title: Increased mean lung density: another independent predictor of lung cancer?
abstract: OBJECTIVE
  To investigate the relationship between emphysema phenotype, mean lung density (MLD), lung function and lung cancer by using an automated multiple feature analysis tool on thin-section computed tomography (CT) data.
  
  
  METHODS
  Both emphysema phenotype and MLD evaluated by automated quantitative CT analysis were compared between outpatients and screening participants with lung cancer (n=119) and controls (n=989). Emphysema phenotype was defined by assessing features such as extent, distribution on core/peel of the lung and hole size. Adjusted multiple logistic regression models were used to evaluate independent associations of CT densitometric measurements and pulmonary function test (PFT) with lung cancer risk.
  
  
  RESULTS
  No emphysema feature was associated with lung cancer. Lung cancer risk increased with decreasing values of forced expiratory volume in 1s (FEV1) independently of MLD (OR 5.37, 95% CI: 2.63-10.97 for FEV1<60% vs. FEV1≥90%), and with increasing MLD independently of FEV1 (OR 3.00, 95% CI: 1.60-5.63 for MLD>-823 vs. MLD<-857 Hounsfield units).
  
  
  CONCLUSIONS
  Emphysema per se was not associated with lung cancer whereas decreased FEV1 was confirmed as being a strong and independent risk factor. The cross-sectional association between increased MLD and lung cancer requires future validations.
authors: Department of Department of Surgical Sciences, Section of Diagnostic Imaging, University of Parma, Padiglione Barbieri, University Hospital of Parma, V. Gramsci 14, 43100 Parma, Italy. nicola.sverzellati@unipr.it
authors: Nicola
authors: N
authors: Sverzellati
authors: Giorgia
authors: G
authors: Randi
authors: Paolo
authors: P
authors: Spagnolo
authors: Alfonso
authors: A
authors: Marchianò
authors: Mario
authors: M
authors: Silva
authors: Jan-Martin
authors: JM
authors: Kuhnigk
authors: Carlo
authors: C
authors: La Vecchia
authors: Maurizio
authors: M
authors: Zompatori
authors: Ugo
authors: U
authors: Pastorino
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015984:Causality; D015897:Comorbidity; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*