Normal lung attenuation distribution and lung volume on computed tomography in a Chinese population

• Published in: International journal of chronic obstructive pulmonary disease Vol. 14; pp. 1657 - 1668
• Main Authors: Cheng, Ting, Li, Yong, Pang, Shuai, Wan, HuanYing, Shi, GuoChao, Cheng, QiJian, Li, QingYun, Pan, ZiLai, Huang, ShaoGuang
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.07.2019; Dove Medical Press Ltd; Dove; Dove Medical Press
• Subjects: CAT scans; China - epidemiology; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; densitometry; Diagnostic imaging; Emphysema; Female; Health screening; Humans; Lung - diagnostic imaging; Lung - physiopathology; lung attenuation; Lung diseases; Lung Volume Measurements - methods; lung volumes; Lungs; Male; Medical imaging; Medical screening; Middle Aged; normal range; Original Research; Population; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Emphysema - diagnostic imaging; Pulmonary Emphysema - physiopathology; quantitative computed tomography; reference equations; Respiratory Function Tests - methods; Respiratory Function Tests - statistics & numerical data; Respiratory tract diseases; Retrospective Studies; Severity of Illness Index; Thoracic surgery; Tomography; Tomography, X-Ray Computed - methods; China; United States > US; densitometry; normal range; quantitative computed tomography; reference equations; lung volumes; emphysema; lung attenuation
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S187596

Although lung attenuation distribution and lung volume on computed tomography (CT) have been widely used in evaluating COPD and interstitial lung disease, there are only a few studies regarding the normal range of these indices, especially in Chinese subjects. We aimed to describe the normal range of lung attenuation distribution and lung volume based on CT. Subjects with normal lung function and basically normal chest CT findings (derivation group) at Ruijin Hospital, Shanghai (from January 2010 to June 2014) were included according to inclusion and exclusion criteria. The range of the percentage of lung volume occupied by low attenuation areas (LAA%), percentile of the histogram of attenuation values (Perc n), and total lung volume were analyzed. Relationships of these measures with demographic variables were evaluated. Participants who underwent chest CT examination for disease screening and had basically normal CT findings served as an external validation group. The number of subjects in the derivation group and external validation groups were 564 and 1,787, respectively. Mean total lung volumes were 4,468±1,271 mL and 4,668±1,192 mL, and median LAA%(-950 HU) was 0.19 (0.03-0.43) and 0.17 (0.01-0.41), in the derivation and external validation groups, respectively. Reference equations for lung volume and attenuation distribution (LAA% using -1,000-210 HU, Perc 1 to Perc 98) were generated: Lung volume (mL) = -1.015 *10^4+605.3*Sex (1= male, 0= female)+92.61*Height (cm) -12.99*Weight (kg) ±1766; LAA% (-950 HU)=[0.2027+0.05926*Sex (1= male, 0= female) -4.111*10^-3*Weight (kg) +4.924*10^-3*Height (cm) +8.504*10^-4*Age]^7.341-0.05; Upper limit of normal range: [0.2027+0.05926*Sex-4.111*10^-3*Weight+4.924*10^-3*Height+8.504*10^-4*Age+0.1993]^7.341-0.05. This large population-based retrospective study demonstrated the normal range of LAA%, Perc n, and total lung volume measured on CT scans among subjects with normal lung function and CT findings. Reference equations are provided.