Interstitial lung diseases in a lung cancer screening trial

Sverzellati, Nicola; Guerci, L.; Randi, Giorgia; Calabrò, Elisa; Vecchia, Carlo La; Marchianò, Alfonso; Pesci, Alberto; Zompatori, Maurizio; Pastorino, Ugo

doi:10.1183/09031936.00201809

Cited by 154 publications

(129 citation statements)

References 31 publications

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“…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. Our presentation of the progression of ILA to imaging findings consistent with UIP in 4% (present in 2 of the 53 follow-up scans initially identified as having ILA) is also consistent with prior reports (5,15). However, our study suggests that because prior reports have only followed up the chest CTs of participants initially noted to have ILA, it is likely that these studies have missed important numbers of participants with progressive imaging abnormalities (including those that can develop a UIP pattern de novo) over a relatively short time frame.…”

Section: Discussionsupporting

confidence: 78%

“…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: 99%

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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: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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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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“…The incidence of radiographic abnormalities was influenced by the amount of smoking and the current smoking status. Sverzellati et al 14 reviewed HRCT findings in 692 smokers being screened for lung cancer and found abnormalities in 158 (23%), including 3% with UIP-like changes, 3.8% with other interstitial pneumonia patterns, 15.7% with RB, and 3% with indeterminate changes. It seems likely that as subtle interstitial changes are becoming increasingly recognizable by improved radiographic techniques, lung biopsy may be utilized more often to clarify the process.…”

Section: Smoking-related Interstitial Fibrosismentioning

confidence: 99%

Smoking-related interstitial fibrosis (SRIF), pathogenesis and treatment of usual interstitial pneumonia (UIP), and transbronchial biopsy in UIP

Katzenstein

2012

Modern Pathology

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This review focuses on three selected topics of current interest that are related to chronic fibrosing lung disorders and are important for pathologists. First, the clinical and pathologic features of smoking-related interstitial fibrosis (SRIF) are highlighted. SRIF is a common finding in smokers that has striking histologic changes but only mild associated clinical manifestations. It is characterized by marked alveolar septal fibrosis composed of a distinct form of hyalinized collagen deposition. The process is present mainly in subpleural and centrilobular parenchyma and is associated with emphysema and respiratory bronchiolitis. Second, important aspects of the pathogenesis and treatment of usual interstitial pneumonia (UIP) are reviewed. The current theory proposes that UIP is caused by tiny foci of acute lung injury (manifest pathologically by fibroblast foci) that occur and recur in the interstitium over many years. Inflammation may be present as a secondary phenomenon, but is not the primary cause, and therefore anti-inflammatory agents have little effect. The recurrent injury leads to permanent fibrosis, through a process that is considered to represent a form of abnormal wound healing. Multiple therapies have been attempted that are aimed largely at interrupting the fibrosing process, but none have been successful. The cause of the injury is unknown, but a role for aspiration due to gastroesophageal reflux is a popular current theory, and there is some evidence that anti-reflux therapy may be beneficial. Genetic predisposition has been implicated in the etiology of familial cases, and there is evidence that telomere shortening may be important in sporadic cases. Third, the use of transbronchial biopsy (TBB) in diagnosing UIP is reviewed. TBB can provide a surprising amount of information and is especially useful in certain situations, such as elderly or very sick patients in whom surgical lung biopsy carries increased morbidity and mortality.

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Interstitial lung diseases in a lung cancer screening trial

Cited by 154 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

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

Smoking-related interstitial fibrosis (SRIF), pathogenesis and treatment of usual interstitial pneumonia (UIP), and transbronchial biopsy in UIP

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