Quantitative Computed Tomography Analysis, Airflow Obstruction, and Lung Cancer in the Pittsburgh Lung Screening Study

Background: To study the relationship between emphysema, airflow obstruction, and lung cancer in a high-risk population, we performed quantitative analysis of screening computed tomography (CT) scans. Methods: Subjects completed questionnaires, spirometry, and low-dose helical chest CT. Analyses compared cases and controls according to automated quantitative analysis of lung parenchyma and airways measures. Results: Our case-control study of 117 matched pairs of lung cancer cases and controls did not reveal any airway or lung parenchymal findings on quantitative analysis of screening CT scans that were associated with increased lung cancer risk. Airway measures including wall area %, lumen perimeter, lumen area and average wall Hounsfield unit, and parenchymal measures including lung fraction less than -910 Hounsfield units were not statistically different between cases and controls. Conclusions: The relationship between visual assessment of emphysema and increased lung cancer risk could not be verified by quantitative analysis of low-dose screening CT scans in a high-risk tobacco exposed population.