Serial CT analysis in idiopathic pulmonary fibrosis: comparison of visual features that determine patient outcome
| Autor: | Coline H.M. van Moorsel, E. P. Judge, Alex J Procter, Joseph Barnett, Frouke T. van Beek, Gary Cross, Athol U. Wells, Marcel Veltkamp, Joseph Jacob, Wouter van Es, Maria Kokosi, Bahareh Gholipour, Nesrin Mogulkoc, Mark Jones, Teresa Burd, Recep Savaş, Andre Altmann, Leon M Aksman, Sujal R. Desai, Christopher J. Brereton, Selen Bayraktaroglu |
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| Přispěvatelé: | Ege Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
LUNG-DISEASE
Male Vital capacity Time Factors bronchiectasis Respiratory System Vital Capacity Severity of Illness Index imaging/CT 030218 nuclear medicine & medical imaging Cohort Studies Idiopathic pulmonary fibrosis 0302 clinical medicine FUNCTION INDEXES Honeycombing Univariate analysis Interstitial lung disease imaging respiratory system Middle Aged idiopathic pulmonary fibrosis 3. Good health Cohort Cardiology Disease Progression Female Life Sciences & Biomedicine CT Pulmonary and Respiratory Medicine medicine.medical_specialty DIAGNOSIS Interstitial Lung Disease 03 medical and health sciences FEV1/FVC ratio Internal medicine medicine Humans Aged Science & Technology Bronchiectasis business.industry 1103 Clinical Sciences medicine.disease respiratory tract diseases 030228 respiratory system sense organs business Tomography X-Ray Computed |
| Zdroj: | Thorax |
| Popis: | Aims Patients with idiopathic pulmonary fibrosis (IPF) receiving antifibrotic medication and patients with non-IPF fibrosing lung disease often demonstrate rates of annualised forced vital capacity (FVC) decline within the range of measurement variation (5.0%-9.9%). We examined whether change in visual CT variables could help confirm whether marginal FVC declines represented genuine clinical deterioration rather than measurement noise. Methods in two IPF cohorts (cohort 1: n=103, cohort 2: n=108), separate pairs of radiologists scored paired volumetric CTs (acquired between 6 and 24 months from baseline). Change in interstitial lung disease, honeycombing, reticulation, ground-glass opacity extents and traction bronchiectasis severity was evaluated using a 5-point scale, with mortality prediction analysed using univariable and multivariable Cox regression analyses. Both IPF populations were then combined to determine whether change in CT variables could predict mortality in patients with marginal FVC declines. Results on univariate analysis, change in all CT variables except ground-glass opacity predicted mortality in both cohorts. on multivariate analysis adjusted for patient age, gender, antifibrotic use and baseline disease severity (diffusing capacity for carbon monoxide), change in traction bronchiectasis severity predicted mortality independent of FVC decline. Change in traction bronchiectasis severity demonstrated good interobserver agreement among both scorer pairs. Across all study patients with marginal FVC declines, change in traction bronchiectasis severity independently predicted mortality and identified more patients with deterioration than change in honeycombing extent. Conclusions Change in traction bronchiectasis severity is a measure of disease progression that could be used to help resolve the clinical importance of marginal FVC declines. Wellcome Trust Clinical Research Career Development FellowshipWellcome Trust [209553/Z/17/Z]; MRC eMedLab Medical Bioinformatics Career Development Fellowship; Medical Research CouncilMedical Research Council UK (MRC) [MR/L016311/1]; European Union's Horizon 2020 research and innovation program [666992]; National Institute for Health Research Biomedical Research Centre at the University of Southampton JJ was supported by a Wellcome Trust Clinical Research Career Development Fellowship (209553/Z/17/Z). AA holds an MRC eMedLab Medical Bioinformatics Career Development Fellowship. This work was supported by the Medical Research Council (grant number MR/L016311/1). This project has received funding from the European Union's Horizon 2020 research and innovation program (grant agreement number 666992). CJB and MGJ were supported by the National Institute for Health Research Biomedical Research Centre at the University of Southampton. |
| Databáze: | OpenAIRE |
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