{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:47:32Z","timestamp":1792684052828,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare low-attenuation analysis (LAA) with visual scoring and explore their application in the detection of emphysema in low-dose CT (LDCT) scans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A random cohort of 352 CT examinations from health-check participants was selected from a lung cancer screening(LCS) dataset. Scans were evaluated for emphysema by four readers according to latest Fleischner criteria, and emphysema was quantified by LAA with thresholds from -900 HU to -980 HU. Fleiss\u2019 Kappa assessed inter-reader agreement on visual detection and severity classification. Cases with full agreement on emphysema presence were used to compare LAA quantification and visual detection. Spearman correlation test measured their correlation and Cohen\u2019s Kappa evaluated the agreement between LAA%-measured emphysema and visual detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Agreement among four observers was found in 266 cases on emphysema presence based on visual evaluation (K\u2009=\u20090.738, 0.737\u20130.739). Concordance between emphysema presence using a LAA% cutoff of 6% and binary visual classification was 61.3% (163\/266, Cohen\u2019s Kappa:0.173. Spearman analysis showed a correlation between LAA% and visual scores (P\u2009&amp;lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LAA emphysema quantification shows in comparison with visual scoring limited performance for discrimination of normal and emphysematous lung parenchyma in a Low dose CT Lung cancer screening dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>Full agreement among four readers regarding visual emphysema classification was achieved in only three-quarters of cases. Limited concordance was found between LAA%-measured emphysema and visual detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag236","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:36:23Z","timestamp":1792683383000},"source":"Crossref","is-referenced-by-count":0,"title":["CT low attenuation area quantification versus visual scoring for early pulmonary emphysema detection in lung cancer screening"],"prefix":"10.1093","author":[{"given":"Hailan","family":"Liu","sequence":"first","affiliation":[{"name":"Erasmus Medical Center Rotterdam Department of Public Health, , Rotterdam, 3015 GD, the","place":["Netherlands"]},{"name":"Research Institute for DiagNostic Accuracy , Groningen, 9713\u2009GH, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiwei","family":"Han","sequence":"additional","affiliation":[{"name":"Research Institute for DiagNostic Accuracy , Groningen, 9713\u2009GH, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein A","family":"Heuvelmans","sequence":"additional","affiliation":[{"name":"Research Institute for DiagNostic Accuracy , Groningen, 9713\u2009GH, the","place":["Netherlands"]},{"name":"Amsterdam University Medical Center Department of Respiratory Medicine, , Amsterdam, 1105 AZ, the","place":["Netherlands"]},{"name":"University of Groningen, University Medical Center Groningen Department of Epidemiology, , Groningen, 9713 GZ, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Silva","sequence":"additional","affiliation":[{"name":"University of Parma Department of Medicine and Surgery (DiMeC), , Parma, 43121 Parma PR,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Willem C","family":"Gratama","sequence":"additional","affiliation":[{"name":"Gelre Hospitals Apeldoorn Department of radiology and Nuclear Medicine, , Apeldoorn, 7334\u2009DZ, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Mao","sequence":"additional","affiliation":[{"name":"Research Institute for DiagNostic Accuracy , Groningen, 9713\u2009GH, the","place":["Netherlands"]},{"name":"University of Groningen, University Medical Center Groningen Department of Epidemiology, , Groningen, 9713 GZ, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlijn","family":"van der Aalst","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center Rotterdam Department of Public Health, , Rotterdam, 3015 GD, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeyoun","family":"Yi","sequence":"additional","affiliation":[{"name":"Coreline Soft , Seoul, 04001, Republic of","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxiang","family":"Ye","sequence":"additional","affiliation":[{"name":"Tianjin Medical University Cancer Institute and Hospital The Department of Radiology, , Tianjin, 300060, People's Republic of","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry J","family":"de Koning","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center Rotterdam Department of Public Health, , Rotterdam, 3015 GD, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Oudkerk","sequence":"additional","affiliation":[{"name":"Research Institute for DiagNostic Accuracy , Groningen, 9713\u2009GH, the","place":["Netherlands"]},{"name":"University of Groningen , Groningen, 9712 CP, the","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,22]]},"container-title":["British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqag236\/72365203\/tqag236.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqag236\/72365203\/tqag236.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:36:24Z","timestamp":1792683384000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article\/doi\/10.1093\/bjr\/tqag236\/8979446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/bjr\/tqag236","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"article-number":"tqag236"}}