and optical coherence tomography (OCT) imaging and the COPD biomarkers that may be helpful for managing COPD patients. We discussed the current role imaging plays in COPD management as well as the potential role quantitative imaging will play by identifying imaging phenotypes to enable more effective COPD management and improved outcomes.