Quantitative interstitial lung disease scores in idiopathic inflammatory myopathies: longitudinal changes and clinical implications
- Authors
- Yeo, Jina; Yoon, Soon Ho; Kim, Ju Yeon; Lee, Jeong Seok; Lee, Eun Young; Goo, Jin Mo; Pourzand, Lila; Goldin, Jonathan G.; Kim, Grace-Hyun J.; Ha, You-Jung
- Issue Date
- Nov-2023
- Publisher
- OXFORD UNIV PRESS
- Keywords
- idiopathic inflammatory myopathy; interstitial lung disease; lung transplant-free survival; quantitative score
- Citation
- RHEUMATOLOGY, v.62, no.11, pp 3690 - 3699
- Pages
- 10
- Journal Title
- RHEUMATOLOGY
- Volume
- 62
- Number
- 11
- Start Page
- 3690
- End Page
- 3699
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/90598
- DOI
- 10.1093/rheumatology/kead122
- ISSN
- 1462-0324
1462-0332
- Abstract
- Objectives To investigate computer-aided quantitative scores from high-resolution CT (HRCT) images and determine their longitudinal changes and clinical significance in patients with idiopathic inflammatory myopathies (IIMs)-related interstitial lung disease (IIMs-ILD). Methods The clinical data and HRCT images of 80 patients with IIMs who underwent serial HRCT scans at least twice were retrospectively analysed. Quantitative ILD (QILD) scores (%) were calculated as the sum of the extent of lung fibrosis, ground-glass opacity, and honeycombing. The individual time-estimated Delta QILD between two consecutive scans was derived using a linear approximation of yearly changes. Results The baseline median QILD (interquartile range) scores in the whole lung were 28.1% (19.1-43.8). The QILD was significantly correlated with forced vital capacity (r = -0.349, P = 0.002) and diffusing capacity for carbon monoxide (r = -0.381, P = 0.001). For Delta QILD between the first two scans, according to the visual ILD subtype, QILD aggravation was more frequent in patients with usual interstitial pneumonia (UIP) than non-UIP (80.0% vs 44.4%, P = 0.013). Multivariable logistic regression analyses identified UIP was significantly related to radiographic ILD progression (Delta QILD >2%, P = 0.015). Patients with higher baseline QILD scores (>28.1%) had a higher risk of lung transplantation or death (P = 0.015). In the analysis of three serial HRCT scans (n = 41), dynamic Delta QILD with four distinct patterns (improving, worsening, convex and concave) was observed. Conclusion QILD changes in IIMs-ILD were dynamic, and baseline UIP patterns seemed to be related to a longitudinal progression in QILD. These may be potential imaging biomarkers for lung function, changes in ILD severity and prognosis in IIMs-ILD.
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