Variation in the Percent of Emphysema-like Lung in a Healthy, Nonsmoking Multiethnic Sample. The MESA Lung Study

Eric A. Hoffman; Firas S. Ahmed; Heather Baumhauer; Mathew Budoff; J. Jeffrey Carr; Richard Kronmal; S. Reddy; R. Graham Barr

doi:10.1513/AnnalsATS.201310-364OC

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Variation in the Percent of Emphysema-like Lung in a Healthy, Nonsmoking Multiethnic Sample. The MESA Lung Study

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Variation in the Percent of Emphysema-like Lung in a Healthy, Nonsmoking Multiethnic Sample. The MESA Lung Study

Eric A. Hoffman, Firas S. Ahmed, Heather Baumhauer, Mathew Budoff, J. Jeffrey Carr, Richard Kronmal, S. Reddy and R. Graham Barr

Annals of the American Thoracic Society, Vol.11(6), pp.898-907

07/01/2014

DOI: 10.1513/AnnalsATS.201310-364OC

PMCID: PMC4213995

PMID: 24983825

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Abstract

Rationale: Computed tomography (CT)-based lung density is used to quantitate the percentage of emphysema-like lung (hereafter referred to as percent emphysema), but information on its distribution among healthy nonsmokers is limited. Objectives: We evaluated percent emphysema and total lung volume on CT scans of healthy never-smokers in a multiethnic, population-based study. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study investigators acquired full-lung CT scans of 3,137 participants (ages 54–93 yr) between 2010–12. The CT scans were taken at full inspiration following the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) protocol. “Healthy never-smokers” were defined as participants without a history of tobacco smoking or respiratory symptoms and disease. “Percent emphysema” was defined as the percentage of lung voxels below −950 Hounsfield units. “Total lung volume” was defined by the volume of lung voxels. Measurements and Main Results: Among 854 healthy never-smokers, the median percent emphysema visualized on full-lung scans was 1.1% (interquartile range, 0.5–2.5%). The percent emphysema values were 1.2 percentage points higher among men compared with women and 0.7, 1.2, and 1.2 percentage points lower among African Americans, Hispanics, and Asians compared with whites, respectively ( P < 0.001). Percent emphysema was positively related to age and height and inversely related to body mass index. The findings were similar for total lung volume on CT scans and for percent emphysema defined at −910 Hounsfield units and measured on cardiac scans. Reference equations to account for these differences are presented for never, former and current smokers. Conclusions: Similar to lung function, percent emphysema varies substantially by demographic factors and body size among healthy never-smokers. The presented reference equations will assist in defining abnormal values for percent emphysema and total lung volume on CT scans, although validation is pending.

emphysema

lung volumes

Original Research

quantitative computed tomography

reference equations

Details

Title: Subtitle: Variation in the Percent of Emphysema-like Lung in a Healthy, Nonsmoking Multiethnic Sample. The MESA Lung Study
Creators: Eric A. Hoffman - University of Iowa
Firas S. Ahmed - Department of Radiology
Heather Baumhauer - Department of Radiology
Mathew Budoff - Department of Medicine, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles, California
J. Jeffrey Carr - VA Medical Center
Richard Kronmal - University of Washington
S. Reddy - Department of Radiology
R. Graham Barr - Columbia University
Resource Type: Journal article
Publication Details: Annals of the American Thoracic Society, Vol.11(6), pp.898-907
Publisher: American Thoracic Society
DOI: 10.1513/AnnalsATS.201310-364OC
PMID: 24983825
PMCID: PMC4213995
ISSN: 2329-6933
eISSN: 2325-6621
Language: English
Date published: 07/01/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984318713302771

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