A Bibliometric Analysis of Quantitative Computed Tomography in Chronic Obstructive Pulmonary Disease Research Based on Web of Science: Trends, Hotspots, and Future Directions (2005–2025)

Background: Chronic Obstructive Pulmonary Disease(COPD) is a heterogeneous lung condition not fully captured by spirometry. Quantitative computed tomography (QCT) enables objective characterization of emphysema, airway remodeling, and other structural abnormalities, playing key roles in early recognition, phenotyping, and prognosis. Despite growing literature in this field, no comprehensive bibliometric synthesis has mapped the intellectual structure, collaborative networks, or thematic evolution of QCT research in COPD. This study aims to fill this gap by providing a structured overview of the field over the past two decades.

Methods: A systematic search was performed in the Web of Science Core Collection (WoSCC) using the topic formula: TS=(("quantitative computed tomography" OR "quantitative CT" OR "QCT" OR "CT quantification" OR "quantitative CT assessment") AND ("chronic obstructive pulmonary disease" OR "COPD" OR "chronic obstructive pulmonary disease")). Publications from 2005 to 2025 were included, limited to English original articles and reviews. Titles and abstracts were independently screened by two reviewers; studies not primarily focusing on QCT-based quantitative analysis in COPD were excluded. Disagreements were resolved through discussion. Bibliometric and visual analyses were conducted using CiteSpace 6.4.R1, VOSviewer 1.6.19, and the R package bibliometrix.

Results: A total of 300 publications (279 original articles, 21 reviews) were included. The United States was the leading contributor in overall output and international collaboration. The University of Iowa was the most productive institution, Hoffman EA was the most prolific author and the International Journal of Chronic Obstructive Pulmonary Disease was the most productive journal. Keyword and thematic analyses revealed a clear evolutionary trajectory: early research (2005-2012) focused on technical quantification of emphysema and airway abnormalities; a transitional phase (2013-2018) emphasized "phenotypes" and disease heterogeneity; and the recent period (2019-2025) has seen rising attention to prognostic evaluation, mortality prediction, and artificial intelligence-assisted analysis.

Conclusions: This study confirms a shift from morphologic quantification toward clinically actionable imaging biomarkers. However, the existing literature suffers from several critical gaps: lack of standardized acquisition and analysis protocols, predominance of cross-sectional designs, and insufficient external validation of artificial intelligence models. Future research should prioritize multicenter prospective validation, integration with multi-omics data for endotyping, and development of open-source automated pipelines to facilitate clinical translation.