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European Radiology
Published in: European Radiology 12/2022

Open Access 09-06-2022 | Lung Cancer | Chest

Association between visual emphysema and lung nodules on low-dose CT scan in a Chinese Lung Cancer Screening Program (Nelcin-B3)

Authors: Xiaofei Yang, Monique D. Dorrius, Wenzhen Jiang, Zhenhui Nie, Rozemarijn Vliegenthart, Harry J. M. Groen, Marjolein A. Heuvelmans, Grigory Sidorenkov, Marleen Vonder, Zhaoxiang Ye, Geertruida H. de Bock

Published in: European Radiology | Issue 12/2022

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Abstract

Objectives

This study aimed to evaluate the association between visual emphysema and the presence of lung nodules, and Lung-RADS category with low-dose CT (LDCT).

Methods

Baseline LDCT scans of 1162 participants from a lung cancer screening study (Nelcin-B3) performed in a Chinese general population were included. The presence, subtypes, and severity of emphysema (at least trace) were visually assessed by one radiologist. The presence, size, and classification of non-calcified lung nodules (≥ 30 mm3) and Lung-RADS category were independently assessed by another two radiologists. Multivariable logistic regression and stratified analyses were performed to estimate the association between emphysema and lung nodules, Lung-RADS category, after adjusting for age, sex, BMI, smoking status, pack-years, and passive smoking.

Results

Emphysema and lung nodules were observed in 674 (58.0%) and 424 (36.5%) participants, respectively. Participants with emphysema had a 71% increased risk of having lung nodules (adjusted odds ratios, aOR: 1.71, 95% CI: 1.26–2.31) and 70% increased risk of positive Lung-RADS category (aOR: 1.70, 95% CI: 1.09–2.66) than those without emphysema. Participants with paraseptal emphysema (n = 47, 4.0%) were at a higher risk for lung nodules than those with centrilobular emphysema (CLE) (aOR: 2.43, 95% CI: 1.32–4.50 and aOR: 1.60, 95% CI: 1.23–2.09, respectively). Only CLE was associated with positive Lung-RADS category (p = 0.02). CLE severity was related to a higher risk of lung nodules (ranges aOR: 1.44–2.61, overall p < 0.01).

Conclusion

In a Chinese general population, visual emphysema based on LDCT is independently related to the presence of lung nodules (≥ 30 mm3) and specifically CLE subtype is related to positive Lung-RADS category. The risk of lung nodules increases with CLE severity.

Key Points

• Participants with emphysema had an increased risk of having lung nodules, especially smokers.
• Participants with PSE were at a higher risk for lung nodules than those with CLE, but nodules in participants with CLE had a higher risk of positive Lung-RADS category.
• The risk of lung nodules increases with CLE severity.
Appendix
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Metadata
Title
Association between visual emphysema and lung nodules on low-dose CT scan in a Chinese Lung Cancer Screening Program (Nelcin-B3)
Authors
Xiaofei Yang
Monique D. Dorrius
Wenzhen Jiang
Zhenhui Nie
Rozemarijn Vliegenthart
Harry J. M. Groen
Marjolein A. Heuvelmans
Grigory Sidorenkov
Marleen Vonder
Zhaoxiang Ye
Geertruida H. de Bock
Publication date
09-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08884-3

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