Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate

Jin, Gong Yong; Lynch, David A.; Chawla, Ashish; Garg, Kavita D.; Tammemägi, M.; Şahin, Hakan; Misumi, Shigeki; Kwon, Keun Sang

doi:10.1148/radiol.13120816

Cited by 254 publications

(274 citation statements)

References 31 publications

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“…Finally, we demonstrate that progressive imaging abnormalities are associated with important physiologic (e.g., accelerated rate of lung function decline) and clinical (e.g., increased rate of mortality) consequences. (5,15,16). The prevalence of ILA in these studies ranged from 3% to 10% (5,16) with estimates of progression ranging from 20% at 2 years (5) to 46% at 4 years (16).…”

Section: Discussionmentioning

confidence: 82%

“…(5,15,16). The prevalence of ILA in these studies ranged from 3% to 10% (5,16) with estimates of progression ranging from 20% at 2 years (5) to 46% at 4 years (16). These findings are comparable with our findings, which noted that ILA was prevalent on 3% of the initial scans of which 43% demonstrated progressive imaging abnormalities over approximately 5 years of follow-up time.…”

Section: Discussionmentioning

confidence: 82%

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Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study

Araki¹,

Putman

Hatabu³

et al. 2016

Am J Respir Crit Care Med

254

218

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Rationale: The relationship between the development and/or progression of interstitial lung abnormalities (ILA) and clinical outcomes has not been previously investigated.Objectives: To determine the risk factors for, and the clinical consequences of, having ILA progression in participants from the Framingham Heart Study.Methods: ILA were assessed in 1,867 participants who had serial chest computed tomography (CT) scans approximately 6 years apart. Mixed effect regression (and Cox) models were used to assess the association between ILA progression and pulmonary function decline (and mortality).Measurements and Main Results: During the follow-up period 660 (35%) participants did not have ILA on either CT scan, 37 (2%) had stable to improving ILA, and 118 (6%) had ILA with progression (the remaining participants without ILA were noted to be indeterminate on at least one CT scan). Increasing age and increasing copies of the MUC5B promoter polymorphism were associated with ILA progression. After adjustment for covariates, ILA progression was associated with a greater FVC decline when compared with participants without ILA (20 ml; SE, 66 ml; P = 0.0005) and with those with ILA without progression (25 ml; SE, 611 ml; P = 0.03). Over a median follow-up time of approximately 4 years, after adjustment, ILA progression was associated with an increase in the risk of death (hazard ratio, 3.9; 95% confidence interval, 1.3-10.9; P = 0.01) when compared with those without ILA.Conclusions: These findings demonstrate that ILA progression in the Framingham Heart Study is associated with an increased rate of pulmonary function decline and increased risk of death.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 82%

Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study

Araki¹,

Putman

Hatabu³

et al. 2016

Am J Respir Crit Care Med

254

218

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“…19 CT can show two distinct patterns of small airways disease in cigarette smokers: inflammatory small airways disease (respiratory bronchiolitis) is characterized by poorly defined centrilobular nodularity (Figure 4), while obstructive small airways disease is characterized by expiratory gas trapping ( Figure 5). Interstitial lung abnormalities may be seen in up to 10% of heavy cigarette smokers, 20,21 most commonly, ground glass abnormality indicating an inflammatory abnormality, though a fibroticappearing abnormality may be found in 1-2% of cases. 21 Evaluation of the pulmonary vasculature is important in individuals with COPD, because enlargement of the central pulmonary arteries is associated with increased risk of exacerbation.…”

Section: Ct: Visual Evaluationmentioning

confidence: 99%

“…Interstitial lung abnormalities may be seen in up to 10% of heavy cigarette smokers, 20,21 most commonly, ground glass abnormality indicating an inflammatory abnormality, though a fibroticappearing abnormality may be found in 1-2% of cases. 21 Evaluation of the pulmonary vasculature is important in individuals with COPD, because enlargement of the central pulmonary arteries is associated with increased risk of exacerbation.…”

