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Effect of Aging on Lung Structure In Vivo: Assessment With Densitometric and Fractal Analysis of High-resolution Computed Tomography Data

Copley, Susan J. MD, FRCP, FRCR*; Giannarou, Stamatia PhD; Schmid, Volker J. PhD; Hansell, David M. MD, FRCP, FRCR§; Wells, Athol U. MD, FRACP, FRCR; Yang, Guang-Zhong PhD

doi: 10.1097/RTI.0b013e31825148c9
Original Articles

Purpose: To test the hypothesis that there is a difference between the lung computed tomography (CT) microstructure of asymptomatic older individuals and that of young individuals as evaluated by objective indices of complexity and density.

Materials and Methods: Two study groups of nonsmoking urban-dwelling individuals over 75 years and under 55 years were prospectively identified. Thirty-three consecutive volunteers (21 older than 75 y and 12 less than 55 y) were included, and CTs were performed with concurrent pulmonary function testing. Pulmonary regions of interest (ROIs) were evaluated with fractal dimension (FD) analysis (an index of complexity), mean lung density (MLD), and percentage of pixels with lung density (LD) less than thresholds of −910 HU and −950 HU. The Student t test and the Mann-Whitney test were used to evaluate for differences in mean values between groups. The Pearson correlation coefficient was used to correlate mean FD value and LD data with pulmonary function.

Results: Significant correlations of ROI MLD, LD −910 HU, and LD −950 HU with age and sex were shown (P=0.029–0.003). The ROI mean FD value was greater in younger individuals compared with older individuals (76.5±1.7 vs. 70.3±1.2; P=0.004). There was a correlation between Kco (gas-diffusing capacity adjusted for alveolar volume) and mean FD value (P=0.006) and MLD (P=0.015).

Conclusion: The lung parenchyma of nonsmoking older urban-dwelling asymptomatic individuals has significantly different CT density and complexity compared with younger individuals.

Supplemental Digital Content is available in the text.

*Department of Radiology, Hammersmith Hospitals NHS Trust

Institute of Biomedical Engineering, Imperial College, South Kensington Campus

§Department of Radiology

Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK

Department of Statistics, Ludwig-Maximilians-Universität München, Munich, Germany

Supported by a Royal College of Radiologists (UK) Kodak Bursary.

The authors declare no conflicts of interest.

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website,

Reprints: Susan J. Copley, MD, FRCP, FRCR, Department of Radiology, Hammersmith Hospital, Imperial NHS Trust, Du Cane Rd, London W12 0HS, UK (e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.