CT quantification of emphysema in young subjects with no recognizable chest disease

AJR Am J Roentgenol. 2009 Mar;192(3):W90-6. doi: 10.2214/AJR.07.3502.

Abstract

Objective: The purpose of this prospective study was to evaluate volumetric CT emphysema quantification (CT densitovolumetry) in a young population with no recognizable lung disease.

Subjects and methods: A cohort of 30 nonsmoking patients with no recognizable lung disease (16 men, 14 women; age range, 19-41 years) underwent inspiratory and expiratory CT, after which the data were postprocessed for volumetric quantification of emphysema (threshold, -950 HU). Correlation was tested for age, weight, height, sex, body surface area (BSA), and physical activity. Normal limits were established by mean +/- 1.96 SD.

Results: No correlation was found between the measured volumes and age or physical activity. Correlation was found between BSA and normal lung volume in inspiration (r = 0.69, p = 0.000), shrink volume (i.e., difference in total lung volume in inspiration and in expiration) (r = 0.66, p = 0.000), and percentage of shrink volume (r = 0.35, p = 0.05). For an alpha error of 5%, the limits of normality based on this sample are percentage of emphysema in inspiration, 0.35%; percentage of emphysema in expiration, 0.12%; and maximum lung volume in expiration, 3.6 L. The maximum predicted percentage of shrink volume can be calculated as %SV = 29.43% + 16.97% x BSA (+/- 1.96 x 7.61%).

Conclusion: Young healthy nonsmokers with no recognizable lung disease can also show a small proportion of emphysematous-like changes on CT densitovolumetry when a threshold of -950 HU is used. Reference values should be considered when applying the technique for early detection or grading of emphysema and when studying aging lungs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Pulmonary Emphysema / diagnostic imaging*
  • Radiographic Image Interpretation, Computer-Assisted
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*