Quantitative computed tomography predicts outcomes in idiopathic pulmonary fibrosis.

Autor: Humphries SM; Department of Radiology, National Jewish Health, Denver, Colorado, USA., Mackintosh JA; Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia.; NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, New South Wales, Australia., Jo HE; NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, New South Wales, Australia.; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., Walsh SLF; Department of Radiology, King's College Hospital Foundation Trust, London, UK., Silva M; Section of 'Scienze Radiologiche', Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.; Department of Radiology, University of Massachusetts Medical School, UMass Memorial Health Care, Worcester, Massachusetts, USA., Calandriello L; Dipartimento di Diagnostica per immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Chapman S; Respiratory Consultants, Adelaide, South Australia, Australia., Ellis S; Department of Radiology, Alfred Health, Melbourne, Victoria, Australia., Glaspole I; NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, New South Wales, Australia.; Department of Allergy and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia., Goh N; Respiratory and Sleep Medicine, Austin Hospital, Melbourne, Victoria, Australia., Grainge C; Department of Respiratory Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia., Hopkins PMA; Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia., Keir GJ; Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia., Moodley Y; School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia., Reynolds PN; Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia., Walters EH; Department of Medicine, University of Tasmania, Hobart, Tasmania, Australia., Baraghoshi D; Division of Biostatistics, National Jewish Health, Denver, Colorado, USA., Wells AU; Royal Brompton and Harefield NHS Foundation Trust, London, UK.; National Heart and Lung Institute, Imperial College London, London, UK., Lynch DA; Department of Radiology, National Jewish Health, Denver, Colorado, USA., Corte TJ; NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, New South Wales, Australia.; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Jazyk: angličtina
Zdroj: Respirology (Carlton, Vic.) [Respirology] 2022 Dec; Vol. 27 (12), pp. 1045-1053. Date of Electronic Publication: 2022 Jul 25.
DOI: 10.1111/resp.14333
Abstrakt: Background and Objective: Prediction of disease course in patients with progressive pulmonary fibrosis remains challenging. The purpose of this study was to assess the prognostic value of lung fibrosis extent quantified at computed tomography (CT) using data-driven texture analysis (DTA) in a large cohort of well-characterized patients with idiopathic pulmonary fibrosis (IPF) enrolled in a national registry.
Methods: This retrospective analysis included participants in the Australian IPF Registry with available CT between 2007 and 2016. CT scans were analysed using the DTA method to quantify the extent of lung fibrosis. Demographics, longitudinal pulmonary function and quantitative CT metrics were compared using descriptive statistics. Linear mixed models, and Cox analyses adjusted for age, gender, BMI, smoking history and treatment with anti-fibrotics were performed to assess the relationships between baseline DTA, pulmonary function metrics and outcomes.
Results: CT scans of 393 participants were analysed, 221 of which had available pulmonary function testing obtained within 90 days of CT. Linear mixed-effect modelling showed that baseline DTA score was significantly associated with annual rate of decline in forced vital capacity and diffusing capacity of carbon monoxide. In multivariable Cox proportional hazard models, greater extent of lung fibrosis was associated with poorer transplant-free survival (hazard ratio [HR] 1.20, p < 0.0001) and progression-free survival (HR 1.14, p < 0.0001).
Conclusion: In a multi-centre observational registry of patients with IPF, the extent of fibrotic abnormality on baseline CT quantified using DTA is associated with outcomes independent of pulmonary function.
(© 2022 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.)
Databáze: MEDLINE
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