Long-Term Follow-Up of Interstitial Lung Abnormalities in Low-Dose Chest CT in Health Screening: Exploring the Predictors of Clinically Significant Interstitial Lung Diseases Using Artificial Intelligence-Based Quantitative CT Analysis

Overview

Journal J Korean Soc Radiol

Specialty Radiology

Date 2024 Dec 11

PMID 39660324

Authors

Won Jong Jeong

Bo Da Nam

Jung Hwa Hwang

Chang Hyun Lee

Hee-Young Yoon

Eun Ji Lee

Eunsun Oh

Jewon Jeong

Sung Hwan Bae

Affiliations

Soon will be listed here.

Abstract

Purpose: This study examined longitudinal changes in interstitial lung abnormalities (ILAs) and predictors of clinically significant interstitial lung diseases (ILDs) in a screening population with ILAs.

Materials And Methods: We retrieved 36891 low-dose chest CT records from screenings between January 2003 and May 2021. After identifying 101 patients with ILAs, the clinical findings, spirometry results, and initial and follow-up CT findings, including visual and artificial intelligence-based quantitative analyses, were compared between patients diagnosed with ILD ( = 23, 23%) and those who were not ( = 78, 77%). Logistic regression analysis was used to identify significant parameters for the clinical diagnosis of ILD.

Results: Twenty-three patients ( = 23, 23%) were subsequently diagnosed with clinically significant ILDs at follow-up (mean, 8.7 years). Subpleural fibrotic ILAs on initial CT and signs of progression on follow-up CT were common in the ILD group (both < 0.05). Logistic regression analysis revealed that emerging respiratory symptoms (odds ratio [OR], 5.56; 95% confidence interval [CI], 1.28-24.21; = 0.022) and progression of ILAs at follow-up chest CT (OR, 4.07; 95% CI, 1.00-16.54; = 0.050) were significant parameters for clinical diagnosis of ILD.

Conclusion: Clinically significant ILD was subsequently diagnosed in approximately one-quarter of the screened population with ILAs. Emerging respiratory symptoms and progression of ILAs at follow-up chest CT can be predictors of clinically significant ILDs.

References

Doyle T, Hunninghake G, Rosas I . Subclinical interstitial lung disease: why you should care. Am J Respir Crit Care Med. 2012; 185(11):1147-53. PMC: 3373068. DOI: 10.1164/rccm.201108-1420PP. View

Hatabu H, Hunninghake G, Richeldi L, Brown K, Wells A, Remy-Jardin M . Interstitial lung abnormalities detected incidentally on CT: a Position Paper from the Fleischner Society. Lancet Respir Med. 2020; 8(7):726-737. PMC: 7970441. DOI: 10.1016/S2213-2600(20)30168-5. View

Tzilas V, Tzouvelekis A, Ryu J, Bouros D . 2022 update on clinical practice guidelines for idiopathic pulmonary fibrosis and progressive pulmonary fibrosis. Lancet Respir Med. 2022; 10(8):729-731. DOI: 10.1016/S2213-2600(22)00223-5. View

Putman R, Hatabu H, Araki T, Gudmundsson G, Gao W, Nishino M . Association Between Interstitial Lung Abnormalities and All-Cause Mortality. JAMA. 2016; 315(7):672-81. PMC: 4828973. DOI: 10.1001/jama.2016.0518. View

Brown S, Padilla M, Mhango G, Powell C, Salvatore M, Henschke C . Interstitial Lung Abnormalities and Lung Cancer Risk in the National Lung Screening Trial. Chest. 2019; 156(6):1195-1203. DOI: 10.1016/j.chest.2019.06.041. View

Araki T, Putman R, Hatabu H, Gao W, Dupuis J, Latourelle J . Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study. Am J Respir Crit Care Med. 2016; 194(12):1514-1522. PMC: 5215030. DOI: 10.1164/rccm.201512-2523OC. View

