Extent of lung fibrosis on quantified CT predicts survival in IPF patients

The extent of fibrotic abnormality on baseline computed tomography (CT), quantified using data-driven texture analysis (DTA), is predictive of outcomes in patients with idiopathic pulmonary fibrosis (IPF), regardless of pulmonary function, suggests a study.

“Prediction of disease course in patients with progressive pulmonary fibrosis remains challenging,” said the researchers, who then went to assess the prognostic value of lung fibrosis extent quantified at CT using DTA in a large cohort of well-characterized IPF patients enrolled in a national registry.

Participants in the Australian IPF Registry with available CT between 2007 and 2016 were included in this retrospective analysis. The researchers analysed CT scans using the DTA method to quantify the extent of lung fibrosis. They also compared the demographics, longitudinal pulmonary function, and quantitative CT metrics using descriptive statistics.

Finally, the associations between baseline DTA, pulmonary function metrics, and outcomes were examined through Cox analyses, adjusted for age, gender, body mass index, smoking history, and antifibrotic treatment.

Of the 393 participants with CT scans, 221 had available pulmonary function testing obtained within 90 days of CT. In linear mixed-effect models, baseline DTA score significantly correlated with the annual rate of decline in forced vital capacity and diffusing capacity of carbon monoxide.

In multivariable Cox proportional hazard models, greater extent of lung fibrosis was predictive of poorer transplant-free survival (hazard ratio [HR], 1.20; p<0.0001) and progression-free survival (HR, 1.14; p<0.0001).

“The results from this IPF cohort support further studies to evaluate the application of DTA in other forms of progressive pulmonary fibrosis,” the researchers said.