The importance of CT quantitative evaluation of emphysema in lung cancer screening cohort with negative findings by visual evaluation

Clin Respir J. 2019 Dec;13(12):741-750. doi: 10.1111/crj.13084. Epub 2019 Sep 30.

Abstract

Introduction: One-stop quantitative evaluation of emphysema and lung nodule in lung cancer screening is very important for patient.

Objective: To evaluate the quantitative emphysema in the large-sample low-dose CT lung cancer screening cohort with negative CT findings by subjective visual assessment.

Methods: One thousand, two hundred and thirty-one participants with negative visual evaluation were included in this retrospective study. The lungs were automatically segmented and the following were calculated: total lung volume (TLV), total emphysema volume (TEV), emphysema index (EI), 15th percentile lung density and mean lung density. EI ≥6% was defined as emphysema. The quantitative parameters were compared between different genders and ages. The quantitative parameters and risk factors were compared between emphysema and non-emphysema groups.

Results: The proportion of smokers, TLV, TEV and EI of men were greater than that of women (P < 0.001). No correlation was found between age and volumes; the TEV and EI of people older than 60 years were greater than those younger than 60 years (P < 0.05) by age categorisation. One hundred and two participants showed emphysema, accounting for 8.29%. The incidence of emphysema in men was greater than that in women in total (P < 0.05). All the CT quantitative parameters were significantly different between emphysema and non-emphysema groups. The ratio of male, secondhand smoke exposure and chronic bronchitis history was greater in emphysema than that in the non-emphysema group (P < 0.05).

Conclusion: CT quantitative emphysema evaluation is recommended in people older than 60 years, especially in males, providing more precise information, aiding the early diagnosis of emphysema and informing early intervention.

Keywords: X-ray computed; computational biology; emphysema; lung cancer screening; tomography.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Bronchitis, Chronic / epidemiology
  • Early Detection of Cancer / standards
  • Early Intervention, Educational / methods
  • Emphysema / diagnostic imaging*
  • Emphysema / epidemiology
  • Emphysema / etiology*
  • Emphysema / pathology
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Incidence
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Lung / physiopathology
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Smoking / epidemiology
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / statistics & numerical data