A contemporary review in Current Opinion in Pulmonary Medicine examined how chest CT can extend assessment of COPD beyond what is captured by spirometry alone. The authors reviewed evidence linking CT-defined emphysema, airway abnormalities, chronic bronchitis-related changes and pulmonary vascular measurements with clinically meaningful outcomes. The key message is that CT can reveal structural and vascular features that help explain differences in symptoms, exacerbation burden and prognosis among patients with similar spirometric impairment. The review also highlights an important implementation gap: although CT-derived biomarkers are increasingly studied, they are not yet routinely translated into standardized clinical decision-making. For practicing pulmonologists, the value of CT is therefore complementary rather than a replacement for pulmonary function testing. The paper aligns closely with the NAPCON imaging theme of reading patterns rather than relying only on reports, and with the COPD session's emphasis on phenotyping beyond spirometry. CT may be particularly useful when symptoms appear disproportionate to lung-function impairment, when emphysema or another structural diagnosis needs clarification, or when imaging is already being obtained for another clinical reason. The article provides a useful bridge between emerging quantitative imaging research and everyday respiratory practice.