{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:56:38Z","timestamp":1790524598706,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,9]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Routine chest CT contains clinically relevant multidomain information beyond the immediate examination indication, but translation into routine care requires more than identifying individual biomarkers. This protocol describes a prospective observational cohort designed to evaluate whether technical assessability, standardised multidomain research phenotyping, routine radiology reporting and documented care can be linked reproducibly within routine clinical chest CT at a tertiary hospital in western China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a single-centre, prospective, consecutive-enrolment observational imaging cohort embedded in routine outpatient and inpatient chest CT practice rather than a dedicated screening programme. The study is organised around a scan-to-phenotype-to-report-to-care framework while retaining a phase 1 feasibility- and implementation-focused primary objective. The initial cohort target is approximately 3000 prospectively consented adults. At the time of this revision, formal recruitment has not commenced and no participant-level study data have been collected or analysed; recruitment will begin after funding and operational preparations are completed and any required ethics notification or amendment has been addressed. The core clinical-reporting layer includes pulmonary nodules, emphysema, interstitial lung abnormalities, coronary artery calcification and pulmonary artery\/ascending aorta metrics. The extended measurement layer includes vertebral attenuation, vertebral deformity, thoracic muscle metrics and liver attenuation-based variables when technically assessable. Research phenotyping will be completed independently before routine-report abstraction. Primary phase 1 analyses will assess screening and enrolment flow, baseline data completeness, core phenotype assessability, report-quality abstraction completion and availability of within-system 6-month follow-up data. Secondary analyses will describe phenotype frequencies and distributions, cross-domain co-occurrence, report-quality indicators and early care-pathway documentation using prespecified operational definitions and variable-specific denominators. Descriptive estimates will be reported with 95% confidence intervals where appropriate. Follow-up will occur at 6 months, 12 months and annually thereafter using routine hospital systems. No additional research imaging is planned, and repeat chest CT is not mandated by the protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study was approved by the Medical Ethics Committee of Dazhou Central Hospital, Dazhou, China (approval no. 2026\u5ba1(084)\u53f7; approved 27 April 2026), and written informed consent will be obtained before cohort enrolment and research data abstraction. Potentially actionable research-identified findings will undergo senior radiologist confirmation and, when confirmed and not already adequately addressed in routine care, will be communicated through the institutional clinical pathway. Planned outputs include a cohort profile or baseline resource paper and subsequent phenotype-specific analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Not applicable. This is an observational cohort protocol rather than a clinical trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121793","type":"journal-article","created":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:27:45Z","timestamp":1790522865000},"page":"e121793","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective chest CT cohort with opportunistic multidimensional phenotype capture in routine care at a tertiary hospital in western China: Protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4358-3635","authenticated-orcid":false,"given":"Heng","family":"Zhang","sequence":"first","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caipan","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dazhou Central Hospital, Dazhou, Sichuan, China"},{"name":"School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunfeng","family":"Xiang","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shucai","family":"Wu","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xifeng","family":"Liang","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huazhang","family":"Song","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhan","family":"Xiang","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Liang","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Peng","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaogang","family":"Ren","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Song","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanhua","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Xuanhan County People\u2019s Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchun","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Xuanhan County People\u2019s Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Wu","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chungang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Medical Imaging Center, Dazhou Central Hospital, Dazhou, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"2026092309102672000_16.9.e121793.1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.211561"},{"key":"2026092309102672000_16.9.e121793.2","doi-asserted-by":"crossref","DOI":"10.2214\/AJR.25.33069","article-title":"Opportunistic Screening on Chest CT, From the AJR Special Series on Screening","volume":"226","author":"Thuere","year":"2026","journal-title":"AJR Am J Roentgenol"},{"key":"2026092309102672000_16.9.e121793.3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201506-1208PP"},{"key":"2026092309102672000_16.9.e121793.4","doi-asserted-by":"crossref","DOI":"10.1038\/s41467-020-15948-9","article-title":"The UK Biobank imaging enhancement of 100,000 participants:\u2009rationale, data collection, management and future directions","volume":"11","author":"Littlejohns","year":"2020","journal-title":"Nat Commun"},{"key":"2026092309102672000_16.9.e121793.5","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.222044","article-title":"Opportunistic Screening: Radiology Scientific Expert Panel","volume":"307","author":"Pickhardt","year":"2023","journal-title":"Radiology"},{"key":"2026092309102672000_16.9.e121793.6","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.252106","article-title":"CT-based Opportunistic Screening for Adding Clinical Value: How I Do It","volume":"319","author":"Pickhardt","year":"2026","journal-title":"Radiology"},{"key":"2026092309102672000_16.9.e121793.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0040297","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration","volume":"4","author":"Vandenbroucke","year":"2007","journal-title":"PLoS Med"},{"key":"2026092309102672000_16.9.e121793.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001885","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med"},{"key":"2026092309102672000_16.9.e121793.9","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.232558","article-title":"Fleischner Society: Glossary of Terms for Thoracic Imaging","volume":"310","author":"Bankier","year":"2024","journal-title":"Radiology"},{"key":"2026092309102672000_16.9.e121793.10","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017161659"},{"key":"2026092309102672000_16.9.e121793.11","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015141579"},{"key":"2026092309102672000_16.9.e121793.12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202505-1054ST"},{"key":"2026092309102672000_16.9.e121793.13","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20200894","article-title":"Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI\/BSCCT and BSTI","volume":"94","author":"Williams","year":"2021","journal-title":"Br J Radiol"},{"key":"2026092309102672000_16.9.e121793.14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.111.968610"},{"key":"2026092309102672000_16.9.e121793.15","doi-asserted-by":"crossref","first-page":"4792","DOI":"10.21037\/qims-24-59","article-title":"Opportunistic use of chest low-dose computed tomography (LDCT) imaging for low bone mineral density and osteoporosis screening: cutoff thresholds for the attenuation values of the lower thoracic and upper lumbar vertebrae","volume":"14","author":"Pan","year":"2024","journal-title":"Quant Imaging Med Surg"},{"key":"2026092309102672000_16.9.e121793.16","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2214\/AJR.16.16744","article-title":"Variation in Attenuation in L1 Trabecular Bone at Different Tube Voltages: Caution Is Warranted When Screening for Osteoporosis With the Use of Opportunistic CT","volume":"208","author":"Garner","year":"2017","journal-title":"AJR Am J Roentgenol"},{"key":"2026092309102672000_16.9.e121793.17","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650080915"},{"key":"2026092309102672000_16.9.e121793.18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0071204","article-title":"Intra and interobserver reliability and agreement of semiquantitative vertebral fracture assessment on chest computed tomography","volume":"8","author":"Buckens","year":"2013","journal-title":"PLoS One"},{"key":"2026092309102672000_16.9.e121793.19","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201307-229OC"},{"key":"2026092309102672000_16.9.e121793.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12931-018-0771-6","article-title":"Pectoralis muscle area and mortality in smokers without airflow obstruction","volume":"19","author":"Diaz","year":"2018","journal-title":"Respir Res"},{"key":"2026092309102672000_16.9.e121793.21","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204288"},{"key":"2026092309102672000_16.9.e121793.22","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019190467"},{"key":"2026092309102672000_16.9.e121793.23","first-page":"842","article-title":"Accuracy of portal venous phase CT for quantitative opportunistic screening of moderate hepatic steatosis","volume":"221","author":"Pickhardt","year":"2023","journal-title":"AJR Am J Roentgenol"},{"key":"2026092309102672000_16.9.e121793.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2017.08.005"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-121793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:27:53Z","timestamp":1790522873000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-121793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,23]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bmjopen-2026-121793"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-121793","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}