Thoracic CT imaging in obesity

Obesity is a growing global medical concern, and most radiologists frequently encounter computed tomography (CT) studies of obese patients. However, the effects of obesity on lung function are not well documented.

A review published in the KeAi journal Meta-Radiology by UK researchers highlights obesity hypoventilation syndrome and associated CT findings, including dynamic upper airway collapse and tracheal morphology. The review also discusses obesity-related restrictive lung patterns, chronic hypoxia, pulmonary arterial hypertension and the possible link to fibrotic interstitial lung disease. Common imaging findings like mosaic attenuation, air trapping and atelectasis are also examined.

“Imaging in obesity poses technical challenges,” notes corresponding author Susan Copley. “The review explains how bariatric CT scanners can help mitigate issues like noise and artifact production due to poor image optimization. Additionally, advancements in AI body morphometry combined with lung imaging assessment are showing promise in improving prognosis, particularly for lung cancer treatment.

Future developments in machine learning could lead to personalized medicine, reducing unnecessary scans and procedures while identifying high-risk patients.

“This is especially relevant for obese patients, as invasive studies are often more challenging in this population. Understanding common imaging features in obese lungs will help improve diagnosis, treatment and prognosis,” adds Copley.

The team hopes this review provides radiologists and imaging specialists with a meaningful overview of thoracic CT imaging in obesity, as well as insights into future AI advancements.

Contact author: Susan Copley, Charing Cross Hospital, United Kingdom, sue.copley1@nhs.net

Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

See the article: Suwathep P, Sheeka A, Copley S. Thoracic CT imaging in obesity: Technical challenges, imaging findings and future outlook[J].Meta-Radiology 2024: 100100. https://doi.org/10.1016/j.metrad.2024.100085