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The presence, subtypes, and severity of emphysema (at least trace) were visually assessed by one radiologist. The presence, size, and classification of non-calcified lung nodules (\u2265 30 mm<jats:sup>3<\/jats:sup>) and Lung-RADS category were independently assessed by another two radiologists. Multivariable logistic regression and stratified analyses were performed to estimate the association between emphysema and lung nodules, Lung-RADS category, after adjusting for age, sex, BMI, smoking status, pack-years, and passive smoking.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Emphysema and lung nodules were observed in 674 (58.0%) and 424 (36.5%) participants, respectively. Participants with emphysema had a 71% increased risk of having lung nodules (adjusted odds ratios, aOR: 1.71, 95% CI: 1.26\u20132.31) and 70% increased risk of positive Lung-RADS category (aOR: 1.70, 95% CI: 1.09\u20132.66) than those without emphysema. Participants with paraseptal emphysema (<jats:italic>n<\/jats:italic> = 47, 4.0%) were at a higher risk for lung nodules than those with centrilobular emphysema (CLE) (aOR: 2.43, 95% CI: 1.32\u20134.50 and aOR: 1.60, 95% CI: 1.23\u20132.09, respectively). Only CLE was associated with positive Lung-RADS category (<jats:italic>p <\/jats:italic>= 0.02). CLE severity was related to a higher risk of lung nodules (ranges aOR: 1.44\u20132.61, overall <jats:italic>p<\/jats:italic> &lt; 0.01).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In a Chinese general population, visual emphysema based on LDCT is independently related to the presence of lung nodules (\u2265 30 mm<jats:sup>3<\/jats:sup>) and specifically CLE subtype is related to positive Lung-RADS category. The risk of lung nodules increases with CLE severity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Participants with emphysema had an increased risk of having lung nodules, especially smokers.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Participants with PSE were at a higher risk for lung nodules than those with CLE, but nodules in participants with CLE had a higher risk of positive Lung-RADS category.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 The risk of lung nodules increases with CLE severity.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-022-08884-3","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T14:02:42Z","timestamp":1654783362000},"page":"8162-8170","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association between visual emphysema and lung nodules on low-dose CT scan in a Chinese Lung Cancer Screening Program (Nelcin-B3)"],"prefix":"10.1007","volume":"32","author":[{"given":"Xiaofei","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique D.","family":"Dorrius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhen","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhui","family":"Nie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozemarijn","family":"Vliegenthart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry J. 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