Quantitative CT predicts outcomes in patients with idiopathic pulmonary fibrosis: Study

Australia: The degree of fibrotic abnormalities on baseline computed tomography (CT) is linked with outcomes independent of pulmonary function in a multi-center observational registry of patients with idiopathic pulmonary fibrosis (IPF). The study was published in the journal Respirology. 

Predicting disease progression in patients with progressive pulmonary fibrosis remains difficult. As a result, Stephen M. Humphries and colleagues conducted this study to evaluate the prognostic value of lung fibrosis extent measured at computed tomography using data-driven texture analysis in a significant number of well-characterized patients with idiopathic pulmonary fibrosis registered in a national registry.

Individuals in the Australian IPF Registry having accessible CT between 2007 and 2016 were included in this retrospective analysis. To determine the extent of lung fibrosis, CT scans were examined using the DTA method. Descriptive statistics were used to compare demographics, longitudinal pulmonary function, and quantitative CT measures. To investigate the correlations between baseline DTA, pulmonary function measurements, and outcomes, linear mixed models and Cox analyses were used, which were adjusted for age, BMI, gender, smoking history, and anti-fibrotic medication.

The key findings of this study were as follows:

1. A total of 393 participants received CT scans, and 221 of them had pulmonary function tests that had been completed within 90 days after the CT scan.

2. The baseline DTA score was strongly correlated with the annual rate of decline in forced vital capacity and carbon monoxide diffusing capacity, according to linear mixed-effect modeling.

3. Greater lung fibrosis was linked, in multivariable Cox proportional hazard models, to worse transplant-free survival.

In conclusion, these results in the Australian Idiopathic Pulmonary Fibrosis Registry (AIPFR) demonstrate significant relationships between outcomes, independent of pulmonary function, and the objectively assessed morphologic degree of pulmonary fibrosis on CT using a deep learning method. The findings from this IPF cohort encourage additional research to assess the use of DTA in other types of progressive pulmonary fibrosis.

Reference: 

Humphries, S. M., Mackintosh, J. A., Jo, H. E., Walsh, S. L. F., Silva, M., Calandriello, L., Chapman, S., Ellis, S., Glaspole, I., Goh, N., Grainge, C., Hopkins, P. M. A., Keir, G. J., Wells, A. U., Lynch, D. A., & Corte, T. J. (2022). Quantitative computed tomography predicts outcomes in idiopathic pulmonary fibrosis. In Respirology. Wiley. https://doi.org/10.1111/resp.14333