PLoS ONE (Jan 2013)

Computed tomography structural lung changes in discordant airflow limitation.

  • Firdaus A A Mohamed Hoesein,
  • Pim A de Jong,
  • Jan-Willem J Lammers,
  • Willem Pthm Mali,
  • Michael Schmidt,
  • Harry J de Koning,
  • Carlijn van der Aalst,
  • Matthijs Oudkerk,
  • Rozemarijn Vliegenthart,
  • Bram van Ginneken,
  • Eva M van Rikxoort,
  • Pieter Zanen

DOI
https://doi.org/10.1371/journal.pone.0065177
Journal volume & issue
Vol. 8, no. 6
p. e65177

Abstract

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BackgroundThere is increasing evidence that structural lung changes may be present before the occurrence of airflow limitation as assessed by spirometry. This study investigated the prevalence of computed tomography (CT) quantified emphysema, airway wall thickening and gas trapping according to classification of airflow limitation (FEV1/FVC MethodsA total number of 1,140 male former and current smokers participating in a lung cancer screenings trial (NELSON) were included and underwent chest CT scanning and spirometry. Emphysema was quantified by the 15(th) percentile, air way wall thickening by the square root of wall area for a theoretical airway with 10mm lumen perimeter (Pi10) and gas trapping by the mean lung density expiratory/inspiratory (E/I)-ratio. Participants were classified by entry FEV1/FVC: group 1>70%; group 2LLN; and group 370% but FEV1 ResultsMean (standard deviation) age was 62.5 (5.2) years and packyears smoked was 41.0 (18.0). Group 2 subjects when compared to group 1 had a significantly lower 15(th) percentile, -920.6 HU versus -912.2 HU; a higher Pi10, 2.87 mm versus 2.57 mm; and a higher E/I-ratio, 88.6% versus 85.6% (all pConclusionSubjects with an FEV1/FVC<70%, but above the LLN, have a significant greater degree of structural lung changes on CT compared to subjects without airflow limitation.