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Sub\u2010optimal <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> patient phenotyping, an incomplete understanding of <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> pathogenesis and a scarcity of sensitive tools that provide patient\u2010relevant intermediate endpoints likely all play a role in the lack of new, efficacious <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> interventions. In other words, <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> patients are still diagnosed based on the presence of persistent airflow limitation measured using spirometry. Spirometry measurements reflect the global sum of all the different possible <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> pathologies and perhaps because of this, we lose sight of the different contributions of airway and parenchymal abnormalities. With recent advances in thoracic X\u2010ray computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) and magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>), lung structure and function abnormalities may be regionally identified and measured. These imaging endpoints may serve as biomarkers of <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> that can be used to better phenotype patients. Therefore, here we review novel <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> measurements that help reveal <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> phenotypes and what <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> really \u2018looks\u2019 like, beyond spirometric indices. We discuss <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> imaging approaches for generating reproducible and sensitive measurements of <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> phenotypes related to pulmonary ventilation and perfusion as well as airway and parenchyma anatomical and morphological features. These measurements may provide a way to advance the development and testing of new <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> interventions and therapies.<\/jats:p>","DOI":"10.1111\/resp.12611","type":"journal-article","created":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T10:35:57Z","timestamp":1440585357000},"page":"224-236","source":"Crossref","is-referenced-by-count":65,"title":["<i>This<\/i> is what <scp>COPD<\/scp> looks like"],"prefix":"10.1111","volume":"21","author":[{"given":"Khadija","family":"Sheikh","sequence":"first","affiliation":[{"name":"Robarts Research Institute  London Canada"},{"name":"Department of Medical Biophysics The University of Western Ontario  London Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey O","family":"Coxson","sequence":"additional","affiliation":[{"name":"UBC Centre for Heart Lung Innovation St. Paul's Hospital  Vancouver Canada"},{"name":"Department of Radiology University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Parraga","sequence":"additional","affiliation":[{"name":"Robarts Research Institute  London Canada"},{"name":"Department of Medical Biophysics The University of Western Ontario  London Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032158"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1106955"},{"key":"e_1_2_8_4_1","volume-title":"World health statistics 2010","author":"Organization WH","year":"2010"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201204-0596PP"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/15412550903499522"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00111707"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-203897"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2010.10.010"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(70)80076-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S2639"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-68260-8"},{"key":"e_1_2_8_13_1","unstructured":"HounsfieldGN.Radiography. 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