Li, Xia, Fang, Guan, Wang, Liu, Fan (2019) The importance of CT quantitative evaluation of emphysema in lung cancer screening cohort with negative findings by visual evaluation The clinical respiratory journal 13(12) 741-750


One-stop quantitative evaluation of emphysema and lung nodule in lung cancer screening is very important for patient. To evaluate the quantitative emphysema in the large-sample low-dose CT lung cancer screening cohort with negative CT findings by subjective visual assessment. 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. 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). 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. © 2019 John Wiley & Sons Ltd.