Section: Ct: Visual Evaluationmentioning

confidence: 99%

Progress in Imaging COPD, 2004 - 2014

Lynch¹

2014

J COPD F

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Abbreviations: computed tomography, CT; magnetic resonance imaging, MRI; positron emission tomography, PET; Global Initiative for chronic Obstructive Lung Disease, GOLD; quantitative CT, QCT; Hounsfield Units, HU; percentage of low attenuation area, %LAA; relative area of lung less than -950 HU, RA950; Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints, ECLIPSE; forced expiratory volume in 1 second, FEV1; forced vital capacity, FVC. Journal of the COPD Foundation(GOLD) stage may have substantial, little, or no emphysema. Discrete subphenotypes of COPD include emphysema of varying morphologic appearance, large airway abnormality and small airway obstruction. Increasing awareness of the heterogeneity of COPD has led to increased use of CT to characterize COPD for purposes of genetic evaluation and identification of specific subgroups which may be amenable to therapeutic trials. 1-3 While visual assessment is important in determining the presence and character of emphysema, the last decade has been characterized by increasing use of quantitative imaging to provide precise estimates of the severity and distribution of emphysema, gas trapping and airway wall thickening. Several large cohorts of cigarette smokers have now been quite extensively characterized by CT, resulting in increased knowledge of the clinical correlates of quantitative CT parameters. [4][5][6] The purpose of this paper is to present the substantial contribution that imaging has made to our understanding of COPD over the past 10 years. AbstractComputed tomography (CT) has contributed substantially to our understanding of COPD over the past decade. Visual and quantitative assessments of CT in COPD are complementary. Visual assessment should provide assessment of centrilobular, panlobular and paraseptal emphysema, airway wall thickening, bronchiectasis, findings of respiratory bronchiolitis, and enlargement of the pulmonary artery. Quantitative CT permits evaluation of severity of emphysema, airway wall thickening, and expiratory air trapping, and is now being used for longitudinal evaluation of the progression of COPD. Innovative techniques are being developed to use CT to characterize the pattern of emphysema and smoking-related respiratory bronchiolitis. Magnetic resonance imaging (MRI) and positron emission tomography PET-CT are useful research tools in the evaluation of COPD.

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“…Fibrotic changes occur at a rate of 2 % (i. e. ground glass and septum thickening, septum thickening only, honeycombing); mixed fibrotic/non-fibrotic findings occur in approx. 2 % of cases [31,32]. Typically the screening trials include smokers and former smokers, but not those who have never smoked (i. e. non-smokers).…”

Section: Interstitial Lung Abnormalities -Incidental Findings Withoutmentioning

confidence: 99%

The Aging Lung: Clinical and Imaging Findings and the Fringe of Physiological State

Schröder

Storbeck

Rabe

et al. 2015

Fortschr Röntgenstr

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Since aspects of demographic transition have become an essential part of socioeconomic, medical and health-care research in the last decades, it is vital for the radiologist to discriminate between normal ageing related effects and abnormal imaging findings in the elderly. This article reviews functional and structural aspects of the ageing lung and focuses on typical ageing related radiological patterns. Key points: ??The physiological aging process of the thoracic organs shows typical structural and functional aspects. ??Mild interstitial fibrosis and focal parenchymal abnormalities like septal thickening can be diagnosed frequently ? whereas a clinical correlate is often lacking. ??With increasing patient age, the influence by various intrinsic and extrinsic factors (including comorbidities of the patient, and drug inhalation toxicants) also increases. ??A growing spectrum of imaging techniques (including functional cardiopulmonary MRI, MRI spectroscopy, hybrid-techniques) is confronted by rare empiric data in the very old people (aging 80 years and older). Citation Format: ??Schr?der TH, Storbeck B, Rabe KF. et?al. The Aging Lung: Clinical and Imaging Findings and the Fringe of Physiological State. Fortschr R?ntgenstr 2015; 187: 430???439

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Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate

Cited by 254 publications

References 31 publications

Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study

Development and Progression of Interstitial Lung Abnormalities in the Framingham Heart Study

Progress in Imaging COPD, 2004 - 2014

The Aging Lung: Clinical and Imaging Findings and the Fringe of Physiological State

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