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Quantitative computed tomography: emphysema and airway wall thickness by sex, age and smoking

¹ Dept of Thoracic Medicine, Haukeland University Hospital, ⁶ Centre for Clinical Research, Haukeland University Hospital, ² Institute of Medicine, University of Bergen, and ⁷ Dept of Public Health and Primary Care, University of Bergen, Bergen, Norway. ³ Pulmonary Dept, Gentofte Hospital, Copenhagen, Denmark. ⁴ Dept of Radiology and James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, University of British Columbia, Vancouver, BC, Canada. ⁵ GlaxoSmithKline, Research & Development, Research Triangle Park, NC, USA.

CORRESPONDENCE: T. B. Grydeland, Dept of Thoracic Medicine, Haukeland University Hospital, N-5021 Bergen, Norway. E-mail: thomas.grydeland{at}med.uib.no

Keywords: Airway, chronic obstructive pulmonary disease, computed tomography, emphysema, sex, smoking

Received: November 5, 2008
Accepted February 26, 2009

We investigated how quantitative high-resolution computed tomography (HRCT) measures of emphysema and airway wall thickness (AWT) vary with sex, age and smoking history.

We included 463 chronic obstructive pulmonary disease (COPD) cases and 431 controls. All included subjects were current or ex-smokers aged 40 yrs, and all underwent spirometry and HRCT examination. The HRCT images were quantitatively assessed, providing indices on lung density and airway dimensions.

The median (25–75th percentile) %LAA950 (% low-attenuation area < -950 HU) was 8.9 (3–19) and 4.7 (1–16) in male and female COPD cases, respectively, and 0.71 (0.3–1.6) and 0.32 (0.1–0.8) in male and female controls, respectively. %LAA950 was higher in ex-smokers and increased with increasing age and with increasing number of pack-years. The mean±SD standardised AWT was 0.504±0.030 and 0.474±0.031 in male and female COPD cases, respectively, and 0.488±0.028 and 0.463±0.025 in male and female controls, respectively. AWT decreased with increasing age in cases, and increased with the degree of current smoking in all subjects.

We found significant differences in quantitative HRCT measures of emphysema and AWT between varying sex, age and smoking groups of both control and COPD subjects.

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