Early Detection Invisible Lung Damage – Study Highlights the Potential of Oscillometry

Using Impulse Oscillometry, early damage to the small airways can be detected—even before lung function shows a noticeable decline. This is the result of a study conducted by scientists from the German Center for Lung Research (DZL), designed as a companion study to the HANSE Study, which has now been published.

The HANSE Study* aimed to investigate the extent to which a population screening using low-dose CT could help detect lung cancer and reduce mortality from the disease. To this end, researchers at the DZL sites ARCN and BREATH examined 5,000 people at increased risk of lung cancer: current or former smokers between the ages of 55 and 79. Results are not yet available.

However, the results of a parallel companion study have now been published in the journal American Journal of Respiratory and Critical Care Medicine. The aim of this research was to determine the extent to which early damage to the small airways can be detected using so-called impulse oscillometry. For this method, participants only need to breathe into a device that measures the small airways using sound waves. The technique is increasingly being investigated in studies because—unlike conventional methods such as spirometry and body plethysmography—it does not require active cooperation from the participant. As a result, measurements are more reliable and less prone to error.

Small airways damaged even in some people with normal lung function

The study showed that damage to the small airways could be diagnosed in 39% of smokers using oscillometry. Among individuals whose impaired lung function was also detectable using spirometry, the proportion of those showing abnormalities in the small airways via oscillometry was 60%. Interestingly, even among 26% of those with initially normal lung function—as measured using spirometric pulmonary function testing—damage to the small airways was detectable using oscillometry. This corresponded to 16% of the entire study population. These individuals also had a higher risk of metabolic or cardiovascular diseases and reported a lower quality of life.

Dr. Mustafa Abdo from the Lung Clinic Grosshansdorf (DZL site ARCN) led this companion study. He is now working at the Thoraxklinik Heidelberg (DZL site TLRC). He is convinced that oscillometry is a suitable tool for the early diagnosis of damaged small airways: “This allows us to intervene preventively in a targeted way—before lung damage develops into classic COPD, with the risk of metabolic or cardiovascular comorbidities.”

In addition, the use of oscillometry in this study demonstrated that it can be applied easily and within a short time to a large number of participants: “This shows its potential for early detection as part of preventive health screenings,” said Abdo.

The HANSE Study is a collaborative project of the Lung Clinic Grosshansdorf, the University Hospital Schleswig-Holstein (Campus Lübeck), and Hannover Medical School at the DZL sites ARCN and BREATH. In addition, colleagues from the Thoraxklinik Heidelberg (DZL site TLRC) were involved in the analysis of the impulse oscillometry data. The study was funded by the DZL and AstraZeneca.

*HANSE: Holistic implementation study Assessing a Northern German interdisciplinary lung cancer Screening Effort

Source: ARCN

Original publication: Abdo M, Watz H, Trinkmann F, Bohnet S, Guess MAM, Roeben J, May K, Reck M, Bollmann B-A, Stiebeler S, Dettmer S, Waschki B, Rabe KF, Franzen KF, Vogel-Claussen J (2025) Oscillometry-defined Small Airway Dysfunction in Tobacco-exposed Adults with Impaired or Preserved Airflow. American Journal of Respiratory and Critical Care Medicine (ARCN, BREATH, TLRC)