Dual-energy CT-derived microvascular perfused blood volume and lung function and %emphysema in the MESA Lung study

Prior findings suggest that pathways relevant to emphysema pathogenesis converge on the pulmonary microvasculature. We measured microvascular perfused blood volume (mPBV) in the peripheral 2cm of lung with iodine-enhanced dual-energy CT (DECT) to examine the vascular hypothesis of emphysema in a multicenter, population-based cohort. The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study performed iodine-enhanced DECT at functional residual capacity, non-contrast full-lung CT at total lung capacity, and spirometry on a subset of the MESA cohort in 2017-18. mPBV was calculated by material decomposition on DECT. Percent emphysema (%emph: voxels DECT scans were acquired for 719 participants, 68 of whom were excluded due to scan quality. Of the remaining 651 participants, mean age was 71+8yrs, 55% were male, 40% White, 30% Black, 17% Hispanic, 14% Chinese, and 51% ever smokers; 10% had COPD (FEV1/FVC mPBV was greater in men (p Microvascular perfused blood volume on DECT was associated with body size and was lower among former smokers and with greater percent emphysema, suggesting the presence of microvascular damage from smoking and with emphysema.