Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes

Salisbury, M.L.; Lynch, David A.; Beek, Edwin Jacques Rudolph van; Kazerooni, Ella A.; Guo, Junfeng; Xia, Meng; Murray, Susan; Anstrom, Kevin J.; Yow, Eric; Martínez, Fernando J.; Hoffman, Eric A.; Flaherty, Kevin R.

doi:10.1164/rccm.201607-1385oc

Cited by 109 publications

(75 citation statements)

References 40 publications

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“…Further, addition of the HRCT pattern variable to a multivariable model including baseline age, baseline lung function, smoking status, and fibrosis extent resulted in improvement in the c-statistic, suggesting that knowledge of this variable improves model discrimination. The guidelines-based HRCT pattern is commonly referenced in HRCT reports, making it a readily available data point providing physicians and patients useful prognostic information beyond that encompassed by clinical variables 3–5 .…”

Section: Discussionmentioning

confidence: 99%

“…The extent of fibrotic HRCT features including overall fibrosis score, honeycombing, reticular pattern, and traction bronchiectasis have been associated with poor prognosis in IPF and other fibrotic idiopathic interstitial pneumonias (IIPs) 2–5 . In unselected patients with fibrotic IIP, a definite UIP HRCT pattern has been associated with significantly worse survival compared to possible or inconsistent with UIP patterns 6,7 .…”

Section: Discussionmentioning

confidence: 99%

“…Older patients and those with greater physiologic impairment at baseline have a higher mortality risk 2 . More extensive fibrosis on HRCT is also associated with increased risk of death 2–5 . Knowledge of the HRCT pattern may add relevant prognostic information.…”

Section: Introductionmentioning

confidence: 99%

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Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Salisbury

Tolle

Xia

et al. 2017

Respiratory Medicine

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Background Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing lung disease of unknown etiology. Inter-society consensus guidelines on IPF diagnosis and management outline radiologic patterns including definite usual interstitial pneumonia (UIP), possible UIP, and inconsistent with UIP. We evaluate these diagnostic categories as prognostic markers among patients with IPF. Methods Included subjects had biopsy-proven UIP, a multidisciplinary team diagnosis of IPF, and a baseline high-resolution computed tomography (HRCT). Thoracic radiologists assigned the radiologic pattern and documented the presence and extent of specific radiologic findings. The outcome of interest was lung transplant-free survival. Results IPF patients with a possible UIP pattern on HRCT had significantly longer Kaplan-Meier event-free survival compared to those with definite UIP pattern (5.21 and 3.57 years, respectively, p=0.002). In a multivariable Cox proportional hazards model adjusted for baseline age, gender, %-predicted FVC, and %-predicted DLCO via the GAP Stage, extent of fibrosis (via the traction bronchiectasis score) and ever-smoker status, possible UIP pattern on HRCT (versus definite UIP) was associated with reduced hazard of death or lung transplant (HR=0.42, CI 95% 0.23–0.78, p=0.006). Conclusions Radiologic diagnosis categories outlined by inter-society consensus guidelines is a widely-reported and potentially useful prognostic marker in IPF patients, with possible UIP pattern on HRCT associated with a favorable prognosis compared to definite UIP pattern, after adjusting for relevant covariates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Salisbury

Tolle

Xia

et al. 2017

Respiratory Medicine

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“…While quantitative disease assessment in lung fibrosis has been around for some years, its application in monitoring disease in therapeutic trials has recently gained interest. One notable recent study in this field by SALISBURY et al [76] involved textural analysis of a cohort of IPF patients enrolled in a clinical therapeutic trial using a novel adaptive multiple features method (AMFM) at two time points. The investigators observed that AMFM-measured fibrosis was independently related to the risk of disease progression as judged by a number of clinical and physiological measures, including the composite gender-age-physiology (GAP) score (a score accounting concurrently for patient age, gender, FVC and DLCO, where a higher score is associated with increased risk of mortality) and smoking history.…”

Section: Quantitative Computed Tomographymentioning

confidence: 99%

Evaluating disease severity in idiopathic pulmonary fibrosis

et al. 2017

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Accurate assessment of idiopathic pulmonary fibrosis (IPF) disease severity is integral to the care provided to patients with IPF. However, to date, there are no generally accepted or validated staging systems. There is an abundance of data on using information acquired from physiological, radiological and pathological parameters, in isolation or in combination, to assess disease severity in IPF. Recently, there has been interest in using serum biomarkers and computed tomography-derived quantitative lung fibrosis measures to stage disease severity in IPF. This review will focus on the suggested methods for staging IPF, at baseline and on serial assessment, their strengths and limitations, as well as future developments.

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“…and used to explore the association between the AMFM regional characterization of the lung and outcomes in IPF patients(46) (Figure 2). Among patients with IPF enrolled in clinical therapeutic trials, both visual and AMFM measurement of baseline extent of mixed ground glass and reticular (GGR) densities predicted subsequent disease progression (defined as composite death, hospitalization, or >10% FVC decline), independent of baseline age, gender, and FVC.…”

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confidence: 99%

Computed Tomographic Biomarkers in Idiopathic Pulmonary Fibrosis. The Future of Quantitative Analysis

Kim

Salisbury

et al. 2019

Am J Respir Crit Care Med

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107

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Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease with great variability in disease severity and rate of progression. The need for a reliable, sensitive, and objective biomarker to track disease progression and response to therapy remains a great challenge in IPF clinical trials. Over the past decade, quantitative computed tomography (QCT) has emerged as an area of intensive research to address this need. We have gathered a group of pulmonologists, radiologists and scientists with expertise in this area to define the current status and future promise of this imaging technique in the evaluation and management of IPF. In this Pulmonary Perspective, we review the development and validation of six computer-based QCT methods and offer insight into the optimal use of an imaging-based biomarker as a tool for prognostication, prediction of response to therapy, and potential surrogate endpoint in future therapeutic trials.

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Idiopathic Pulmonary Fibrosis: The Association between the Adaptive Multiple Features Method and Fibrosis Outcomes

Cited by 109 publications

References 40 publications

Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Possible UIP pattern on high-resolution computed tomography is associated with better survival than definite UIP in IPF patients

Evaluating disease severity in idiopathic pulmonary fibrosis

Computed Tomographic Biomarkers in Idiopathic Pulmonary Fibrosis. The Future of Quantitative Analysis

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