RT Journal Article
SR Electronic
T1 Computed tomography in screening for smoking induced emphysema
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2263
VO 42
IS Suppl 57
A1 Martin Anderson
A1 Gunnar Engström
A1 Lars Nordenmark
A1 Dag Mohlkert
A1 Elmira Rouzbeh
A1 Maria Gerhardsson de Verdier
A1 Ulf Nihlén
A1 Thomas Fehniger
A1 Magnus Dahlbäck
A1 Magnus Svartengren
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2263.abstract
AB Computerized methods and visual assessment of computed tomography (CT) scans were compared in a subsample of a population based twin study to explore the relationships between emphysema, smoking, decreased pulmonary function, and elastin degradation products.138 twins were investigated. Two radiologists classified the CT-scans by presence of Centrilobular Emphysema (CE). PD15 (i.e. the cut off value in Hounsfield units [HU] for the 15% darkest areas) as well as fixed HU limits were used in the computerized analyses. Lung function and urinary desmosines were measured by specialist laboratories.There was no significant relationship between PD15 and current smoking or pack-years. Low C-reactive protein and body-mass-index were associated with low PD15 (p<0.01 for both). Also sex was significantly associated with PD15. Of the lung function measures, FEV1/FVC (low values) and FVC (high values) were associated with low PD15. Associations between these measures and CT findings were strongest for the upper third of the lung.106 of the 138 twins had CE, 27 had not CE. Five subjects were omitted due to poor quality and technical problems. In the CE group FEV1 % pred. was lower (p=0.018), as was the FEV1/FVC-ratio and DLCO (both p<0.001), further, CRP was higher (p= 0.014) and U-desmosines showed a tendency to be higher (p= 0.054).The proportion with CE was associated with PD15.In this population based study on mild COPD, the lung function and biomarker parameters of disease were closer associated to visual scoring of emphysema than to quantitative CT measurements. If quantitative measures should be used for staging and phenotyping smoking induced emphysema, such measurements should be focused on the upper third of the lungs.