Prevalence and Long-term Outcomes of CT Interstitial Lung                     Abnormalities in a Health Screening Cohort

Lee, Jong Eun; Chae, Kum Ju; Suh, Young Ju; Jeong, Won Gi; Lee, Taebum; Kim, Yun‐Hyeon; Jin, Gong Yong; Jeong, Yohan

doi:10.1148/radiol.221172

Cited by 24 publications

(31 citation statements)

References 19 publications

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“…Their ILA criteria were less well-defined, including scarring, and thus may have included CTs that would be categorized as indeterminate or no ILA in our study based on Fleischner methodology [ 3 ]. In a recent study by Lee, et al, using criteria in line with Fleischner guidelines, the prevalence of ILA was 3% and of equivocal (or indeterminate) ILA was 4% [ 29 ]. These findings are similar to the prevalence in our study of 2.4% and 5.9%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…There is limited data in the literature on interobserver agreement in visual analysis of ILA on CT scans, partly due to differing reading methodologies. Lee et al reported a κ > 0.80 in their study of a general health screening cohort [ 29 ]. Jin et al [ 27 ] reported a κ of 0.60 in their study of nearly 900 baseline NLST CTs for presence of ILA, a result which also demonstrates the need for more reproducible methodology.…”

Section: Discussionmentioning

confidence: 99%

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Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

et al. 2023

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Background Interstitial lung abnormalities (ILA) are CT findings suggestive of interstitial lung disease in individuals without a prior diagnosis or suspicion of ILD. Previous studies have demonstrated that ILA are associated with clinically significant outcomes including mortality. The aim of this study was to determine the prevalence of ILA in a large CT lung cancer screening program and the association with clinically significant outcomes including mortality, hospitalizations, cancer and ILD diagnosis. Methods This was a retrospective study of individuals enrolled in a CT lung cancer screening program from 2012 to 2014. Baseline and longitudinal CT scans were scored for ILA per Fleischner Society guidelines. The primary analyses examined the association between baseline ILA and mortality, all-cause hospitalization, and incidence of lung cancer. Kaplan–Meier plots were generated to visualize the associations between ILA and lung cancer and all-cause mortality. Cox regression proportional hazards models were used to test for this association in both univariate and multivariable models. Results 1699 subjects met inclusion criteria. 41 (2.4%) had ILA and 101 (5.9%) had indeterminate ILA on baseline CTs. ILD was diagnosed in 10 (24.4%) of 41 with ILA on baseline CT with a mean time from baseline CT to diagnosis of 4.47 ± 2.72 years. On multivariable modeling, the presence of ILA remained a significant predictor of death, HR 3.87 (2.07, 7.21; p < 0.001) when adjusted for age, sex, BMI, pack years and active smoking, but not of lung cancer and all-cause hospital admission. Approximately 50% with baseline ILA had progression on the longitudinal scan. Conclusions ILA identified on baseline lung cancer screening exams are associated with all-cause mortality. In addition, a significant proportion of patients with ILA are subsequently diagnosed with ILD and have CT progression on longitudinal scans. Trial registration number: ClinicalTrials.gov; No.: NCT04503044.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

et al. 2023

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“…We also think our DL-based analysis is a potentially useful tool for the health care screening of lung cancer. It is known that both severe and mild ILD (e.g., interstitial lung abnormalities) is associated with mortality and lung cancer incidence [ 29 ]. Quantitative evaluations of the screening CT might detect a lung tumor as increased volume of consolidation or GGO.…”

Section: Discussionmentioning

confidence: 99%

Effects of Automatic Deep-Learning-Based Lung Analysis on Quantification of Interstitial Lung Disease: Correlation with Pulmonary Function Test Results and Prognosis

et al. 2022

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We investigated the feasibility of a new deep-learning (DL)-based lung analysis method for the evaluation of interstitial lung disease (ILD) by comparing it with evaluation using the traditional computer-aided diagnosis (CAD) system and patients’ clinical outcomes. We prospectively included 104 patients (84 with and 20 without ILD). An expert radiologist defined regions of interest in the typical areas of normal, ground-glass opacity, consolidation, consolidation with fibrosis (traction bronchiectasis), honeycombing, reticulation, traction bronchiectasis, and emphysema, and compared them with the CAD and DL-based analysis results. Next, we measured the extent of ILD lesions with the CAD and DL-based analysis and compared them. Finally, we compared the lesion extent on computed tomography (CT) images, as measured with the DL-based analysis, with pulmonary function tests results and patients’ overall survival. Pearson’s correlation analysis revealed a significant correlation between DL-based analysis and CAD results. Forced vital capacity was significantly correlated with DL-based analysis (r = 0.789, p < 0.001 for normal lung volume and r = −0.316, p = 0.001 for consolidation with fibrosis volume). Consolidation with fibrosis measured using DL-based analysis was independently associated with poor survival. The lesion extent measured using DL-based analysis showed a negative correlation with the pulmonary function test results and prognosis.

