Quantitative Emphysema on Low-Dose CT Imaging of the Chest and Risk of Lung Cancer and Airflow Obstruction

Labaki, Wassim W.; Xia, Meng; Murray, Susan; Hatt, Charles R.; Al-abcha, Abdullah; Ferrera, Michael; Meldrum, Catherine A.; Keith, Lauren; Galbán, Craig J.; Curtis, Jeffrey L.; Martínez, Fernando J.; Kazerooni, Ella A.; Han, MeiLan K.

doi:10.1016/j.chest.2020.12.004

Cited by 44 publications

(39 citation statements)

References 43 publications

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“…Patients were divided into three groups according to emphysema score (emphysema score ≤1%, 1%< emphysema score ≤5%, and emphysema score >5%) based on a previous study. 16 Among the 146 patients, 80 (55%), 55 (38%), and 11 (8%) had emphysema scores ≤1%, between 1% and 5%, and >5%, respectively. The median emphysema scores were 0.5% (IQR, 0.2–0.9%), 1.8% (IQR, 1.2–2.0%), and 8.0% (IQR, 5.0–13.0%) in groups with emphysema scores ≤1%, >1% and ≤5%, and >5%, respectively ( Table 1 ).…”

Section: Resultsmentioning

confidence: 92%

Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19

Lim¹,

Park²,

Park³

et al. 2021

IJGM

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Background: Chronic obstructive pulmonary disease (COPD) is considered a risk factor for poor outcomes in patients with coronavirus disease 2019 . However, data on the prognostic impact of radiological emphysema extent on patients with COVID-19 are limited. Thus, this study aimed to examine whether computed tomography (CT)-quantified emphysema score is associated with a worse clinical outcome in patients with COVID-19. Methods: Volumetric quantitative analyses of CT images were performed to obtain emphysema scores in COVID-19 patients admitted to four tertiary referral hospitals in Daegu, South Korea, between February 18 and March 25, 2020. Patients were divided into three groups according to emphysema score (emphysema score ≤1%, 1%< emphysema score ≤5%, and emphysema score >5%). Results: A total of 146 patients with confirmed SARS-CoV-2 infection were included. The median emphysema score was 1.0% (interquartile range, 0.5-1.8%). Eight patients (6%) had a previous COPD diagnosis. Eighty (55%), 55 (38%), and 11 (8%) patients had emphysema scores ≤1%, between 1% and 5%, and >5%, respectively. The number of patients who received oxygen therapy two weeks after admission was significantly higher in the group with emphysema scores >5% than in other groups (p=0.025). The frequency of deaths was three (27%) in the group with emphysema scores >5% and tended to be higher than that in other groups. Multivariate analysis revealed that age, COPD, and serum lactate dehydrogenase levels were associated with a greater risk of in-hospital mortality in patients with COVID-19. Conclusion:The current study demonstrated that patients with CT-quantified emphysema scores >5% tended to progress to severe disease over time; however, they did not exhibit an increased risk of mortality in our COVID-19 cohort. Further studies with consideration of both emphysema extent and airflow limitation degree are warranted.

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Section: Resultsmentioning

confidence: 92%

Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19

Lim¹,

Park²,

Park³

et al. 2021

IJGM

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“… 17 In current or former smokers, the low attenuation area on low-dose CT imaging ordered as part of routine lung cancer screening may be able to detect quantitative emphysema and diagnose subjects with early COPD, allowing clinicians to monitor patients closely and perhaps initiate appropriate treatment when needed. 61 These findings suggest that PRM could allow clinicians to further understand the variable disease progression of COPD, resulting in better-tailored treatments.…”

Section: Commercial Platformsmentioning

confidence: 96%

CT-Based Commercial Software Applications: Improving Patient Care Through Accurate COPD Subtyping

Wang¹,

Ram²,

Labaki³

et al. 2022

COPD

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Chronic obstructive pulmonary disease (COPD) is heterogenous in its clinical manifestations and disease progression. Patients often have disease courses that are difficult to predict with readily available data, such as lung function testing. The ability to better classify COPD into well-defined groups will allow researchers and clinicians to tailor novel therapies, monitor their effects, and improve patient-centered outcomes. Different modalities of assessing these COPD phenotypes are actively being studied, and an area of great promise includes the use of quantitative computed tomography (QCT) techniques focused on key features such as airway anatomy, lung density, and vascular morphology. Over the last few decades, companies around the world have commercialized automated CT software packages that have proven immensely useful in these endeavors. This article reviews the key features of several commercial platforms, including the technologies they are based on, the metrics they can generate, and their clinical correlations and applications. While such tools are increasingly being used in research and clinical settings, they have yet to be consistently adopted for diagnostic work-up and treatment planning, and their full potential remains to be explored.

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“…The assessment of lung density in LDCT examinations for LCS (Fig. 5 ) is valuable since emphysema severity is correlated with either LC incidence, and hence it adds to the post-test risk of LC [ 74 , 75 ]. Moreover, lung density is correlated with pulmonary function test, smoking history and smoking-cessation [ 76 ], and the overall prognosis [ 77 ].…”

Section: Collateral and Incidental Findingsmentioning

confidence: 99%

Low-dose CT for lung cancer screening: position paper from the Italian college of thoracic radiology

et al. 2022

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Smoking is the main risk factor for lung cancer (LC), which is the leading cause of cancer-related death worldwide. Independent randomized controlled trials, governmental and inter-governmental task forces, and meta-analyses established that LC screening (LCS) with chest low dose computed tomography (LDCT) decreases the mortality of LC in smokers and former smokers, compared to no-screening, especially in women. Accordingly, several Italian initiatives are offering LCS by LDCT and smoking cessation to about 10,000 high-risk subjects, supported by Private or Public Health Institutions, envisaging a possible population-based screening program. Because LDCT is the backbone of LCS, Italian radiologists with LCS expertise are presenting this position paper that encompasses recommendations for LDCT scan protocol and its reading. Moreover, fundamentals for classification of lung nodules and other findings at LDCT test are detailed along with international guidelines, from the European Society of Thoracic Imaging, the British Thoracic Society, and the American College of Radiology, for their reporting and management in LCS. The Italian College of Thoracic Radiologists produced this document to provide the basics for radiologists who plan to set up or to be involved in LCS, thus fostering homogenous evidence-based approach to the LDCT test over the Italian territory and warrant comparison and analyses throughout National and International practices.

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Quantitative Emphysema on Low-Dose CT Imaging of the Chest and Risk of Lung Cancer and Airflow Obstruction

Cited by 44 publications

References 43 publications

Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19

Impact of Computed Tomography-Quantified Emphysema Score on Clinical Outcome in Patients with COVID-19

CT-Based Commercial Software Applications: Improving Patient Care Through Accurate COPD Subtyping

Low-dose CT for lung cancer screening: position paper from the Italian college of thoracic radiology

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