Quantitative CT Evaluation of Emphysema Progression over 10 Years in the COPDGene Study.
Quantitative CT Evaluation of Emphysema Progression over 10 Years in the COPDGene Study.
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COPDGene 研究中 10 年来肺气肿进展的定量 CT 评估。
DOI：
10.1148/radiol.222786
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发表时间：
2023
期刊：
影响因子：
19.7
通讯作者：
Lynch,DavidA
中科院分区：
文献类型：
--
作者：
Baraghoshi,David;Strand,Matthew;Humphries,StephenM;SanJoséEstépar,Raúl;VegasSanchez-Ferrero,Gonzalo;Charbonnier,Jean-Paul;Latisenko,Rudolfs;Silverman,EdwinK;Crapo,JamesD;Lynch,DavidA
慢性阻塞性肺疾病（COPD）的长期研究可以 评估肺气肿进展。设备差异调整数 个人CT检查的扫描协议尚未 目的：评估肺气肿在吸烟者和既往吸烟者中的进展， 在5年间隔获得的3个成像点上的COPD基因队列 材料和方法2008年至2011年期间招募的当前和既往吸烟者， 从2008年到2010年， 和2020年。肺气肿的程度作为校正的肺密度（ALD）， 在基线、5年和10年时测量定量CT 随访根据CT技术特性调整的线性混合模型 用于评估肺气肿的进展。平均年度变化 在连续5年的研究期间， 结果8431名基线参与者（平均年龄60岁± 9岁[SD]; 3905例女性参与者），4913例接受了5年随访，1544例 参与者接受了10年的随访。4134人（49%） 目前吸烟的参与者，4449（53%）参与者 超过基线时的微量肺气肿。目前吸烟者超过 微量肺气肿的ALD下降幅度最大， 前5年降低1.4 g/L（95% CI：1.2，1.5），前5年降低0.9 g/L (95% CI：0.7，1.2）。考虑CT噪声，场 和扫描仪模型的改进模型适合估计 肺气肿进展（P<0.001 比率检验）。结论COPD基因研究中肺气肿进展的CT评估显示 在10年的时间里， 持续吸烟的肺气肿患者ALD下降幅度最大。 调整CT设备和协议因素改善了这些 纵向估计。临床试验注册号NCT 00608764 © RSNA，2023参见Parraga和Kirby在本期的社论。早期的错误版本出现在网上。本文已于2023年11月10日更正。
BackgroundLong-term studies of chronic obstructive pulmonary disease (COPD) can evaluate emphysema progression. Adjustment for differences in equipment and scanning protocols of individual CT examinations have not been studied extensively.PurposeTo evaluate emphysema progression in current and former smokers in the COPDGene cohort over three imaging points obtained at 5-year intervals accounting for individual CT parameters.Materials and MethodsCurrent and former cigarette smokers enrolled between 2008 and 2011 from the COPDGene study were prospectively followed for 10 years between 2008 and 2020. Extent of emphysema as adjusted lung density (ALD) from quantitative CT was measured at baseline and at 5- and 10-year follow-up. Linear mixed models adjusted for CT technical characteristics were constructed to evaluate emphysema progression. Mean annual changes in ALD over consecutive 5-year study periods were estimated by smoking status and baseline emphysema.ResultsOf 8431 participants at baseline (mean age, 60 years ± 9 [SD]; 3905 female participants), 4913 were at 5-year follow-up and 1544 participants were at 10-year follow-up. There were 4134 (49%) participants who were current smokers, and 4449 (53%) participants had more than trace emphysema at baseline. Current smokers with more than trace emphysema showed the largest decline in ALD, with mean annual decreases of 1.4 g/L (95% CI: 1.2, 1.5) in the first 5 years and 0.9 g/L (95% CI: 0.7, 1.2) in the second 5 years. Accounting for CT noise, field of view, and scanner model improved model fit for estimation of emphysema progression (P< .001 by likelihood ratio test).ConclusionEvaluation at CT of emphysema progression in the COPDGene study showed that, during the span of 10 years, participants with pre-existing emphysema who continued smoking had the largest decline in ALD. Adjusting for CT equipment and protocol factors improved these longitudinal estimates.Clinical trial registration no. NCT00608764© RSNA, 2023See the editorial by Parraga and Kirby in this issue.An earlier incorrect version appeared online. This article was corrected on November 10, 2023.
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