Prediction of survival by texture-based automated quantitative assessment of regional disease patterns on CT in idiopathic pulmonary fibrosis
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To retrospectively investigate whether the baseline extent and 1-year change in regional disease patterns on CT can predict survival of patients with idiopathic pulmonary fibrosis (IPF).
A total of 144 IPF patients with CT scans at the time of diagnosis and 1 year later were included. The extents of five regional disease patterns were quantified using an in-house texture-based automated system. The fibrosis score was defined as the sum of the extent of honeycombing and reticular opacity. The Cox proportional hazard model was used to determine the independent predictors of survival.
A total of 106 patients (73.6%) died during the follow-up period. Univariate analysis revealed that age, baseline forced vital capacity, total lung capacity, diffusing capacity of the lung for carbon monoxide, six-minute walk distance, desaturation, honeycombing, reticular opacity, fibrosis score, and interval changes in honeycombing and fibrosis score were significantly associated with survival. Multivariate analysis revealed that age, desaturation, fibrosis score and interval change in fibrosis score were significant independent predictors of survival (p = 0.003, <0.001, 0.001 and <0.001). The C-index for the developed model was 0.768.
Texture-based, automated CT quantification of fibrosis can be used as an independent predictor of survival in IPF patients.
• Automated quantified fibrosis on CT was a significant predictor of survival.
• Automated quantified interval change in fibrosis on CT was an independent predictor.
• The predictive model showed comparable discriminative power with a C-index of 0.768.
• Automated CT quantification can be considered to evaluate prognosis in routine practice.
KeywordsIdiopathic pulmonary fibrosis CT Quantification Texture analysis Survival
six-minute walk distance
diffusing capacity of the lung for carbon monoxide
forced vital capacity
gender, age, and physiology
idiopathic pulmonary fibrosis
pulmonary function test
region of interest
total lung capacity
Compliance with ethical standards
The scientific guarantor of this publication is Dr. Joon Beom Seo.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
This study was supported by a grant (2016-7014) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the institutional review board.
Institutional review board approval was obtained.
Study subjects or cohorts overlap
The 144 patients of our study were identical to the study population in the previous report . While the previous study assessed predictive factors for decline in FVC on initial CT using texture-based automated quantification in IPF, this work focused on whether baseline extent and 1-year change in regional disease patterns on CT can be used to predict survival of patients with IPF. Thus, this work is substantially different from the previous report.
• performed at one institution
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