Early imaging biomarkers of lung cancer, COPD and coronary artery disease in the general population: rationale and design of the ImaLife (Imaging in Lifelines) Study

Congying Xia, Mieneke Rook, Gert Jan Pelgrim, Grigory Sidorenkov, Hendrik J Wisselink, Jurjen N van Bolhuis, Peter M A van Ooijen, Jiapan Guo, Matthijs Oudkerk, Harry Groen, Maarten van den Berge, Pim van der Harst, Hildebrand Dijkstra, Marleen Vonder, Marjolein A Heuvelmans, Monique D Dorrius, Peter Paul De Deyn, Geertruida H de Bock, Aafje Dotinga, Rozemarijn Vliegenthart*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Lung cancer, chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD) are expected to cause most deaths by 2050. State-of-the-art computed tomography (CT) allows early detection of lung cancer and simultaneous evaluation of imaging biomarkers for the early stages of COPD, based on pulmonary density and bronchial wall thickness, and of CAD, based on the coronary artery calcium score (CACS), at low radiation dose. To determine cut-off values for positive tests for elevated risk and presence of disease is one of the major tasks before considering implementation of CT screening in a general population. The ImaLife (Imaging in Lifelines) study, embedded in the Lifelines study, is designed to establish the reference values of the imaging biomarkers for the big three diseases in a well-defined general population aged 45 years and older. In total, 12,000 participants will undergo CACS and chest acquisitions with latest CT technology. The estimated percentage of individuals with lung nodules needing further workup is around 1-2%. Given the around 10% prevalence of COPD and CAD in the general population, the expected number of COPD and CAD is around 1000 each. So far, nearly 4000 participants have been included. The ImaLife study will allow differentiation between normal aging of the pulmonary and cardiovascular system and early stages of the big three diseases based on low-dose CT imaging. This information can be finally integrated into personalized precision health strategies in the general population.

Original languageEnglish
Pages (from-to)75-86
Number of pages12
JournalEuropean Journal of Epidemiology
Issue number1
Early online date23-Apr-2019
Publication statusPublished - Jan-2020


  • Cardiovascular disease
  • Chronic obstructive pulmonary disease
  • General population
  • Imaging biomarkers
  • Low-dose computed tomography
  • Lung cancer
  • CT
  • RISK

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