Humphries S, Yagihashi K, Huckleberry J, Rho B, Schroeder J, Strand M . Idiopathic Pulmonary Fibrosis: Data-driven Textural Analysis of Extent of Fibrosis at Baseline and 15-Month Follow-up. Radiology. 2017; 285(1):270-278. PMC: 5621716. DOI: 10.1148/radiol.2017161177. View

Hunninghake G, Hatabu H, Okajima Y, Gao W, Dupuis J, Latourelle J . MUC5B promoter polymorphism and interstitial lung abnormalities. N Engl J Med. 2013; 368(23):2192-200. PMC: 3747636. DOI: 10.1056/NEJMoa1216076. View

Kliment C, Araki T, Doyle T, Gao W, Dupuis J, Latourelle J . A comparison of visual and quantitative methods to identify interstitial lung abnormalities. BMC Pulm Med. 2015; 15:134. PMC: 4625729. DOI: 10.1186/s12890-015-0124-x. View

10.

Raghunath S, Rajagopalan S, Karwoski R, Maldonado F, Peikert T, Moua T . Quantitative stratification of diffuse parenchymal lung diseases. PLoS One. 2014; 9(3):e93229. PMC: 3968138. DOI: 10.1371/journal.pone.0093229. View

11.

Kim M, Choe J, Hwang H, Lee S, Yun J, Kim N . Interstitial lung abnormalities (ILA) on routine chest CT: Comparison of radiologists' visual evaluation and automated quantification. Eur J Radiol. 2022; 157:110564. DOI: 10.1016/j.ejrad.2022.110564. View

12.

Choe J, Hwang H, Seo J, Lee S, Yun J, Kim M . Content-based Image Retrieval by Using Deep Learning for Interstitial Lung Disease Diagnosis with Chest CT. Radiology. 2021; 302(1):187-197. DOI: 10.1148/radiol.2021204164. View

13.

Buendia-Roldan I, Fernandez R, Mejia M, Juarez F, Ramirez-Martinez G, Montes E . Risk factors associated with the development of interstitial lung abnormalities. Eur Respir J. 2021; 58(2). DOI: 10.1183/13993003.03005-2020. View

14.

Chae K, Chung M, Jin G, Ju Song Y, An A, Choi H . Radiologic-pathologic correlation of interstitial lung abnormalities and predictors for progression and survival. Eur Radiol. 2022; 32(4):2713-2723. DOI: 10.1007/s00330-021-08378-8. View

15.

Putman R, Gudmundsson G, Axelsson G, Hida T, Honda O, Araki T . Imaging Patterns Are Associated with Interstitial Lung Abnormality Progression and Mortality. Am J Respir Crit Care Med. 2019; 200(2):175-183. PMC: 6635786. DOI: 10.1164/rccm.201809-1652OC. View

16.

Rose J, Menon A, Hino T, Hata A, Nishino M, Lynch D . Suspected Interstitial Lung Disease in COPDGene Study. Am J Respir Crit Care Med. 2022; 207(1):60-68. PMC: 9952869. DOI: 10.1164/rccm.202203-0550OC. View

17.

Axelsson G, Putman R, Aspelund T, Gudmundsson E, Hida T, Araki T . The associations of interstitial lung abnormalities with cancer diagnoses and mortality. Eur Respir J. 2020; 56(6). PMC: 7876778. DOI: 10.1183/13993003.02154-2019. View

18.

Sverzellati N, Guerci L, Randi G, Calabro E, La Vecchia C, Marchiano A . Interstitial lung diseases in a lung cancer screening trial. Eur Respir J. 2011; 38(2):392-400. DOI: 10.1183/09031936.00201809. View

19.

Lee J, Chae K, Suh Y, Jeong W, Lee T, Kim Y . Prevalence and Long-term Outcomes of CT Interstitial Lung Abnormalities in a Health Screening Cohort. Radiology. 2022; 306(2):e221172. DOI: 10.1148/radiol.221172. View

20.

Hoyer N, W Wille M, Thomsen L, Wilcke T, Dirksen A, Pedersen J . Interstitial lung abnormalities are associated with increased mortality in smokers. Respir Med. 2018; 136:77-82. DOI: 10.1016/j.rmed.2018.02.001. View