title: Chronic respiratory symptoms associated with airway wall thickening measured by thin-slice low-dose CT.
abstract: OBJECTIVE
  In lung cancer screening, the prevalence of chronic respiratory symptoms is high among heavy smokers. The purpose of this study was to compare CT-derived airway wall measurements between male smokers with and those without chronic respiratory symptoms.
  
  
  METHODS
  Fifty male heavy smokers with chronic respiratory symptoms (cough, excessive mucus secretion, dyspnea, and wheezing) and 50 without any respiratory symptom were randomly selected from the Dutch-Belgian Randomized Lung Cancer Screening Trial. Thin-slice low-dose CT images were evaluated with dedicated software for airway measurements. Wall area percentage and airway wall thickness were measured from trachea to bronchi in five different pulmonary lobes of airways with a luminal diameter of 5 mm or greater. Association between airway wall measurements and respiratory symptoms was analyzed by multiple linear regression adjusted for age, body mass index, smoking status, emphysema, and pulmonary function.
  
  
  RESULTS
  After adjustment for relevant factors, a significant positive association between airway wall measurements and respiratory symptoms was found in airways with a luminal diameter between 5 to 10 mm (p < 0.01), but not in airways measuring 10 mm or greater (p > 0.05). At the airway level between 5 to 10 mm, the mean wall area percentages were 51.5% ± 7.9%. Airway wall thicknesses were 1.54 ± 0.39 mm and 1.37 ± 0.35 mm (p < 0.001).
  
  
  CONCLUSIONS
  Male heavy smokers with chronic respiratory symptoms in lung cancer screening, who are at high-risk of chronic bronchitis, have bronchial wall thickening in airways with a luminal diameter of 5-10 mm but not in larger airways.
authors.affiliation: 1 Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Xueqian
authors.initials: X
authors.lastname: Xie
authors.forename: Akkelies E
authors.initials: AE
authors.lastname: Dijkstra
authors.forename: Judith M
authors.initials: JM
authors.lastname: Vonk
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.forename: Rozemarijn
authors.initials: R
authors.lastname: Vliegenthart
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
mesh_terms: D000368:Aged; D001530:Belgium; D015984:Causality; D002908:Chronic Disease; D015897:Comorbidity; D006801:Humans; D015994:Incidence; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009929:Organ Size; D015203:Reproducibility of Results; D012120:Respiration Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
keywords: CT; airway wall thickening; chronic bronchitis; large airway; respiratory symptoms