Longitudinal Changes in Quantitative Interstitial Lung Disease on Computed Tomography after Immunosuppression in the...

Area of Science:

• Pulmonology
• Radiology
• Rheumatology

Background:

• Scleroderma-related interstitial lung disease (SSc-ILD) significantly impacts patient health.
• Previous studies showed SSc-ILD treatments improve lung function and dyspnea.
• The Scleroderma Lung Study II (SLS II) provided a basis for further investigation into imaging outcomes.

Purpose of the Study:

• To assess changes in SSc-ILD extent using high-resolution computed tomography (HRCT) quantitative analysis after 2 years.
• To correlate HRCT findings with physiologic and clinical measures over the same interval.
• To evaluate the impact of cyclophosphamide and mycophenolate mofetil on SSc-ILD structural changes.

Main Methods:

• Ninety-seven patients from SLS II underwent HRCT at baseline and 24 months.
• Quantitative computer-aided diagnosis scores (e.g., QILD) were derived from volumetric HRCT scans.
• Paired t tests analyzed changes in whole lung and worst lobe QILD scores in pooled treatment groups.

Main Results:

• Quantitative interstitial lung disease (QILD) in the whole lung significantly decreased by 2.51% (P=.001) in pooled groups.
• No significant difference in QILD improvement was observed between cyclophosphamide and mycophenolate groups.
• Changes in QILD scores correlated with improvements in forced vital capacity, diffusing capacity, and breathlessness.

Conclusions:

• Treatments with cyclophosphamide or mycophenolate mofetil significantly reduced HRCT-assessed SSc-ILD extent.
• Computer-aided HRCT analysis revealed structural improvements in SSc-ILD.
• These imaging changes correlate with improved lung function and symptoms, confirming structural benefits of treatment.