Interstitial lung abnormality evaluated by an automated quantification system: prevalence and progression rate

Area of Science:

• Pulmonary Medicine
• Radiology
• Epidemiology

Background:

• Screening for interstitial lung abnormalities (ILA) using quantitative analysis is underdeveloped.
• Studies on ILA prevalence in Asian populations, particularly Koreans, are scarce.

Purpose of the Study:

• To determine the prevalence and progression rate of ILA in the Korean population.
• To evaluate an automated quantification system for ILA detection and monitoring.

Main Methods:

• Included 2,890 healthy Korean adults with serial chest CT scans (≥5 years apart).
• Utilized an automated system to measure quantitative lung fibrosis scores.
• Defined ILA as a score ≥3; progression as any score increase from baseline.

Main Results:

• ILA identified in 8.6% (251/2890) of participants, more common in older individuals with higher BMI.
• Prevalence of ILA increased with age.
• Follow-up (median 6.5 years) showed 23.5% progression in diagnosed ILA cases; 11% developed new abnormalities.
• Older age, higher BMI, and elevated erythrocyte sedimentation rate were independent risk factors for ILA development/progression.
• The ILA group had significantly worse 5-year survival (3.4% vs. 1.5%, P=0.010).

Conclusions:

• Automated quantification can identify ILA in approximately one-tenth of the Korean population.
• About a quarter of individuals with ILA experience progression.
• Older age, higher BMI, and elevated erythrocyte sedimentation rate are key risk factors for ILA development and progression.