ArticleChest2021
Quantitative Emphysema on Low-Dose CT Imaging of the Chest and Risk of Lung Cancer and Airflow Obstruction: An Analysis of the National Lung Screening Trial.
Article in Chest, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.The Cochrane database of systematic reviews · 2022Pooled it
- The impact of chest computed tomography-defined emphysema on extrapulmonary metastases in patients with lung cancer.BMC medical imaging · 2026Article
- Correlation analysis of chest HRCT quantitative parameters, exhaled nitric oxide, and pulmonary function in patients with chronic obstructive pulmonary disease.Scientific reports · 2026Article
- Airway Quantification Using Ultra-Low-Dose Computed Tomography Correlates With Pulmonary Function Indices in Patients With Asthma.Journal of Korean medical science · 2026Article
- Reliability and Agreement of Quantitative Pulmonary Imaging Biomarkers Between Ultra-Low-Dose and Low-Dose Chest CT: A Paired Intra-Individual Study.Diagnostics (Basel, Switzerland) · 2026Article
- Imaging features of lung cancer with cystic airspaces: clinical utility, challenges, and perspectives.Frontiers in oncology · 2026Review
- COPD-Lung Cancer Comorbidity: Mechanistic Insights and Precision Oncology Implications.International journal of chronic obstructive pulmonary disease · 2026Review
- Association of AI-Derived Quantitative CT Parameters of Airway, Emphysema, and Pulmonary Vasculature with Lung Cancer: A Cross-Sectional AnalysisCurrent medical imaging · 2026Article
- Preoperative low attenuation area percentage as a predictor of postoperative pulmonary complications and prognosis in esophagectomy: a retrospective cohort study.Esophagus : official journal of the Japan Esophageal Society · 2026Article
- CT-based emphysema score is associated with prolonged air leak after lung resection: a retrospective cohort study.Journal of thoracic disease · 2025Article
- Harmonized low-dose computed tomographic protocols for quantitative lung imaging using dose modulation and advanced reconstructions.Medical physics · 2025Article
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- Lung NR3C1Communications biology · 2025Article
- Quantitative Computed Tomography Measures of Lung Fibrosis and Outcomes in the National Lung Screening Trial.Annals of the American Thoracic Society · 2025Article
- Coronary calcium score and emphysema extent on different CT radiation dose protocols in lung cancer screening.European radiology · 2025Article
- The Prevalence of Emphysema in Patients Undergoing Lung Cancer Screening in a Middle-Income Country.Diseases (Basel, Switzerland) · 2025Article
- The association between emphysema detected on computed tomography and increased risk of lung cancer: a systematic review and meta-analysis.Quantitative imaging in medicine and surgery · 2025Article
- The pros and cons of lung cancer screening.European radiology · 2025Review
- Quantitatively Assessed Emphysema Severity on HRCT Independently Predicts Coronary Artery Disease in COPD: A Retrospective Cohort Study.International journal of chronic obstructive pulmonary disease · 2025Article
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14 authors at 4 institutions in 1 country.
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Abstract
backgroundLung cancer risk prediction models do not routinely incorporate imaging metrics available on low-dose CT (LDCT) imaging of the chest ordered for lung cancer screening. RESEARCH QUESTION: What is the association between quantitative emphysema measured on LDCT imaging and lung cancer incidence and mortality, all-cause mortality, and airflow obstruction in individuals who currently or formerly smoked and are undergoing lung cancer screening? STUDY DESIGN AND
methodsIn 7,262 participants in the CT arm of the National Lung Screening Trial, percent low attenuation area (%LAA) was defined as the percentage of lung volume with voxels less than -950 Hounsfield units on the baseline examination. Multivariable Cox proportional hazards models, adjusting for competing risks where appropriate, were built to test for association between %LAA and lung cancer incidence, lung cancer mortality, and all-cause mortality with censoring at 6 years. In addition, multivariable logistic regression models were built to test the cross-sectional association between %LAA and airflow obstruction on spirometry, which was available in 2,700 participants.
resultsThe median %LAA was 0.8% (interquartile range, 0.2%-2.7%). Every 1% increase in %LAA was independently associated with higher hazards of lung cancer incidence (hazard ratio [HR], 1.02; 95% CI, 1.01-1.03; P = .004), lung cancer mortality (HR, 1.02; 95% CI, 1.00-1.05; P = .045), and all-cause mortality (HR, 1.01; 95% CI, 1.00-1.03; P = .042). Among participants with spirometry, 892 had airflow obstruction. The likelihood of airflow obstruction increased with every 1% increase in %LAA (odds ratio, 1.07; 95% CI, 1.06-1.09; P < .001). A %LAA cutoff of 1% had the best discriminative accuracy for airflow obstruction in participants aged > 65 years.
interpretationQuantitative emphysema measured on LDCT imaging of the chest can be leveraged to improve lung cancer risk prediction and help diagnose COPD in individuals who currently or formerly smoked and are undergoing lung cancer screening.
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