title: Quantitative CT assessment of emphysema and airways in relation to lung cancer risk.
abstract: OBJECTIVE
  To determine whether quantitative computed tomographic (CT) measurements of emphysema and airway dimensions are associated with lung cancer risk in a screening population.
  
  
  METHODS
  Institutional review board approval and informed consent for the use of deidentified images were obtained. In this retrospective study, CT scans were analyzed from 279 participants in the CT screening arm of the National Lung Screening Trial who were diagnosed with lung cancer and 279 participants who were not diagnosed with lung cancer after a median follow-up period of 6.6 years. Quantitative CT measurements of emphysema and right upper lobe apical segmental and subsegmental airway dimensions, and multiple patient history-related variables, were compared between the two groups. Significant variables were tested in multivariate models for association with lung cancer by using multiple logistic regression.
  
  
  RESULTS
  The emphysema index of percentage upper lung volume less than -950 HU had the strongest association with lung cancer (mean, 10.7% [standard deviation, 13.5] in patients vs 7.2% [standard deviation, 10.4] in control subjects; P < .001), but the relationship was weak (R(2) = 0.015, P < .001, c = 0.57). No CT measures of emphysema had an association with lung cancer independent of the patient medical history variables. Airway dimensions were not associated with lung cancer.
  
  
  CONCLUSIONS
  Quantitative CT measurements of emphysema but not airway dimensions were only weakly associated with lung cancer, demonstrating no potential practical value for clinical risk stratification.
authors: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110, USA. gieradad@wustl.edu
authors: David S
authors: DS
authors: Gierada
authors: Preethi
authors: P
authors: Guniganti
authors: Blake J
authors: BJ
authors: Newman
authors: Mark T
authors: MT
authors: Dransfield
authors: Paul A
authors: PA
authors: Kvale
authors: David A
authors: DA
authors: Lynch
authors: Thomas K
authors: TK
authors: Pilgram
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States / Q000453:epidemiology