David A Kaminsky1, Nirav Daphtary2, Raul S J Estepar3, Taka Ashikaga4, Lukas Mikulic2, Jeffrey Klein5, C Matthew Kinsey2. 1. Vermont Lung Center, University of Vermont Larner College of Medicine, 89 Beaumont Avenue, Burlington, VT. Electronic address: david.kaminsky@uvm.edu. 2. Vermont Lung Center, University of Vermont Larner College of Medicine, 89 Beaumont Avenue, Burlington, VT. 3. Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, Massachusetts. 4. Medical Biostatistics, University of Vermont, Burlington, Vermont. 5. Department of Radiology, McClure 1, University of Vermont Medical Center, Burlington, Vermont.
Abstract
RATIONALE AND OBJECTIVES: We have developed a technique to measure ventilation heterogeneity (VH) on low dose chest CT scan that we hypothesize may be associated with the development of lung nodules, and perhaps cancer. If true, such an analysis may improve screening by identifying regional areas of higher risk. MATERIALS AND METHODS: Using the National Lung Screening Trial database, we identified a small subset of those participants who were labeled as having a positive screening test at 1 year (T1) but not at baseline (T0). We isolated the region in which the nodule would form on the T0 scan ("target region") and measured VH as the standard deviation of the linear dimension of a virtual cubic airspace based on measurement of lung attenuation within the region. RESULTS: We analyzed 24 cases, 9 with lung cancer and 15 with a benign nodule. We found that the VH of the target region was nearly statistically greater than that of the corresponding contralateral control region (0.168 [0.110-0.226] vs. 0.112 [0.083-0.203], p = 0.051). The % emphysema within the target region was greater than that of the corresponding contralateral control region (1.339 [0.264-4.367] vs. 1.092 [0.375-4.748], p = 0.037). There was a significant correlation between the % emphysema and the VH of the target region (rho = +0.437, p = 0.026). CONCLUSION: Our study provides the first data in support of increased local VH being associated with subsequent lung nodule formation. Further work is necessary to determine whether this technique can enhance screening for lung cancer by low dose chest CT scan.
RATIONALE AND OBJECTIVES: We have developed a technique to measure ventilation heterogeneity (VH) on low dose chest CT scan that we hypothesize may be associated with the development of lung nodules, and perhaps cancer. If true, such an analysis may improve screening by identifying regional areas of higher risk. MATERIALS AND METHODS: Using the National Lung Screening Trial database, we identified a small subset of those participants who were labeled as having a positive screening test at 1 year (T1) but not at baseline (T0). We isolated the region in which the nodule would form on the T0 scan ("target region") and measured VH as the standard deviation of the linear dimension of a virtual cubic airspace based on measurement of lung attenuation within the region. RESULTS: We analyzed 24 cases, 9 with lung cancer and 15 with a benign nodule. We found that the VH of the target region was nearly statistically greater than that of the corresponding contralateral control region (0.168 [0.110-0.226] vs. 0.112 [0.083-0.203], p = 0.051). The % emphysema within the target region was greater than that of the corresponding contralateral control region (1.339 [0.264-4.367] vs. 1.092 [0.375-4.748], p = 0.037). There was a significant correlation between the % emphysema and the VH of the target region (rho = +0.437, p = 0.026). CONCLUSION: Our study provides the first data in support of increased local VH being associated with subsequent lung nodule formation. Further work is necessary to determine whether this technique can enhance screening for lung cancer by low dose chest CT scan.
Authors: Annette McWilliams; Martin C Tammemagi; John R Mayo; Heidi Roberts; Geoffrey Liu; Kam Soghrati; Kazuhiro Yasufuku; Simon Martel; Francis Laberge; Michel Gingras; Sukhinder Atkar-Khattra; Christine D Berg; Ken Evans; Richard Finley; John Yee; John English; Paola Nasute; John Goffin; Serge Puksa; Lori Stewart; Scott Tsai; Michael R Johnston; Daria Manos; Garth Nicholas; Glenwood D Goss; Jean M Seely; Kayvan Amjadi; Alain Tremblay; Paul Burrowes; Paul MacEachern; Rick Bhatia; Ming-Sound Tsao; Stephen Lam Journal: N Engl J Med Date: 2013-09-05 Impact factor: 91.245
Authors: Denise R Aberle; Amanda M Adams; Christine D Berg; William C Black; Jonathan D Clapp; Richard M Fagerstrom; Ilana F Gareen; Constantine Gatsonis; Pamela M Marcus; JoRean D Sicks Journal: N Engl J Med Date: 2011-06-29 Impact factor: 91.245
Authors: David O Wilson; Joel L Weissfeld; Arzu Balkan; Jeffrey G Schragin; Carl R Fuhrman; Stephen N Fisher; Jonathan Wilson; Joseph K Leader; Jill M Siegfried; Steven D Shapiro; Frank C Sciurba Journal: Am J Respir Crit Care Med Date: 2008-06-19 Impact factor: 21.405
Authors: Martin C Tammemägi; Hormuzd A Katki; William G Hocking; Timothy R Church; Neil Caporaso; Paul A Kvale; Anil K Chaturvedi; Gerard A Silvestri; Tom L Riley; John Commins; Christine D Berg Journal: N Engl J Med Date: 2013-02-21 Impact factor: 91.245
Authors: C Matthew Kinsey; Raul San Jose Estepar; Yang Zhao; Xiaojin Yu; Nancy Diao; Rebecca Suk Heist; John C Wain; Eugene J Mark; George Washko; David C Christiani Journal: Lung Cancer Date: 2014-02-11 Impact factor: 5.705
Authors: Stephen S F Yip; Chintan Parmar; Daniel Blezek; Raul San Jose Estepar; Steve Pieper; John Kim; Hugo J W L Aerts Journal: PLoS One Date: 2017-06-08 Impact factor: 3.240