Correlations Between Changes in FVC and Imaging Parameters in Patients with Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD): Sub-Study of the SENSCIS Trial

Imaging Features of Autoimmune Disease-Related Interstitial Lung Diseases

“…In a retrospective study of 129 patients with SSc who had a median time between HRCT scans of 16 months, no significant correlations were found between change in semi-quantitative CT score (extent of lung fibrosis) and change in FVC % predicted or DLco % predicted over the same period 55 . In a sub-study of the SENSCIS trial in patients with SSc-ILD, only weak correlations were observed between changes in qualitative HRCT parameters (honeycombing, reticulation, and/or fibrotic ground glass opacity) and the rate of decline in FVC over 52 to 60 weeks 54 . In a sub-study of the INBUILD trial in patients with progressive pulmonary fibrosis, changes in the extent of fibrosis and other qualitative HRCT parameters over 52 weeks were small, despite a marked decline in FVC 56 …”

“…55 In a sub-study of the SENSCIS trial in patients with SSc-ILD, only weak correlations were observed between changes in qualitative HRCT parameters (honeycombing, reticulation, and/or fibrotic ground opacity) and the rate of decline in FVC over 52 to 60 weeks. 54 In a sub-study of the INBUILD trial in patients with progressive pulmonary fibrosis, changes in the extent of fibrosis and other qualitative HRCT parameters over 52 weeks were small, despite a marked decline in FVC. 56 Quantitative computed tomography softwares have demonstrated better performance than visual assessment in predicting the progression of ILD, including in patients with autoimmune disease-related ILDs, 38,39,57,58 but are not widely available in clinical practice.…”

“…There is often not a close relationship between progression identified based on pulmonary function tests and based on visual assessment of HRCT scans, which is probably less sensitive to change. 48,53,54 In a retrospective study of 129 patients with SSc who had a median time between HRCT scans of 16 months, no significant correlations were found between change in semi-quantitative CT score (extent of lung fibrosis) and change in FVC % predicted or DLco % predicted over the same period. 55 In a sub-study of the SENSCIS trial in patients with SSc-ILD, only weak correlations were observed between changes in qualitative HRCT parameters (honeycombing, reticulation, and/or fibrotic ground opacity) and the rate of decline in FVC over 52 to 60 weeks.…”

“…However, it is important to be aware that these criteria have not been validated and that visual assessment of HRCT scans does not enable radiologists to predict the progression of ILD nor to assess the worsening of ILD with any degree of accuracy. There is often not a close relationship between progression identified based on pulmonary function tests and based on visual assessment of HRCT scans, which is probably less sensitive to change 48,53,54 . In a retrospective study of 129 patients with SSc who had a median time between HRCT scans of 16 months, no significant correlations were found between change in semi-quantitative CT score (extent of lung fibrosis) and change in FVC % predicted or DLco % predicted over the same period 55 .…”