1. Quantitative chest computed tomography predicts mortality in systemic sclerosis: A longitudinal study.
- Author
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Amorim FG, Dos Santos ER, Yuji Verrastro CG, and Kayser C
- Subjects
- Humans, Middle Aged, Female, Male, Longitudinal Studies, Retrospective Studies, Aged, Adult, Kaplan-Meier Estimate, Respiratory Function Tests, Lung diagnostic imaging, Lung pathology, Lung physiopathology, Prognosis, Scleroderma, Systemic mortality, Scleroderma, Systemic diagnostic imaging, Scleroderma, Systemic complications, Tomography, X-Ray Computed methods, Lung Diseases, Interstitial diagnostic imaging, Lung Diseases, Interstitial mortality
- Abstract
Objective: Quantitative chest computed tomography (qCT) methods are new tools that objectively measure parenchymal abnormalities and vascular features on CT images in patients with interstitial lung disease (ILD). We aimed to investigate whether the qCT measures are predictors of 5-year mortality in patients with systemic sclerosis (SSc)., Methods: Patients diagnosed with SSc were retrospectively selected from 2011 to 2022. Patients should have had volumetric high-resolution CTs (HRCTs) and pulmonary function tests (PFTs) performed at baseline and at 24 months of follow-up. The following parameters were evaluated in HRCTs using Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER): ground glass opacities, reticular pattern, honeycombing, and pulmonary vascular volume. Factors associated with death were evaluated by Kaplan‒Meier survival curves and multivariate analysis models. Semiquantitative analysis of the HRCTs images was also performed., Results: Seventy-one patients were included (mean age, 54.2 years). Eleven patients (15.49%) died during the follow-up, and all patients had ILD. As shown by Kaplan‒Meier curves, survival was worse among patients with an ILD extent (ground glass opacities + reticular pattern + honeycombing) ≥ 6.32%, a reticular pattern ≥ 1.41% and a forced vital capacity (FVC) < 70% at baseline. The independent predictors of mortality by multivariate analysis were a higher reticular pattern (Exp 2.70, 95%CI 1.26-5.82) on qCT at baseline, younger age (Exp 0.906, 95%CI 0.826-0.995), and absolute FVC decline ≥ 5% at follow-up (Exp 15.01, 95%CI 1.90-118.5), but not baseline FVC. Patients with extensive disease (>20% extension) by semiquantitative analysis according to Goh's staging system had higher disease extension on qCT at baseline and follow-up., Conclusion: This study showed that the reticular pattern assessed by baseline qCT may be a useful tool in the clinical practice for assessing lung damage and predicting mortality in SSc., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Amorim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2024
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