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“…11 The prevalence of ILA in an Asian health screening cohort and an Asian lung cancer screening cohort was approximately 3%-4%. 12,16 It was also reported that fibrotic ILA was independently associated with imaging progression, lung cancer development, and higher mortality within the 10-year follow-up 12 and that ILA was associated with higher mortality from lung cancer in a general population cohort. 17 Abdominal CT is commonly used to evaluate distant metastases and disease progression in high-risk prostate cancer patients.…”

mentioning

confidence: 98%

“…Male sex, advanced age, and smoking are the representative risk factors for ILA. [11][12][13] Interstitial lung abnormalities are considered the early stages of pulmonary fibrosis, which can progress to idiopathic pulmonary fibrosis and are associated with poor clinical outcomes. 14 They are also associated with several respiratory diseases including interstitial lung disease (ILD), chronic obstructive pulmonary disease (COPD), pulmonary infections, lung cancer, and respiratory failure.…”

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confidence: 99%

Pretreatment Interstitial Lung Abnormalities Detected on Abdominal Computed Tomography Scans in Prostate Cancer Patients

Kim,

Jeong,

Lee

et al. 2024

J Comput Assist Tomogr

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Objective Prostate cancer and interstitial lung abnormality (ILA) share similar risk factor, which is men and older age. The purpose of this study was to investigate the prevalence of pretreatment ILA among prostate cancer patients who underwent abdominal computed tomography (CT) within 1 year at their first visit to the urology department. In addition, we aimed to assess the association between pretreatment ILA and long-term survival in prostate cancer patients. Methods This study was conducted in patients who had a first visit for prostate cancer at urology department between 2005 and 2016 and underwent an abdominal CT within 1 year. A thoracic radiologist evaluated the presence of ILA through inspecting the lung base scanned on an abdominal CT. The association between pretreatment ILA and survival was assessed using Kaplan-Meier analysis with log-rank test. Specific survival rates at 12, 36, and 60 months according to the presence of ILA were evaluated using z-test. Cox regression analysis was used to assess the risk factors of mortality. Results A total of 173 patients were included (mean age, 70.23 ± 7.98 years). Pretreatment ILA was observed in 10.4% of patients. Patients with ILA were more likely to be older and current smokers. Pretreatment ILA was associated with poor survival (P < 0.001). Age ≥70 years (hazards ratio [HR], 1.98; 95% confidence interval [CI], 1.24–3.16; P = 0.004), metastatic stage (HR, 2.26; 95% CI, 1.36–3.74; P = 0.002), and ILA (HR, 1.96; 95% CI, 1.06–3.60; P = 0.031) were the independent risk factors of mortality. An ILA (HR, 3.94; 95% CI, 1.78–8.72; P = 0.001) was the only independent risk factor of mortality in localized stage prostate cancer patients. Conclusions This study provides important insights into the unexplored effect of pretreatment ILA in prostate cancer patients. Pretreatment ILAs were observed considerably in the lung bases scanned on the abdominal CT scans among prostate cancer patients. Furthermore, pretreatment ILAs were the risk factor of mortality. Therefore, lung bases should be routinely inspected in the abdominal CT scans of prostate cancer patients. This result may help clinicians in establishing personalized management strategy of prostate cancer patients.

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Prevalence and Long-term Outcomes of CT Interstitial Lung Abnormalities in a Health Screening Cohort

Cited by 24 publications

References 19 publications

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

Interstitial lung abnormalities in a large clinical lung cancer screening cohort: association with mortality and ILD diagnosis

Effects of Automatic Deep-Learning-Based Lung Analysis on Quantification of Interstitial Lung Disease: Correlation with Pulmonary Function Test Results and Prognosis

Pretreatment Interstitial Lung Abnormalities Detected on Abdominal Computed Tomography Scans in Prostate Cancer Patients

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