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Eur Radiol. 2018 Feb;28(2):807-815. doi: 10.1007/s00330-017-5030-6. Epub 2017 Sep 7.

Effect of smoking cessation on quantitative computed tomography in smokers at risk in a lung cancer screening population.

Author information

1
Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. Bertram.jobst@med.uni-heidelberg.de.
2
Translational Lung Research Centre Heidelberg (TLRC), Member of the German Lung Research Centre (DZL), Im Neuenheimer Feld 430, 69120, Heidelberg, Germany. Bertram.jobst@med.uni-heidelberg.de.
3
Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University of Heidelberg, Amalienstr. 5, 69126, Heidelberg, Germany. Bertram.jobst@med.uni-heidelberg.de.
4
Department of Radiology, German Cancer Research Center (dkfz), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. Bertram.jobst@med.uni-heidelberg.de.
5
Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
6
Translational Lung Research Centre Heidelberg (TLRC), Member of the German Lung Research Centre (DZL), Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
7
Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at the University of Heidelberg, Amalienstr. 5, 69126, Heidelberg, Germany.
8
Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ Heidelberg), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
9
Department of Radiology, German Cancer Research Center (dkfz), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.

Abstract

OBJECTIVE:

To longitudinally evaluate effects of smoking cessation on quantitative CT in a lung cancer screening cohort of heavy smokers over 4 years.

METHODS:

After 4 years, low-dose chest CT was available for 314 long-term ex-smokers (ES), 404 continuous smokers (CS) and 39 recent quitters (RQ) who quitted smoking within 2 years after baseline CT. CT acquired at baseline and after 3 and 4 years was subjected to well-evaluated densitometry software, computing mean lung density (MLD) and 15th percentile of the lung density histogram (15TH).

RESULTS:

At baseline, active smokers showed significantly higher MLD and 15TH (-822±35 and -936±25 HU, respectively) compared to ES (-831±31 and -947±22 HU, p<0.01-0.001). After 3 years, CS again had significantly higher MLD and 15TH (-801±29 and -896±23 HU) than ES (-808±27 and -906±20 HU, p<0.01-0.001) but also RQ (-813±20 and -909±15 HU, p<0.05-0.001). Quantitative CT parameters did not change significantly after 4 years. Importantly, smoking status independently predicted MLD at baseline and year 3 (p<0.001) in multivariate analysis.

CONCLUSION:

On quantitative CT, lung density is higher in active smokers than ex-smokers, and sustainably decreases after smoking cessation, reflecting smoking-induced inflammation. Interpretations of quantitative CT data within clinical trials should consider smoking status.

KEY POINTS:

• Lung density is higher in active smokers than ex-smokers. • Lung density sustainably decreases after smoking cessation. • Impact of smoking cessation on lung density is independent of potentially confounding factors. • Smoke-induced pulmonary inflammation and particle deposition influence lung density on CT.

KEYWORDS:

Biomarker; Chronic-obstructive pulmonary disease; Emphysema; Quantitative computed tomography; Smoking cessation

PMID:
28884215
DOI:
10.1007/s00330-017-5030-6
[Indexed for MEDLINE]

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