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Rapid fall in lung density following smoking cessation in COPD
Saher B Shaker1, Trine Stavngaard, Lars Christian Laursen
1Gentofte University Hospital, Dept. of Respiratory Medicine, Hellerup, Denmark. saher@dadlnet.dk
COPD
|February 9, 2011
Summary
Smoking cessation in COPD patients paradoxically lowers lung density on CT scans, suggesting inflammation masks emphysema. This effect is likely due to smoking cessation
Area of Science:
- Pulmonary Medicine
- Radiology
- Respiratory Research
Background:
- Debate exists on whether smoking-induced lung inflammation resolves after smoking cessation.
- Computed tomography (CT) is utilized to assess lung changes in patients with chronic obstructive pulmonary disease (COPD).
Purpose of the Study:
- To evaluate the impact of smoking cessation on lung density in COPD patients using CT.
- To determine if inflammation influences CT-based emphysema assessment.
Main Methods:
- 36 COPD patients who quit smoking were analyzed from a larger randomized trial.
- Lung density was measured using 15th percentile density (PD15) and relative emphysema area (RA-910) via CT.
- Linear regression analyzed CT-lung density trends before and after smoking cessation.
Main Results:
- Smoking cessation led to a significant increase in RA-910 (2.6%) and a decrease in PD15 (-4.9 HU).
- These changes, indicating increased emphysema, were more pronounced in the budesonide group but not statistically significant.
- Lung function tests (FEV1, diffusion capacity) showed no significant changes post-cessation.
Conclusions:
- Smoking cessation causes a paradoxical decrease in lung density on CT scans.
- This density reduction, resembling emphysema progression, is attributed to the anti-inflammatory effects of quitting smoking.
- Inflammation may mask the true extent of emphysema on CT imaging in smokers.
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