Generation-based study of airway remodeling in smokers with normal-looking CT with normalization to control inter-subject variability. Issue 138 (May 2021)

• Record Type: Journal Article
• Authors: Chae, Kum Ju; Jin, Gong Yong; Choi, Jiwoong; Lee, Chang Hyun; Choi, Sanghun; Choi, Hyemi; Park, Jeongjae; Lin, Ching-Long; Hoffman, Eric A.
• Is Part Of: European journal of radiology. Issue 138(2021)
• Publication Date: 2021-05
• Subjects: COPD chronic obstructive pulmonary disease -- QCT quantitative computed tomography -- PFT pulmonary function test -- FEV1 forced expiratory volume in one second -- FVC forced vital capacity -- LA luminal area -- WT wall thickness -- D diameter -- WA wall area -- Pi10 square root of a hypothetical airway with an internal perimeter of 10mm; Chronic obstructive pulmonary disease -- Airway remodeling -- Smoking -- Quantitative computed tomography; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.109657
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: With the help of quantitative computed tomography (QCT), it is possible to identify smoking-associated airway remodeling. However, there is currently little information on whether QCT-based airway metrics are sensitive to early airway wall remodeling in subclinical phases of smoking-associated airway disease. This study aimed to evaluate a predictive model that normalized airway parameters and investigate structural airway alterations in smokers with normal-looking CT using the normalization scheme. Methods: In this retrospective analysis, 222 non-smokers (male 97, female 125) and 69 smokers (male 66, female 3) from January 2014 to December 2016 were included, and airway parameters were quantitatively analyzed. To control inter-subject variability, multiple linear regressions of tracheal wall thickness (WT), diameter (D), and luminal area (LA) were performed, adjusted for age, sex, and height. Using this normalization scheme, airway parameters with matched generation were compared between smokers and non-smokers. Results: Using the normalization scheme, it was possible to assess generation-based structural alterations of the airways in subclinical smokers. Smokers showed diffuse luminal narrowing of airways for most generations ( P < 0.05, except 3rd generation), no change in wall thickness of the proximal bronchi (1st-3rd generation), and a thinning of distal airways ( P <0.05, ≥4th generation). Conclusion: QCT assessment for subclinical smokers can help identify minimal structural changes in airways induced by smoking.