Interstitial lung disease in systemic sclerosis quantification of disease classification and progression with high-resolution computed tomography: An observational study

Johan Clukers, Maarten Lanclus, Dennis Belmans, Cedric Van Holsbeke, Wilfried De Backer, Dharshan Vummidi, Paul Cronin, Ben R Lavon, Jan De Backer and Dinesh Khanna

INTRODUCTION:

Systemic sclerosis-associated interstitial lung disease accounts for up to 20% of mortality in these patients and has a highly variable prognosis. Functional respiratory imaging, a quantitative computed tomography imaging technique that allows mapping of regional information, can provide a detailed view of lung structures. It thereby shows potential to better characterize this disease.

PURPOSE:

To evaluate the use of functional respiratory imaging quantitative computed tomography in systemic sclerosis–
associated interstitial lung disease staging, as well as the relationship between short-term changes in pulmonary function tests and functional respiratory imaging quantitative computed tomography with respect to disease severity.
Materials and methods: An observational cohort of 35 patients with systemic sclerosis was retrospectively studied
by comparing serial pulmonary function tests and in- and expiratory high-resolution computed tomography over 1.5-
year interval. After classification into moderate to severe lung disease and limited lung disease (using a hybrid method integrating quantitative computed tomography and pulmonary function tests), post hoc analysis was performed using mixed-effects models and estimated marginal means in terms of functional respiratory imaging parameters.

Results:

At follow-up, relative mean forced vital capacity percentage change was not significantly different in the limited
(6.37%; N=13; p=0.053) and moderate to severe disease (−3.54%; N=16; p=0.102) groups, respectively. Specific airway resistance decreased from baseline for both groups. (Least square mean changes −25.11% predicted (p=0.006) and
−14.02% predicted (p=0.001) for limited and moderate to severe diseases.) In contrast to limited disease from baseline,
specific airway radius increased in moderate to severe disease by 8.57% predicted (p=0.011) with the decline of lower lobe volumes of 2.97% predicted (p=0.031).

Conclusion:

Functional respiratory imaging is able to differentiate moderate to severe disease versus limited disease and to detect disease progression in systemic sclerosis.

Categorised in: Papers / June 14, 2021 11:41 am / Published by Fluidda