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Related Experiment Video

Updated: Sep 13, 2025

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Visual and Quantitative Interstitial Lung Abnormality Progression in COPDGene.

Rachel K Putman1, Jonathan A Rose1, Ruben San José Estepar2

  • 1Pulmonary and Critical Care Division.

American Journal of Respiratory and Critical Care Medicine
|July 28, 2025
PubMed
Summary
This summary is machine-generated.

Longitudinal changes in quantitative interstitial abnormalities (QIA) predict imaging progression and mortality in smokers with interstitial lung abnormalities (ILA). Baseline QIA and FVC did not predict progression, but increased QIA correlated with adverse outcomes.

Keywords:
interstitial lung abnormalitiesinterstitial lung diseasepulmonary fibrosis

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Quantitative Imaging

Background:

  • Interstitial lung abnormalities (ILA) on CT scans may indicate early pulmonary fibrosis.
  • Quantitative interstitial abnormalities (QIA) offer automated assessment of lung injury.
  • The combined predictive value of visual and quantitative ILA assessments for progression is unknown.

Purpose of the Study:

  • To evaluate the utility of quantitative imaging in predicting ILA progression.
  • To assess the association between ILA progression and adverse clinical outcomes in smokers.
  • To determine if combining visual and quantitative assessments improves prediction.

Main Methods:

  • Chest CT scans from the COPDGene cohort were analyzed for ILA presence, subtypes, and progression over ~5 years.
  • Quantitative interstitial abnormalities (QIA) and forced vital capacity (FVC) were measured.
  • Multivariable logistic regression and Cox proportional hazards models were used to assess associations with ILA progression and mortality.

Main Results:

  • Of 4373 participants, 544 (12%) had ILA, with 391 (72%) showing visual progression.
  • Specific imaging features like traction bronchiectasis were associated with progression (OR=3.1).
  • Baseline QIA and FVC did not predict progression, but visual progression correlated with increased longitudinal QIA (6.5% difference).
  • Increased QIA independently predicted increased mortality (HR=1.05).

Conclusions:

  • Baseline quantitative measures (QIA, FVC) did not predict visual ILA progression.
  • Longitudinal changes in QIA were correlated with imaging progression.
  • Increased QIA over time is linked to adverse clinical outcomes, including mortality, independent of FVC decline.