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Prediction of survival by texture-based automated quantitative assessment of regional disease patterns on CT in idiopathic pulmonary fibrosis

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Abstract

Objectives

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).

Methods

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.

Results

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.

Conclusion

Texture-based, automated CT quantification of fibrosis can be used as an independent predictor of survival in IPF patients.

Key Points

• 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.

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Abbreviations

6MWD:

six-minute walk distance

CONS:

consolidation

DLCO :

diffusing capacity of the lung for carbon monoxide

EMPH:

emphysema

FVC:

forced vital capacity

GAP:

gender, age, and physiology

GGO:

ground-glass opacity

HC:

honeycombing

IPF:

idiopathic pulmonary fibrosis

NL:

normal

PFT:

pulmonary function test

RO:

reticular opacity

ROI:

region of interest

SpO2 :

oxyhaemoglobin saturation

TLC:

total lung capacity

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 Gil, Seoul, Songpa-gu, 138-736, Korea

    Sang Min Lee, Joon Beom Seo, Sang Young Oh, Sang Min Lee & Namkug Kim

  2. Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    Tae Hoon Kim & Jin Woo Song

Authors
  1. Sang Min Lee
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  2. Joon Beom Seo
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  3. Sang Young Oh
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  5. Jin Woo Song
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  6. Sang Min Lee
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Corresponding author

Correspondence to Joon Beom Seo.

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Guarantor

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.

Funding

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.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

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 [21]. 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.

Methodology

• retrospective

• observational

• performed at one institution

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Lee, S.M., Seo, J.B., Oh, S.Y. et al. Prediction of survival by texture-based automated quantitative assessment of regional disease patterns on CT in idiopathic pulmonary fibrosis. Eur Radiol 28, 1293–1300 (2018). https://doi.org/10.1007/s00330-017-5028-0

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  • DOI: https://doi.org/10.1007/s00330-017-5028-0

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