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To assess the feasibility of attenuation and size measurement of the thyroid gland as an imaging biomarker for hypothyroidism in patients undergoing lung cancer screening (LCS) with low dose CT. With institutional review board (IR approval, we retrospectively reviewed all patients with LCS CT between September 1, 2016 and March 31, 2020, who had at least 1 thyroid-stimulating hormone (TSH) test within 90 days of the patient's most recent screening CT. Hypothyroid patients were identified through billing diagnosis and/or elevated TSH or those on tr